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Morphine

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Morphine
Clinical data
Pronunciation/ˈmɔːrfiːn/ MOR-feen
Trade namesStatex, MS Contin, Kadian, Oramorph, M-ESLON,[1] others[2]
AHFS/Drugs.comMonograph
MedlinePlusa682133
License data
Pregnancy
category
Dependence
liability		High
Addiction
liability		High[4]
Routes of
administration		Inhalation, insufflation, by mouth, rectal, subcutaneous, intramuscular, intravenous, epidural, intrathecal
Drug classOpiate
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityIV/IM: 100%
Intranasal: 10%
PO: 20–40%
Rectal: 36–71%[11]
Protein binding30–40%
MetabolismLiver: UGT2B7
Metabolites• Morphine-3-glucuronide (90%)
• Morphine-6-glucuronide (10%)
Onset of actionIV: 5 minutes,
IM: 15 minutes,[12]
PO: 20 minutes[13]
Elimination half-life2–3 hours
Duration of action3–7 hours[14][15]
ExcretionKidney 90%, bile duct 10%
Identifiers
  • (4R,4aR,7S,7aR,12bS)-3-Methyl-2,3,4,4a,7,7a-hexahydro-1H-4,12-methano[1]benzofuro[3,2-e]isoquinoline-7,9-diol
CAS Number
  • 57-27-2 checkY
    64-31-3 (neutral sulfate),
    52-26-6 (hydrochloride)
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
PDB ligand
CompTox Dashboard (EPA)
ECHA InfoCard100.000.291 Edit this at Wikidata
Chemical and physical data
FormulaC17H19NO3
Molar mass285.34 g·mol−1
3D model (JSmol)
Solubility in water149 mg/L (at 20 °C)[16]
  • CN1CC[C@]23C4=C5C=CC(O)=C4O[C@H]2[C@@H](O)C=C[C@H]3[C@H]1C5
  • InChI=1S/C17H19NO3/c1-18-7-6-17-10-3-5-13(20)16(17)21-15-12(19)4-2-9(14(15)17)8-11(10)18/h2-5,10-11,13,16,19-20H,6-8H2,1H3/t10-,11+,13-,16-,17-/m0/s1 checkY
  • Key:BQJCRHHNABKAKU-KBQPJGBKSA-N checkY
  (verify)

Morphine (INN) (IPA: [ˈmɔ(ɹ)fin]) is a drug which belongs to the opiate pain killer class. It is the principal active agent in natural opium latex and the prototypical opiate. Brand-name or specially bred poppies contained more codeine than morphine and then more thebaine (to synthesize codeine or naloxone) and outside poppies do not generally contain morphine or codeine. Morphine comes in oral form as tablets or powder. It can be injected into a vein (intravenous), eaten, or put in a body cavity such as the anus or vagina.

In the body, heroin is converted into morphine among other things. In real life about 70% of morphine is used to make other opioids such as hydromorphone, oxymorphone, and heroin.[17][18]

Like other opioids, e.g. diacetylmorphine (heroin), morphine acts directly on the central nervous system (CNS) to relieve pain, and at synapses of the nucleus accumbens in particular. Morphine is highly addictive when compared to other substances (but not some of the other opiates), and tolerance and physical-mental dependences develop very rapidly. Extended-release, long-acting formulations of morphine are sold under the brand names MS Contin and Kadian, among others. Generic long-acting formulations are also available.[14]

Morphine is marketed under multiple different brand names in different parts of the world.[2] It used to be called Morphia in British English.[19] It is a Schedule II drug in the United States,[18] Class A in the United Kingdom,[6] and Schedule I in Canada.[20]

Patients on morphine sometimes say they have insomnia, visual hallucinations and nightmares.[21]

It is on the World Health Organization's List of Essential Medicines.[22] In 2023, it was the 156th most commonly prescribed medication in the United States, with more than 3 million prescriptions.[23][24] It is available as a generic medication.[25]

Medical uses

[change | change source]

Morphine is used as a pain killer in hospital settings for:

  • pain after surgery
  • pain associated with trauma
  • In severe chronic pain, e.g.
  • As an adjunct to general pain killers, such as paracetamol
  • In epidural anesthesia or intrathecal analgesia (uses with an anesthetic)
  • For palliative care (i.e. to lessen pain without curing the underlying reason for it in the patients last moments. This is often done for patients with incurable diseases)
  • As a medication for severe cough, like codeine was originally used for (but today this is mostly done with dextromethorphan if any opioid is used)
  • As an antidiarrheal in chronic conditions (e.g., for diarrhea associated with AIDS), although loperamide (a non-absorbed opioid acting only on the gut) is the most commonly used opioid for diarrhea.

History

[change | change source]

Morphine was first isolated in 1804 by Friedrich Sertürner, which is generally believed to be the first ever isolation of a natural plant alkaloid in history. Sertürner began distributing it in 1817, and Merck began marketing it commercially in 1827. At the time, Merck was a single small chemists' shop. Morphine was more widely used after the invention of the hypodermic syringe in 1857.

Sertürner originally named the substance morphium after the Greek god of dreams, Morpheus (Greek: Μορφεύς), for its tendency to cause sleep.[2] Morpheus is the god of dreams in Greek mythology. He is the son of Hypnos, god of sleep.

The name of the poppy plant (Papaver somniferum) is "papaver" for poppy, and "somni - ferum" which means "sleep bringing" in latin.

References

[change | change source]
  1. ↑ "NM-ESLON® (morphine sulfate) Product Monograph PRODUCT MONOGRAPH" (PDF). Ethypharm Inc. 26 February 2018. p. 1. Archived from the original (PDF) on 17 April 2025. Retrieved 17 April 2025.
  2. 1 2 "International listings for Morphine". Drugs.com. Archived from the original on 14 June 2015. Retrieved 2 June 2015.
  3. ↑ "Morphine Use During Pregnancy". Drugs.com. 14 October 2019. Retrieved 21 August 2020.
  4. ↑ Bonewit-West K, Hunt SA, Applegate E (2012). Today's Medical Assistant: Clinical and Administrative Procedures. Elsevier Health Sciences. p. 571. ISBN 978-1-4557-0150-6.
  5. ↑ "Morphine Product information". Health Canada. 9 August 2005. Retrieved 4 April 2024.
  6. 1 2 Macpherson G, ed. (2002). Black's Medical Dictionary. Nature. Vol. 87 (40th ed.). p. 162. Bibcode:1911Natur..87R.313.. doi:10.1038/087313b0. ISBN 978-0-7136-5442-4. S2CID 3979058. Archived from the original on 8 September 2017.
  7. ↑ "Sevredol Summary of Product Characteristics (SmPC)". (emc). 13 February 2024. Retrieved 20 February 2024.
  8. ↑ "Orange Book - List of Controlled Substances and Regulated Chemicals" (PDF). DEA. 31 December 2024. Retrieved 10 January 2025.
  9. ↑ "Modified-released oral opioids". European Medicines Agency. 18 November 2010. Retrieved 20 February 2024.
  10. ↑ https://fass.se/health/product/20130713000067/smpc#:~:text=Om%20l%C3%A4kemedlet-,Narkotikaklass%20II,-S%C3%A4rskilt%20l%C3%A4kemedel
  11. ↑ Jonsson T, Christensen CB, Jordening H, Frølund C (April 1988). "The bioavailability of rectally administered morphine". Pharmacology & Toxicology. 62 (4): 203–5. doi:10.1111/j.1600-0773.1988.tb01872.x. PMID 3387374.
  12. ↑ Whimster F (1997). Cambridge textbook of accident and emergency medicine. Cambridge: Cambridge University Press. p. 191. ISBN 978-0-521-43379-2. Archived from the original on 8 September 2017.
  13. ↑ Liben S (2012). Oxford textbook of palliative care for children (2 ed.). Oxford: Oxford University Press. p. 240. ISBN 978-0-19-959510-5. Archived from the original on 8 September 2017.
  14. 1 2 "Morphine sulfate". The American Society of Health-System Pharmacists. Archived from the original on 2 May 2015. Retrieved 1 June 2015.
  15. ↑ >Rockwood CA (2009). Rockwood and Wilkins' fractures in children (7th ed.). Philadelphia, Pa.: Lippincott Williams & Wilkins. p. 54. ISBN 978-1-58255-784-7. Archived from the original on 8 September 2017.
  16. ↑ https://pubchem.ncbi.nlm.nih.gov/compound/5288826#:~:text=3.2.7%20Solubility-,149%20mg/L%20(at%2020%20%C2%B0C),-MSDS
  17. ↑ Cite error: The named reference UN2015 was used but no text was provided for refs named (see the help page).
  18. 1 2 Triggle DJ (2006). Morphine. New York: Chelsea House Publishers. pp. 20–21. ISBN 978-1-4381-0211-5.
  19. ↑ "Morphia". Lexico Dictionaries | English. Archived from the original on 4 August 2020. Retrieved 14 September 2019.
  20. ↑ Davis's Canadian Drug Guide for Nurses. F.A. Davis. 2014. p. 1409. ISBN 978-0-8036-4086-3.
  21. ↑ Waller SL, Bailey M. Hallucinations during morphine administration. Lancet. 1987 Oct 3;2(8562):801.
  22. ↑ World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. 2021. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
  23. ↑ "Top 300 of 2023". ClinCalc. Archived from the original on 12 August 2025. Retrieved 12 August 2025.
  24. ↑ "Morphine Drug Usage Statistics, United States, 2013 - 2023". ClinCalc. Retrieved 19 August 2025.
  25. ↑ "First Generic Drug Approvals 2023". U.S. Food and Drug Administration (FDA). 30 May 2023. Archived from the original on 30 June 2023. Retrieved 30 June 2023.


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