# Morphine

Source: https://onco.cc/drugs/morphine/  
OnCo record `morphine` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Morphine is the standard strong painkiller for cancer pain. NICE advises starting with regular morphine by mouth, with extra quick-acting doses for pain that breaks through.

## Summary

US morphine labels cover acute and chronic pain severe enough to need an opioid when alternatives are inadequate, with warnings on addiction, abuse and misuse. NICE CG140 for adults needing strong opioids in palliative care: start with regular oral sustained-release or immediate-release morphine, with immediate-release morphine for breakthrough pain; with normal kidney and liver function a typical starting dose is 20 mg to 30 mg of oral morphine a day (for example 10 mg to 15 mg sustained-release twice daily) plus 5 mg immediate-release rescue doses; and oral sustained-release morphine is the first-line maintenance treatment. MASCC/ISOO 2020 suggests topical morphine 0.2% mouthwash for mucositis pain in head and neck cancer during chemoradiotherapy. The MS Contin NDA was approved on 29 May 1987.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-11-11
- Also known as: morphine sulfate
- Tags: supportive; generic; supportive-care-gaps-2026-11
- Brand: MS Contin / Oramorph / Sevredol
- Modality: Strong opioid analgesic
- Mechanism: A full agonist at the mu-opioid receptor.
- Approvals: US 1987: Pain severe enough to require an opioid analgesic when alternatives are inadequate

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Morphine
- US label (DailyMed): morphine sulfate tablets: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=07593aa4-f2c4-4d6e-b186-ab2a4ecaa38a
- NICE CG140: Palliative care for adults, strong opioids for pain relief, recommendations: https://www.nice.org.uk/guidance/cg140/chapter/Recommendations
- Elad et al., MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy (Cancer 2020): https://doi.org/10.1002/cncr.33100

## Connected records

- drugs: [Fentanyl (transmucosal, for breakthrough cancer pain)](https://onco.cc/drugs/fentanyl/), [Methylnaltrexone](https://onco.cc/drugs/methylnaltrexone/), [Naloxone](https://onco.cc/drugs/naloxone/), [Oxycodone](https://onco.cc/drugs/oxycodone/)
- technologies: [Cancer pain management](https://onco.cc/technologies/pain-management/), [Early integrated palliative care](https://onco.cc/technologies/palliative-care/)
- terms: [Mucositis and stomatitis](https://onco.cc/terms/mucositis/)
- key papers: [MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy](https://onco.cc/key-papers/paper-elad-cancer/)

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