Medical Editor: John P. Cunha, DO, FACOEP
DepoDur (morphine sulfate) extended-release liposome injection is a long-acting narcotic pain reliever (opiate-type) used to treat pain after major surgery. The brand name DepoDur is discontinued, but generic versions may be available. Common side effects of DepoDur (morphine sulfate) include:
- mild itching
- low blood pressure
- urinary retention
- low levels of iron in the blood (anemia), and
For major orthopedic surgery of the lower extremity the recommended dose of DepoDur is 15 mg. For lower abdominal or pelvic surgery, the recommended dose of DepoDur is 10-15 mg. DepoDur may interact with naltrexone, blood thinners, other epidural medications, corticosteroids, other pain medications, anti-seizure drugs, drugs that lower blood pressure, muscle relaxants, pyridostigmine, sodium oxybate, drugs that cause drowsiness (such as antihistamines, anti-anxiety drugs, sedatives, psychiatric medicines, tranquilizers). Tell your doctor all medications and supplements you use. Before using DepoDur, tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only if prescribed. It may slightly increase the risk of birth defects if used during the first two months of pregnancy. Using it near the expected delivery date may harm the fetus. Tell the doctor if you notice any symptoms in your newborn baby such as slow/shallow breathing, irritability, abnormal/persistent crying, vomiting, or diarrhea. This drug passes into breast milk and may have undesirable effects on a nursing infant. Tell the doctor if your baby develops unusual sleepiness, difficulty feeding, or trouble breathing. Consult your doctor before breastfeeding. Withdrawal symptoms may occur if you suddenly stop taking this medication.
Our DepoDur (morphine sulfate) extended-release liposome injection Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: dizziness upon standing, slow/fast/irregular heartbeat, mental/mood changes, severe stomach/abdominal pain, change in the amount of urine.
Get medical help right away if you have any very serious side effects, including: slow/irregular/shallow breathing, seizures.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Read the entire patient information overview for DepoDur (Morphine Sulfate XR Liposome Injection)
In controlled and open label clinical studies with DepoDur (morphine sulfate xr liposome injection) , the majority of the adverse events were typical of opiate medications and would be expected in the surgical populations studied. The most common adverse events (greater than 10%) reported at least once during therapy in patients treated with DepoDur (morphine sulfate xr liposome injection) were decreased oxygen saturation, hypotension, urinary retention, vomiting, constipation, nausea, pruritus, pyrexia, anemia, headache, and dizziness. Adverse events occurring in 5-10% of study patients were hypoxia, tachycardia, insomnia, and flatulence. Other less common side effects (seen in 2-5% of patients receiving DepoDur (morphine sulfate xr liposome injection) ) included respiratory depression, hypercapnia, paralytic ileus, somnolence, bladder spasm, abdominal distension, hypoesthesia, hypertension, oliguria, bradycardia, anxiety, back pain, increased sweating, dyspepsia, rigors, dyspnea, hypokalemia, paresthesia, and decreased hematocrit.
Of the patients treated with DepoDur (morphine sulfate xr liposome injection) in clinical trials, 4% exhibited signs of respiratory depression requiring treatment with narcotic antagonists. In clinical trials, 90% of respiratory depression occurred within 24 hours after administration of DepoDur (morphine sulfate xr liposome injection) . However, onset of respiratory depression occurred in 0.6% of patients after more than 48 hours.
During post-marketing experience, central nervous system (CNS) depression, including obtunded feeling, non-arousable condition, unresponsiveness, confusion, and lethargy, has been reported following epidural administration of DepoDur (morphine sulfate xr liposome injection) . In most of these cases with CNS depression, there was concomitant administration of different narcotics or hypnotic/sedative medications in the post operative period.
During post-marketing experience, severe respiratory depression, involving apnea or respiratory arrest, and cardiac arrest have been reported following administration of labeled doses of DepoDur (morphine sulfate xr liposome injection) .
Prolonged respiratory depression or apnea may occur when administration of epidural DepoDur (morphine sulfate xr liposome injection) is associated with subarachnoid puncture.
Drug Abuse And Dependence
DepoDur (morphine sulfate xr liposome injection) is a n-agonist opiate and is a Schedule II controlled substance. Morphine, as with other opiates used in analgesia, can be abused and is subject to criminal diversion. Drug addiction is characterized by compulsive use, use for non-medical purposes, and continued use despite harm or risk of harm.
As with all potent µ-agonist opiates, tolerance as well as psychological and physical dependence to morphine may develop irrespective of the route of administration (intravenous, intramuscular, intrathecal, epidural or oral). Tolerance is a condition in which previous exposure to an opiate results in the necessity for increasingly larger doses of the drug in order to produce the same degree of analgesia. Withdrawal symptoms, indicating the presence of psychophysiological dependence, may occur when morphine is discontinued abruptly after chronic administration for analgesia, or upon administration of a drug with full or partial opiate antagonist effects. Care must be taken to avert withdrawal in patients who have been maintained on parenteral/oral opiates prior to epidural administration of DepoDur (morphine sulfate xr liposome injection) .
Individuals with a history of opiate or other substance abuse would be considered to be at greater risk of addiction or abuse, given that they are more apt to respond to the euphorigenic and reinforcing properties of morphine. However, concerns about abuse, addiction or diversion of opiates should not prevent proper management of pain.
DepoDur (morphine sulfate xr liposome injection) is intended for epidural use only. Abuse of DepoDur (morphine sulfate xr liposome injection) may pose a hazard of overdose and death when administered through other routes. This risk is increased with concurrent use of other medications or illicit drugs.
Read the entire FDA prescribing information for DepoDur (Morphine Sulfate XR Liposome Injection)