ABSTRACT
Morphine intravenous or subcutaneously: 10-20 mg every 4 hours with escape of 10 mg; calculate daily dose needed for pain control and change to other route of administraton (equianalgesic dose) Morphine orally: 10-20 mg every 4 hours with escape of 10 mg, calculate daily dose needed for pain control and change to SR morphine (dose is same as of daily dose of immediate acting morphine),
Practical considerations
In the context of emergency, avoid morphine with long half-life (requires 6-24 hours to be active). Only physicians familiar with opioids should titrate morphine. In other situations, start treatment by conventional dose of morphine (compare with above). Surveillance of vital emergency is necessary and naloxone (antidote) must be available. Example of protocol for titration: morphine 2 mg intravenously/5 minutes until disappearance of pain.
