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Morphine Sulfate/Naltrexone Hydrochloride Dosage

Making the Switch

In most cases, the starting amount of morphine sulfate/naltrexone hydrochloride your healthcare provider recommends will depend mostly on the dose and type of painkillers you were previously taking. If you are switching from another oral form of morphine, a straight mg-per-mg conversion is recommended. Simply add up the total mg of morphine you are taking per day; this is the recommended morphine sulfate/naltrexone hydrochloride dose (in terms of morphine content), taken either as a single dosing once daily or split up into two twice-daily doses.
For injected morphine or any non-morphine painkillers, your healthcare provider will need to convert your current dosage into an appropriate morphine sulfate/naltrexone hydrochloride dosage. It is best to underestimate (rather than overestimate) the dosage initially, in order to avoid dangerous side effects.

Morphine Sulfate/Naltrexone Hydrochloride Dosing Guidelines

If you are not accustomed to taking opioid medications, you should not take the morphine sulfate/naltrexone hydrochloride 100 mg/4 mg capsules, as they contain too much morphine.
In general, your healthcare provider should not adjust your dosage more often than every other day, as it takes awhile to see how your body will adjust to a new dosage.
Your healthcare provider may also recommend a "rescue" medication (a short-acting painkiller) to use in addition to morphine sulfate/naltrexone hydrochloride for times when your pain is especially severe (known as "breakthrough pain," as it breaks through the baseline, long-acting painkiller).

General Dosing Information

Some considerations for people taking morphine sulfate/naltrexone hydrochloride include the following:
  • The medication comes in capsule form. It is taken by mouth once a day (every 24 hours) or twice a day (every 12 hours). It is not meant to be taken on an "as needed" basis (at unscheduled times only when needed for pain).
  • Never crush, chew, or dissolve the capsules (or the beads inside the capsules), as this would release a dangerous amount of morphine and would release the naltrexone (potentially negating the effects of the morphine). It is also dangerous to inject this medication, as it contains inactive ingredients that can cause damage when injected directly into the bloodstream.
  • You cannot drink any alcohol (or even take medications or eat foods that contain alcohol) while taking morphine sulfate/naltrexone hydrochloride, as alcohol can cause the beads to release morphine too quickly. This may result in an overdose. Check the ingredient list of all your liquid medications (such as cough syrups) for alcohol content.
  • It does not matter if you take the medication with food or on an empty stomach. If it bothers your stomach, try taking the capsules with food.
  • Most people swallow the capsules whole. However, if you have difficulty swallowing, your healthcare provider may recommend taking it with applesauce. To do this, open the capsule and sprinkle the beads on a small amount of room-temperature (or colder) applesauce. Swallow the applesauce immediately, entirely, and without chewing. Rinse your mouth and swallow to make sure there are no beads remaining in your mouth.
  • For the medication to work properly, it must be taken as prescribed. Do not increase your dose without your healthcare provider's approval. Do not suddenly stop taking morphine sulfate/naltrexone hydrochloride, especially if you have taken it regularly for more than several weeks (see Embeda Withdrawal).
  • If you are unsure about anything related to your morphine sulfate/naltrexone hydrochloride dosage, please talk with your healthcare provider, nurse, or pharmacist. Do not stop taking the drug without first discussing it with your healthcare provider.
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Morphine-Naltrexone Drug Information

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