Important Dosing Instructions for MORPHABOND ER

Important Dosing Instructions for MORPHABOND ER1

An easy 1-to-1 conversion from MS Contin®

4 strengths for dosing flexibility and multiple titration options


Tablets not shown at actual size.

Taken orally
every 8 or 12 hours

Instruct patients to
swallow tablets whole

Can be administered
without regard to food

Dosing Considerations for MORPHABOND ER1

Ensure patients receive MORPHABOND ER as intended
by indicating “Do Not Substitute” on all prescriptions

Dosing Considerations for MORPHABOND ER1

MORPHABOND ER should be prescribed only by healthcare professionals who are knowledgeable in the use of potent opioids for the management of chronic pain.

  • Start patients who are opioid naïve or who are not opioid tolerant on 15-mg tablets orally every 8 or 12 hours
    • Use of higher starting doses in patients who are not opioid tolerant may cause fatal respiratory depression
  • Initiate the dosing regimen for each patient individually, taking into account the patient’s severity of pain, response, prior analgesic treatment, and risk factors for addiction, abuse, and misuse
  • Use the lowest effective dose for the shortest duration consistent with individual treatment goals
  • Monitor patients closely for respiratory depression, especially within the first 24 to 72 hours of initiating therapy or when adjusting the dose
  • Start with 15 mg every 12 hours and monitor patients for signs of respiratory depression, sedation, and hypotension, and consider using a lower dosage of the concomitant CNS depressant
  • When the patient no longer requires therapy with MORPHABOND ER, taper the dose gradually, by 25% to 50% every 2 to 4 days, while monitoring carefully for signs and symptoms of withdrawal. If a patient develops these signs and symptoms, raise the dose to the previous level and taper more slowly, either by increasing the interval between decreases, decreasing the amount of change in dose, or both
  • Reserve MORPHABOND ER for use in patients for whom alternative treatment options (eg, non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain. MORPHABOND ER is not indicated as an as-needed (prn) analgesic
  • Crushing, chewing, or dissolving MORPHABOND ER tablets will result in uncontrolled delivery of morphine and can lead to overdose or death
  • MORPHABOND ER 100-mg tablets, a single dose greater than 60 mg, or a total daily dose greater than 120 mg are only for use in patients in whom tolerance to an opioid of comparable potency has been established
  • Patients who are opioid tolerant are those receiving, for 1 week or longer, at least 60-mg oral morphine per day, 25-mcg transdermal fentanyl per hour, 30-mg oral oxycodone per day, 8-mg oral hydromorphone per day, 25-mg oral oxymorphone per day, 60-mg oral hydrocodone per day, or an equianalgesic dose of another opioid
  • The effect of food upon the systemic bioavailability of MORPHABOND ER has not been systematically evaluated for all strengths. Administration of a single dose of MORPHABOND ER with a standardized high-fat meal resulted in a 33% increase in morphine peak plasma concentration and no change in AUC compared to fasted state

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