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" What is it used for?  Prolonged relief of severe pain, for example associated with cancer, severe injury or following surgery.    How does it work? Zomorph capsules contain the active ingredient morphine sulfate, which is a type of medicine called an opioid painkiller.  Opioids are strong painkillers that work by mimicking the action of naturally occurring pain-reducing chemicals called endorphins. Endorphins are found in the brain and spinal cord and reduce pain by combining with opioid receptors.  Morphine mimicks the action of endorphins by combining with the opioid receptors in the brain and spinal cord. This blocks the transmission of pain signals sent by the nerves to the brain. Therefore, even though the cause of the pain may remain, less pain is actually felt.  Morphine is used to relieve severe pain, for example associated with cancer or severe injury. Zomorph capsules are prolonged-release capsules. They are designed to release the morphine slowly and continuously over 12 hours to help provide steady blood levels of the medicine throughout the day and hence prolonged pain relief.    How do I take it?  The dose of morphine that your doctor prescribes will depend on your individual circumstances and level of pain. Always follow the instructions given by your doctor. These will also be printed on the dispensing label that your pharmacist has put on the packet of medicine. Zomorph capsules should be taken twice a day at 12 hourly intervals, for example 8am and 8pm.  The capsules should be swallowed whole with a drink and not chewed or crushed. Alternatively, if you have trouble swallowing the capsules they can be opened and the contents sprinkled on to soft, cold food that can be easily swallowed without chewing, eg yoghurt. The granules inside the capsules must not be chewed or crushed, as this would damage the prolonged-release action and could lead to the rapid release and absorption of a potentially fatal dose of morphine.  The capsules can be taken either with or without food. If you forget to take a dose at your usual time and you remember within four hours of the time it was due, take the dose straight away, then take your next dose as usual when it is due. If you forget to take a dose and it is more than four hours late you should get advice from your doctor or pharmacist. Do not take a double dose to make up for a missed dose.   Warning!  Zomorph capsules must be swallowed whole and not crushed or chewed (see above).  This medicine may cause drowsiness and dizziness and can affect your ability to concentrate. This could affect your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure you can do so safely.  You should avoid drinking alcohol while taking this medicine as this will increase the chance of you feeling drowsy or dizzy.  From March 2015 a new &amp;#039;drug driving&amp;#039; law comes into force, which makes it an offence to drive with certain drugs or prescription medicines above specified limits in your body. The list includes morphine, which means it may be an offence to drive while you are taking this medicine. The new law will allow police to use roadside drug tests to check for the presence of the prohibited drugs in a driver&amp;#039;s saliva. There are very low limits for illegal drugs, but higher limits for prescribed medicines. This should mean that most people taking morphine as prescribed will not be breaking the law, provided they are not driving dangerously. If you are found to be above the limit for morphine there is a medical defence if you are taking the medicine as prescribed, as long as your driving is not impaired. If you are taking a high dose of morphine it may therefore be sensible to carry your prescription with you when driving, in case you are asked to take a test by the police. However, if you are driving dangerously while taking this medicine you will be breaking the law. You should not drive if you think this medicine affects your ability to drive safely, for example if it makes you feel sleepy, dizzy, unable to concentrate or make decisions, or if you have blurred or double vision. This medicine has severe side effects in an overdose. Do not exceed the dose prescribed by your doctor. If you become very sleepy or have slow and/or shallow breathing after taking this medicine, you or your carer should contact your doctor immediately and call for emergency help. If this medicine is taken for prolonged periods of time, the body can become tolerant to it and it may become less effective at relieving pain. This means that with time, higher doses may be needed to control pain. With prolonged use the body may also become dependent on the medicine. As a result, withdrawal symptoms can occur if the medicine is stopped suddenly. For this reason, when a person no longer needs this medicine it may be necessary to reduce treatment gradually to avoid withdrawal symptoms. Morphine is a controlled drug. If you are planning to travel abroad with it you should check its legal status in the countries you are travelling through and to. There are legal limits on how much of this medicine you can take abroad with you. If you need to take more than this limit you will have to apply to the Home Office for a licence before you travel. Even if you don&amp;#039;t need a licence, if you are taking this medicine abroad it is always a good idea to carry a letter from your doctor that confirms your need for the medicine. You should always carry the medicine in correctly labelled packaging, as dispensed by the pharmacy.   Not to be used in  People with very slow, shallow breathing (respiratory depression). People with obstructive lung conditions such as chronic obstructive pulmonary disease (COPD). People having an asthma attack. People with heart failure secondary to chronic lung disease. People with a head injury or increased pressure in the brain (raised intracranial pressure). People in unresponsive, unconscious states (coma). People with inactivity of the intestine that stops material passing through the gut (paralytic ileus). People with delayed emptying of the stomach contents into the intestine. People with sudden emergency conditions affecting one or more of the organs in the abdomen (acute abdomen, eg appendicitis). People with a tumour of the adrenal glands (phaeochromocytoma). Acute liver disease. People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days. Zomorph capsules are not recommended just before surgery, or in the first 24 hours following surgery (until normal bowel function has returned). Zomorph capsules are not suitable for children.   This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.   Use with caution in  Elderly people. Weak or debilitated people. People with decreased kidney or liver function. People with decreased lung function or breathing difficulties, for example asthma (see also above). People with a history of convulsions (fits), eg epilepsy. People with low blood pressure (hypotension) or low circulating blood volume (hypovolaemia). People with diseases of the bile ducts. Inflammation of the pancreas (pancreatitis). Inflammatory bowel disease such as ulcerative colitis or Crohn&amp;#039;s disease. Men with an enlarged prostate gland (prostatic hypertrophy). People with an underactive thyroid gland (hypothyroidism). People with reduced production of natural steroid hormones by the adrenal glands (adrenocortical insufficiency). A condition called myasthenia gravis, in which there is abnormal muscle weakness. People with a history of drug or alcohol abuse or dependence. People who have recently had surgery, particularly surgery on the gut.   Pregnancy and breastfeeding Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.  The manufacturer states that Zomorph capsules should not be taken during pregnancy. If morphine is used during labour it may cause breathing difficulties in the baby after the birth. Babies born to mothers who have been having long-term treatment with this medicine may have withdrawal symptoms after the birth. Seek further medical advice from your doctor. The manufacturer states that Zomorph capsules should not be taken during breastfeeding. Morphine passes into breast milk and can potentially cause problems in the baby, such as breathing or feeding problems. If used during breastfeeding the nursing infant may need to be monitored. Seek further medical advice from your doctor.   Side effects Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.  Nausea and vomiting. Constipation. Drowsiness. See warnings above. Confusion. Headache. Loss of appetite. Dry mouth. Rash or itching. Sweating. Feeling weak. Muscle rigidity. Low blood pressure (hypotension). Dizziness or spinning sensation. Increased blood flow to the skin on the face (facial flushing). Problems passing urine. Breathing difficulties due to a narrowing of the airways (bronchospasm). Slow, shallow breathing (respiratory depression). Changes in mood. Seeing or hearing things that are not really there (hallucinations). Awareness of your heartbeat (palpitations). Seizures.  The side effects listed above may not include all of the side effects reported by the medicine&amp;#039;s manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist. If you think you have experienced a side effect from a medicine or vaccine you should check the patient information leaflet. This lists the known side effects and what to do if you get them. You can also get advice from your doctor, nurse or pharmacist. If they think it\u2019s necessary they&amp;#039;ll report it for you. You can also report side effects yourself using the yellow card website: www.mhra.gov.uk/yellowcard.   How can this medicine affect other medicines? It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.  This medicine should not be taken by people who are taking a monoamine oxidase inhibitor antidepressant (MAOI), for example the antidepressants phenelzine, tranylcypromine or isocarboxazid, or by people who have taken one of these medicines in the last 14 days. There may be an increased risk of side effects such as drowsiness, sedation, low blood pressure and slow, shallow breathing, if this medicine is used with other medicines that have a sedative effect on the central nervous system. These include the following:  antipsychotics, eg haloperidol  barbiturates, eg phenobarbital, amobarbital benzodiazepines, eg diazepam, temazepam muscle relaxants, eg baclofen other opioids, eg codeine, tramadol sedating antihistamines, eg chlorphenamine, hydroxyzine sleeping tablets, eg zopiclone tricyclic antidepressants, eg amitriptyline.   Cimetidine may reduce the breakdown of morphine and increase its level in the blood. This may increase the risk of side effects such as drowsiness and breathing difficulties with morphine. Morphine may oppose the effects of the following medicines on the gut:  domperidone metoclopramide.  Morphine may increase the blood level of gabapentin. The following medicines may reduce the amount of morphine in the blood and could make it less effective:  rifampicin ritonavir.   Other medicines containing the same active ingredient  Filnarine SR tablets. Morphgesic SR tablets. MST continus suspension. MST continus tablets. MXL capsules. Oramorph. Sevredol tablets.  Morphine injection, oral solution and suppositories are also available without a brand name, ie as the generic medicine.   Further reading For background information about our medicine factsheets, including the references used to produce them, click here.  Last updated 15.02.2015 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/aches-and-pains/a8049/zomorph-capsules-morphine/>