Morphine

Not to be confused with morpheein or morpheme.

Morphine
Clinical data
Pronunciation/ˈmɔːrfiːn/
Trade namesStatex, MS Contin, Kadian, Oramorph, M-ESLON,[1] others[2]
AHFS/Drugs.comMonograph
MedlinePlusa682133
License data
Pregnancy
category
Dependence
liability		High
Addiction
liability		High[4]
Routes of
administration		Inhalation, insufflation, by mouth, rectal, subcutaneous, intramuscular, intravenous, epidural, intrathecal
Drug classOpiate
ATC code
Legal status
Legal status
  • AU: S8 (Controlled drug)
  • BR: Class A1 (Narcotic drugs)
  • CA: Schedule I[5]
  • DE: Anlage III (Special prescription form required)
  • NZ: Class B
  • UK: POM (Prescription only) / Class A[6][7]
  • US: Schedule II / Schedule III[8]
  • UN: Narcotic Schedules I and III
  • EU: Rx-only[9]
Pharmacokinetic data
BioavailabilityIVTooltip Intravenous therapy/IMTooltip Intramuscular injection: 100%
Intranasal: 10%
POTooltip Oral administration: 20–40%
Rectal: 36–71%[10]
Protein binding30–40%
MetabolismLiver: UGT2B7
Metabolites• Morphine-3-glucuronide (90%)
• Morphine-6-glucuronide (10%)
Onset of actionIVTooltip Intravenous therapy: 5 minutes,
IMTooltip Intramuscular injection: 15 minutes,[11]
POTooltip Oral administration: 20 minutes[12]
Elimination half-life2–3 hours
Duration of action3–7 hours[13][14]
ExcretionKidney 90%, bile duct 10%
Identifiers
IUPAC name
  • (4R,4aR,7S,7aR,12bS)-3-Methyl-2,3,4,4a,7,7a-hexahydro-1H-4,12-methano[1]benzofuro[3,2-e]isoquinoline-7,9-diol
CAS Number
  • 57-27-2 Y
    64-31-3 (neutral sulfate),
    52-26-6 (hydrochloride)
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
PDB ligand
CompTox Dashboard (EPA)
ECHA InfoCard100.000.291
Chemical and physical data
FormulaC17H19NO3
Molar mass285.343 g·mol−1
3D model (JSmol)
Solubility in waterHCl & sulf.: 60
SMILES
  • CN1CC[C@]23C4=C5C=CC(O)=C4O[C@H]2[C@@H](O)C=C[C@H]3[C@H]1C5
  • InChI=1S/C17H19NO3/c1-18-7-6-17-10-3-5-13(20)16(17)21-15-12(19)4-2-9(14(15)17)8-11(10)18/h2-5,10-11,13,16,19-20H,6-8H2,1H3/t10-,11+,13-,16-,17-/m0/s1 Y
  • Key:BQJCRHHNABKAKU-KBQPJGBKSA-N Y
  (verify)

Morphine, formerly known as morphium, is an opiate found naturally in opium, a dark brown resin produced by drying the latex of opium poppies (Papaver somniferum). It is mainly used as an analgesic (pain medication). There are multiple methods used to administer morphine: oral; sublingual; via inhalation; injection into a muscle, injection under the skin, or injection into the spinal cord area; transdermal; or via rectal suppository.[13][15] It acts directly on the central nervous system (CNS) to induce analgesia and alter perception and emotional response to pain. Physical and psychological dependence and tolerance may develop with repeated administration.[13] It can be taken for both acute pain and chronic pain and is frequently used for pain from myocardial infarction, kidney stones, and during labor.[13] Its maximum effect is reached after about 20 minutes when administered intravenously and 60 minutes when administered by mouth, while the duration of its effect is 3–7 hours.[13][14] Long-acting formulations of morphine are sold under the brand names MS Contin and Kadian, among others. Generic long-acting formulations are also available.[13]

Common side effects of morphine include drowsiness, euphoria, nausea, dizziness, sweating, and constipation.[13] Potentially serious side effects of morphine include decreased respiratory effort, vomiting, and low blood pressure.[13] Morphine is highly addictive and prone to abuse.[13] If one's dose is reduced after long-term use, opioid withdrawal symptoms may occur.[13] Caution is advised for the use of morphine during pregnancy or breastfeeding, as it may affect the health of the baby.[13][3]

Morphine was first isolated in 1804 by German pharmacist Friedrich Sertürner.[16][17] This is believed to be the first isolation of a medicinal alkaloid from a plant.[18] Merck began marketing it commercially in 1827.[17] Morphine was more widely used after the invention of the hypodermic syringe in 1853–1855.[17][19] Sertürner originally named the substance morphium, after the Greek god of dreams, Morpheus, as it has a tendency to cause sleep.[19][20]

The primary source of morphine is isolation from poppy straw of the opium poppy.[21] In 2013, approximately 523 tons of morphine were produced.[22] Approximately 45 tons were used directly for pain, an increase of 400% over the last twenty years.[22] Most use for this purpose was in the developed world.[22] About 70% of morphine is used to make other opioids such as hydromorphone, oxymorphone, and heroin.[22][23][24] It is a Schedule II drug in the United States,[23] Class A in the United Kingdom,[6] and Schedule I in Canada.[25] It is on the World Health Organization's List of Essential Medicines.[26] In 2023, it was the 156th most commonly prescribed medication in the United States, with more than 3 million prescriptions.[27][28] It is available as a generic medication.[29]

  1. ^ "NM-ESLON® (morphine sulfate) Product Monograph PRODUCT MONOGRAPH" (PDF). Ethypharm Inc. 26 February 2018. p. 1. Archived from the original (PDF) on 17 April 2025. Retrieved 17 April 2025.
  2. ^ Cite error: The named reference drugs.com-page was invoked but never defined (see the help page).
  3. ^ a b "Morphine Use During Pregnancy". Drugs.com. 14 October 2019. Retrieved 21 August 2020.
  4. ^ Bonewit-West K, Hunt SA, Applegate E (2012). Today's Medical Assistant: Clinical and Administrative Procedures. Elsevier Health Sciences. p. 571. ISBN 978-1-4557-0150-6.
  5. ^ "Morphine Product information". Health Canada. 9 August 2005. Retrieved 4 April 2024.
  6. ^ a b Macpherson G, ed. (2002). Black's Medical Dictionary. Nature. Vol. 87 (40th ed.). p. 162. Bibcode:1911Natur..87R.313.. doi:10.1038/087313b0. ISBN 978-0-7136-5442-4. S2CID 3979058. Archived from the original on 8 September 2017.
  7. ^ "Sevredol Summary of Product Characteristics (SmPC)". (emc). 13 February 2024. Retrieved 20 February 2024.
  8. ^ "Orange Book - List of Controlled Substances and Regulated Chemicals" (PDF). DEA. 31 December 2024. Retrieved 10 January 2025.
  9. ^ "Modified-released oral opioids". European Medicines Agency. 18 November 2010. Retrieved 20 February 2024.
  10. ^ Jonsson T, Christensen CB, Jordening H, Frølund C (April 1988). "The bioavailability of rectally administered morphine". Pharmacology & Toxicology. 62 (4): 203–5. doi:10.1111/j.1600-0773.1988.tb01872.x. PMID 3387374.
  11. ^ Whimster F (1997). Cambridge textbook of accident and emergency medicine. Cambridge: Cambridge University Press. p. 191. ISBN 978-0-521-43379-2. Archived from the original on 8 September 2017.
  12. ^ Liben S (2012). Oxford textbook of palliative care for children (2 ed.). Oxford: Oxford University Press. p. 240. ISBN 978-0-19-959510-5. Archived from the original on 8 September 2017.
  13. ^ a b c d e f g h i j k "Morphine sulfate". The American Society of Health-System Pharmacists. Archived from the original on 2 May 2015. Retrieved 1 June 2015.
  14. ^ a b Rockwood CA (2009). Rockwood and Wilkins' fractures in children (7th ed.). Philadelphia, Pa.: Lippincott Williams & Wilkins. p. 54. ISBN 978-1-58255-784-7. Archived from the original on 8 September 2017.
  15. ^ Stefano GB, Ptáček R, Kuželová H, Kream RM (2012). "Endogenous morphine: up-to-date review 2011" (PDF). Folia Biologica. 58 (2): 49–56. doi:10.14712/fb2012058020049. PMID 22578954. Archived from the original (PDF) on 24 August 2016. Retrieved 10 October 2016. Positive evolutionary pressure has apparently preserved the ability to synthesize chemically authentic morphine, albeit in homeopathic concentrations, throughout animal phyla.
  16. ^ Trescot AM, Datta S, Lee M, Hansen, H (March 2008). "Opioid Pharmacology". Pain Physician. 11 (2): S133-53. doi:10.36076/ppj.2008/11/S133. PMID 18443637.
  17. ^ a b c Courtwright DT (2009). Forces of habit drugs and the making of the modern world (1 ed.). Cambridge, Mass.: Harvard University Press. pp. 36–37. ISBN 978-0-674-02990-3. Archived from the original on 8 September 2017.
  18. ^ Luch A, ed. (2009). Molecular, clinical and environmental toxicology. Springer. p. 20. ISBN 978-3-7643-8335-0.
  19. ^ a b Mosher CJ (2013). Drugs and Drug Policy: The Control of Consciousness Alteration. SAGE Publications. p. 123. ISBN 978-1-4833-2188-2. Archived from the original on 8 September 2017.
  20. ^ Fisher GL (2009). Encyclopedia of substance abuse prevention, treatment, & recovery. Los Angeles: SAGE. p. 564. ISBN 978-1-4522-6601-5. Archived from the original on 8 September 2017.
  21. ^ Narcotic Drugs Estimated World Requirements for 2008, Statistics for 2006. New York: United Nations Pubns. 2008. p. 77. ISBN 978-92-1-048119-9. Archived from the original on 8 September 2017.
  22. ^ a b c d Narcotic Drugs 2014 (PDF). INTERNATIONAL NARCOTICS CONTROL BOARD. 2015. pp. 21, 30. ISBN 978-92-1-048157-1. Archived (PDF) from the original on 2 June 2015.
  23. ^ a b Triggle DJ (2006). Morphine. New York: Chelsea House Publishers. pp. 20–21. ISBN 978-1-4381-0211-5.
  24. ^ Karch SB (2006). Drug abuse handbook (2nd ed.). Boca Raton: CRC/Taylor & Francis. pp. 7–8. ISBN 978-1-4200-0346-8.
  25. ^ Davis's Canadian Drug Guide for Nurses. F.A. Davis. 2014. p. 1409. ISBN 978-0-8036-4086-3.
  26. ^ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
  27. ^ "Top 300 of 2023". ClinCalc. Archived from the original on 12 August 2025. Retrieved 12 August 2025.
  28. ^ "Morphine Drug Usage Statistics, United States, 2013 - 2023". ClinCalc. Retrieved 19 August 2025.
  29. ^ "First Generic Drug Approvals 2023". U.S. Food and Drug Administration (FDA). 30 May 2023. Archived from the original on 30 June 2023. Retrieved 30 June 2023.
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