Oramorph

What is it?

An analgesic opiate preparation available in a variety of different forms, all containing morphine sulphate. ORAMORPH SOLUTION contains 10mg of morphine sulphate per 5ml in a sugar-containing solution. ORAMORPH UNIT DOSE is a sugar-free solution in single dose vials containing 10mg, 30mg or 100mg of morphine sulphate per 5ml. ORAMORPH CONCENTRATE is a sugar-free solution containing 100mg morphine sulphate per 5ml. Supplied with dropper.

Medical Uses

Severe pain.

Dosage

Adults, 10 to 20mg at 4 hourly intervals. Children, aged 1 to 5 years, up to 5mg; 6 to 12 years, 5 to 10mg, both every 4 hours.

Special Care

Elderly, breastfeeding, lowered respiratory function, under- activity of thyroid gland, reduced function of adrenal glands, enlarged prostate gland, liver or kidney disease, shock, after surgery.

Avoid Use

Pregnancy, children under 1 year, obstructive airways disease, disorders characterized by convulsions, depressed respiration, head injuries, coma, severe liver disease, severe alcoholism, raised intracranial pressure (pressure within skull).

Possible Drug and Food Interactions

Central nervous system depressants, MAOIs.

Known Side Effects

Gastrointestinal disturbance, sedation, drug dependence and tolerance.

Manufacturer

Boehringer Ingelheim. ORAPDescnption: an antipsychotic drug and diphenylbutylpiperidine available as quarter-scored, green tablets containing 4mg of pimozide marked Janassen.

Medical Uses

Schizophrenia and other psychotic disorders.

Dosage

Adults, schizophrenia, 2mg each day at first, increasing gradually, if required, by increments of 2 to 4mg each day at minimal one week intervals. The daily maximum is 20mg. Other psychotic disorders, 4mg each day at first, increasing, if necessary in manner described above to a daily maximum of 16mg. Elderly patients should start with half the adult dose.

Special Care

Pregnancy, imbalance in electrolyte (salts) levels, liver or kidney disorders, epilepsy, phaeoehromoeytoma (tumour of adrenal gland), thyrotoxicosis (toxicity of the thyroid gland). Perform ECG before and during the course of treatment - evaluate treatment if repolarisation occurs. Patients require careful monitoring.

Avoid Use

Children, those with a very long QT interval (part of the ECG) which can result in a potentially fatal type of tachycardia, history of heart arrhythmias, Parkinson's disease, depression, depression of central nervous system.

Possible Drug and Food Interactions

Analgesics, TCAlls, anti-arrhythmics, drugs that inhibit P450 CYP 3A4, anticonvulsants, astemizole, drugs affecting electrolyte balance and those that prolong QT interval, antimalarial agents, terfenadine, depressants of central nervous system, levodopa, other neuroleptics (drugs that alter state of consciousness), anti- diabetics, alcohol, antihypertensives, anticoagulants, antidepressants.

Known Side Effects

Consult manufacturer's literature. All ventricular arrhythmias and any unexpected fatalities must be reported to the Committee on the Safety of Medicines (CSM).