morphine

Reserved/Restricted : Extended release capsules- prescribing and management is restricted to prescribers with Pediatric Acute Pain Service (APS), Pediatric Advanced Care Team (PACT), and hematology/oncology.

• These dosing guidelines are intended for opioid-naive, acute pain situations. 
• Practitioners should consider whether the patient is opioid naive and other underlying medical conditions when choosing an initial dose.
• The Children’s Health Program is supported by an Acute Pain Service which is available for medical consultation in complex dosing situations.
• Patients already receiving regular opioids or with cancer or chronic pain may require significantly higher or more frequent doses.

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Go to Pediatric Parenteral Administration Information for morphine

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Analgesia
Intermittent- Oral
Initial dosing
Less than 6 months

0.1 mg/kg/dose PO every 4 hours PRN

6 months and greater

0.2 mg/kg/dose PO every 3 to 4 hours PRN
Maximum: (usual initial maximum) 10 mg/dose

Usual dosing range:
6 months and greater

0.2-0.5 mg/kg/dose PO every 3 to 4 hours PRN

Intermittent- Parenteral
Initial dosing
Less than 6 months

0.05 mg/kg/dose IV every 4 hours PRN

6 months and greater

0.05-0.1 mg/kg/dose IV/IM/Subcutaneous every 3 to 4 hours PRN
Maximum: (usual initial maximum) 2 mg/dose

Usual dosing range:
6 months and greater

0.05-0.2 mg/kg/dose IV every 3 to 4 hours PRN

Continuous Infusion - Greater than 1 month
MSNU, PMU, 6 Link
(Note: for infants less than 6 months, morphine continuous infusion MUST be prescribed by Acute Pain Service or Pediatric Advanced Care Team)

Go to order set IWK MOCO "Morphine Continuous Infusion MSNU, PMU, 6 Link"

Critical Care Areas - PICU/OR/PACU/ED
Ordered as :____ mg/kg/hour

Loading Dose
0.1 mg/kg/dose IV x 1

Initial Dosing
0.02 mg/kg/hour 

Suggested Titration
0.01 mg/kg/hour every 2 to 4 hours

Usual Range
0.01-0.04 mg/kg/hour 

Usual* Maximum:
0.04 mg/kg/hour   *May require higher doses for sedation or if switching between opioids (e.g. converting from fentaNYL to morphine)

Patient Controlled Analgesia

Go to IWK IVPA "ACUTE PAIN SERVICE (APS) PATIENT CONTROLLED ANALGESIA (PCA) ORDERS − PEDIATRICS""

Post-Tonsillectomy

Go to order set IWK TOADPO "Post Tonsillectomy and/or Adenoidectomy Surgery Orders"

Withdrawal Management (PICU)

Go to PICU Withdrawal Guidelines

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Comments

IWK Opioid Dose Conversion and Equianalgesic Guidelines

Note: morphine 1 mg/mL (50 mL prefilled syringe) is supplied as morphine sulphate

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Go to Neonatal Drug Dosing Guideline for morphine

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Supplied

Capsule, Extended Release: 10 mg, 15 mg, 30 mg
Injection: 1 mg/mL (50 mL Prefilled Syringe) IWK Compounded, 1 mg/mL (100 mL Bag) , 2 mg/mL, 10 mg/mL, 0.5 mg/mL
Syrup: 1 mg/mL
Tablet: 5 mg

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For more detailed information, go to Micromedex

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Created on August 26, 2019 01:56 PM
Updated on January 11, 2024 09:39 AM