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morphine ER how it works

I take 120 mg morphine er and I need to know how long it takes for the medicine to kick in.  I also don't understand what percentage of the dose ( or mg ) produces relief in what time stages.  I hope my question is understandable.  Thanks  Merritt42
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82861 tn?1333453911
It also depends on what you mean by "kick in."  If you mean noticeable pain relief, femmy nailed it.  If you mean euphoria, you'll be waiting a long time.  Time released meds aren't designed to do that.  Calling opiates "pain killers" is kind of a misnomer since they don't actually kill pain.  They just make us feel good so we don't care about it so much.  It takes time to adjust to dose and med changes and it's not always pleasant, so try to be patient.  Best of luck to you.  :-)
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1331804 tn?1336867358
Hi Merritt and welcome to the pain management community!

Morphine ER is a 12 hour medication, meaning it releases the medication slowly into your system over a 12 hour period.  Do you take 120 mg per day split up as two 60 mg doses?  If you take one 60 mg dose every 12 hours, you are getting on average 60 mg/12 hour = 5 mg of morphine per hour.  If you taking 120 mg over a 12 hour period, you are getting on average 120 mg/12 hour = 10 mg of morphine per hour.  

Take 25% of those morphine mg per hour numbers above and that will yield the bioavailability of morphine (i.e.,how much of the dose in the pill is actually active towards relieving your pain).  Don't let the bioavailability fool you into thinking you are not getting enough medication for your pain.  Bioavailabilities can be extremely low and still provide sufficient pain relief as the manufacturer puts enough mgs in the pill to ensure the patient is receiving a therapeutic dose.

I was prescribed Morphine ER for about a year and just recently I was switched to Opana ER which works over a 12 hour period also.  When I was taking Morphine ER, it was only effective for about 6 hours...a little bit longer when I first began taking it.  The Opana ER is only effective for 9 hours and not 12 hours for me.  That's because our systems are all different in the way ER meds are processed.  I am currently working with my doctor to find a way to get coverage of my pain over the full 12 hours.  One option we are looking at is taking 1/2 of my full Opana ER dose 8-9 hours afterwards to provide more coverage and eliminate the need to use breakthrough pain medication.  

Hopefully, the Morphine ER works the full 12 hours for you.  If not there are many people that take ER meds every 8 hours instead of every 12 hours.  

If you are finding that you experience a lot of breakthrough pain throughout the day, you may need a titration in your ER dose.  If you are only getting breakthrough pain 1 to 2 times per day, your ER dose is optimal but if the breakthrough pain medicine doesn't work well for the breakthrough pain you experience, then you may need a stronger dose of breakthrough pain medication.

ER medications take longer to start working.  They typically peak 2 hours after taking the medication versus within 30-60 minutes for short-acting medications.  But then the ER medication levels out and remains at or near the peak dose for 8-12 hours before tapering down.  Whereas, short-acting medications peak quicker but begin to ramp down at a much quicker pace such that the peak level is only sustained for 30-60 mins versus 8-12 hours.

It does take about 3 days for the medication to become fully effective so you may notice that you need more breakthrough pain medication for the first 3 days while the ER medication builds up to a full steady state level in the bloodstream.

Hopefully, I have answered your questions.  If you have any more questions let us know!  I hope Morphine ER is very helpful with your pain.

femmy
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