Morphine in the anus
Morphine rectal may be habit forming, especially with prolonged use. Use morphine exactly as directed. Do not use more of it, use it more often, or use it in a different way than directed by your doctor. While you are using morphine rectal, discuss with your health care provider your pain treatment goals, length of treatment, and other ways to manage your pain. Tell your doctor if you or anyone in your family drinks or has ever drunk large amounts of alcohol, uses or has ever used street drugs, or has overused prescription medications, or has had an overdose, or if you have or have ever had depression or another mental illness.
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NEJM Journal Watch
Rectal Morphine for Cancer Pain
Several routes of opioid administration are available for patients who cannot take medications orally. This randomized crossover study from Italy and Canada examined the efficacy. This randomized crossover study from Italy and Canada examined the efficacy of a morphine solution given rectally. Researchers enrolled 34 patients with pain from advanced cancer who had not previously received opioid drugs.
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ANSWER: Certain patients may not be able to tolerate oral morphine administration due to either intractable nausea or the inability to swallow. Although not an FDA-approved route of administration, a limited number of small studies have evaluated rectal administration of sustained-release morphine tablets. Maloney et al reported on 39 terminally ill cancer patients who could no longer tolerate oral administration of MS Contin, either due to the inability to swallow, persistent nausea, or both.
Purpose: The aim of this double-blind, double-dummy, crossover study was to compare the efficacy, tolerability, and time of onset of analgesia after the administration of 10 mg of morphine hydrochloride via the oral and rectal routes in opioid-naive cancer patients with pain. Patients and methods: Thirty-four patients with cancer pain and no previous opioid treatment were randomized to receive morphine hydrochloride 10 mg orally or rectally in the form of a microenema for 2 days. During days 3 and 4, a crossover took place.
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