Morphine

Excreted Unchanged %
Hepatic
Half-Life (Normalesrd) Hours
1-4/Unchanged
Plasma Protein Binding %
20-30
Volume Of Distribution L/Kg
3.5
Dose For Normal Renal Function
20-25 mg q4h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
75% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
50% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None
Supplement For Dialysis [Recommendation Level]: Pd
PD: No data
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, titrate, [B]
References
Benyhe S. Morphine: new aspects in the study of an ancient compound. Life Sci. 1994; 55: 969-79. [PMID: 8084213] / Chauvin M, Sandouk P, Scherrmann JM, Farinotti R, Strumza P, Duvaldestin P. Morphine pharmacokinetics in renal failure. Anesthesiology. 1987; 66: 327-31. [PMID: 3826690] / Davies G, Kingswood C, Street M. Pharmacokinetics of opioids in renal dysfunction. Clin Pharmacokinet. 1996; 31: 410-22. [PMID: 8968655] / Jamal JA, Joh J, Bastani B. Removal of morphine with the new high-efficiency and high-flux membranes during haemofiltration and haemodialfiltration. Nephrol Dial Transplant. 1998; 13: 1535-7. [PMID: 9641188] / Rushton AR, Sneyd JR. Opioid analgesics. Br J Hosp Med. 1997; 57: 105-6. [PMID: 9196589] / S&#246; we J. High-dose morphine and methadone in cancer patients. Clinical pharmacokinetic considerations of oral treatment. Clin Pharmacokinet. 1986; 11: 87-106. [PMID: 3514045] / Sj&#246; str&#246; m S, Hartvig P, Persson MP, Tamsen A. Pharmacokinetics of epidural morphine and meperidine in humans. Anesthesiology. 1987; 67: 877-88. [PMID: 2891328] / Upton RN, Semple TJ, Macintyre PE. Pharmacokinetic optimisation of opioid treatment in acute pain therapy. Clin Pharmacokinet. 1997; 33: 225-44. [PMID: 9314613] / Wagner BK, O&#146; Hara DA. Pharmacokinetics and pharmacodynamics of sedatives and analgesics in the treatment of agitated critically ill patients. Clin Pharmacokinet. 1997; 33: 426-53. [PMID: 9435992]
Toxicity Notes
Increased sensitivity to drug effect in ESRD.