From the FDA Drug Label
The usual starting dose in adults is 0.1 mg to 0.2 mg per kg every 4 hours as needed to manage pain. Administer the injection slowly. The dose should be adjusted according to the severity of pain, the occurrence of adverse events, as well as the patient’s underlying disease, age, and size.
The frequency of intravenous (IV) morphine administration is every 4 hours as needed to manage pain, with the dose adjusted according to individual patient factors. 1 1
From the Research
Frequency of Intravenous Morphine Administration
- The frequency of intravenous (IV) morphine administration varies depending on the patient's condition and the treatment protocol 2, 3, 4.
- In a study on cancer patients with episodic pain, IV morphine was administered as needed, with a mean of 17.7 minutes to achieve maximum pain relief 2.
- Another study on patients with sickle cell crisis pain found that IV morphine was administered every 30 to 60 minutes as necessary for a linear analog scale for pain intensity greater than 50 mm 4.
- A study on postoperative pain control in pediatric patients found that IV bolus morphine was administered with monitoring at baseline and 10 and 20 minutes after the dose, but adherence to the monitoring procedure was suboptimal 5.
- The dose of IV morphine also varies, with one study using a dose equivalent to 20% of the basal oral dosage 2, and another study using a dose of 1.5 mg IV bolus doses every ten minutes till pain relief was total or until the patient became drowsy 3.
Administration Protocols
- IV morphine can be administered using different protocols, including intermittent injections and patient-controlled analgesia (PCA) 4.
- A study comparing PCA with intermittent IV injections found that both methods were safe and effective, but PCA may be used in place of intermittent IV administration in the emergency department treatment of sickle cell crisis pain 4.
- Another study found that titrated morphine with an algorithm was highly effective, with 80% of patients reporting pain relief within 60 minutes of starting therapy 6.
Safety and Efficacy
- IV morphine is generally considered safe and effective for pain relief, but it can cause adverse effects such as respiratory depression 2, 3, 5.
- Monitoring of patients receiving IV morphine is essential to detect potential signs of respiratory depression and other adverse effects 5.
- Studies have found that IV morphine can provide rapid and effective pain relief, with a significant reduction in pain intensity within a short period of time 2, 3.