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Patients receiving AVINZA (morphine sulfate) (morphine sulfate extended-release capsules) should be given the following instructions by the physician:

1. Patients should be advised that AVINZA (morphine sulfate) capsules contain morphine and should be taken once daily.
2. AVINZA (morphine sulfate) must be swallowed whole (not chewed, crushed, or dissolved) or AVINZA (morphine sulfate) may be opened and the entire bead contents sprinkled on a small amount of applesauce immediately prior to ingestion. The beads must NOT be chewed, crushed, or dissolved due to the risk of exposure to a potentially toxic dose of morphine.
3. Patients should be informed that they must not consume alcoholic beverages while on AVINZA (morphine sulfate) therapy. Additionally, patients should be informed that they must not use prescription or non-prescription medication containing alcohol while on AVINZA (morphine sulfate) therapy. Consumption of alcohol while taking AVINZA (morphine sulfate) may result in the rapid release and absorption of a potentially fatal dose of morphine.
4. The dose of AVINZA (morphine sulfate) should not be adjusted without consulting with a physician or other healthcare professional.
5. Patients should be advised that AVINZA (morphine sulfate) may impair mental and/or physical ability required for the performance of potentially hazardous tasks (e.g., driving, operating machinery). Patients started on AVINZA (morphine sulfate) or patients whose dose has been adjusted should refrain from any potentially dangerous activity until it is established that they are not adversely affected.
6. Patients should be advised that AVINZA (morphine sulfate) should not be combined with alcohol or other CNS depressants (e.g., sleep medications, tranquilizers). A physician should be consulted if other medications are currently being used or are added in the future.
7. Women of childbearing potential who become or are planning to become pregnant should consult a physician prior to initiating or continuing therapy with AVINZA (morphine sulfate) .
8. If patients have been receiving treatment with AVINZA (morphine sulfate) for more than a few weeks and cessation of therapy is indicated, they should be counseled on the importance of safely tapering the dose and that abruptly discontinuing the medication could precipitate withdrawal symptoms. The physician should provide a dose schedule to accomplish a gradual discontinuation of the medication.
9. Patients should be advised that AVINZA (morphine sulfate) is a potential drug of abuse. They should protect it from theft. It should never be given to anyone other than the individual for whom it was prescribed.
10. Patients should be instructed to keep AVINZA (morphine sulfate) in a secure place out of the reach of children. When AVINZA (morphine sulfate) is no longer needed, the unused capsules should be destroyed by flushing down the toilet.

As with other opioids, patients taking AVINZA (morphine sulfate) should be advised of the potential for severe constipation; appropriate laxatives, and/or stool softeners as well as other appropriate treatments should be initiated from the onset of opioid therapy.

Last reviewed on RxList: 2/26/2009
This monograph has been modified to include the generic and brand name in many instances.