Morphine Sulphate

Form

Tablets: 10mg, 20mg, 50mg
Tablets/capsules (modified release): 5mg, 10mg, 15mg, 20mg, 30mg, 50mg, 60mg, 90mg, 100mg, 120mg, 150mg, 200mg.
Granules for suspension (modified release): 20mg, 30mg, 60mg, 100mg, 200mg sachets.
Oral solution: 10mg in 5mL; 100mg in 5mL
Injection: 10mg in 1mL, 15mg in 1mL, 20mg in 1mL and 30mg in 1mL
Suppositories: 10mg, 15mg, 20mg, 30mg.

Morphine is the recommended first line opioid of choice in the Paediatric population.

Dose for opioid-naive children use the following start doses (the maximum dose stated applies to starting doses only):

Oral or Rectal route

1-3months: 50µg/kg 4hrly
3-6 months: 100µg/kg every 4 hrs.
6-12 months: 200µg/kg every 4 hrs
1-12yr: 200-300µg/kg every 4hrs (initial maximum 5-10mg)
>12yr: Initial 5-10mg every 4hrs

Single SC or IV injection

Neonate: 25µg/kg every 6hrs
1-6 months: 50µg/kg every 6 hrs
6 months -2yrs: 100µg/kg every 4 hrs
2-12yrs: 100µg/kg every 4hrs (max:2.5mg/dose)
12-18yrs: 2.5-5mg every 4hrs (max: 20mg/24hr)

Continuous SC or IV infusion

Neonate: 5µg/kg/hr
1-6 months: 10µg/kg/hr
6 months-18yrs: 20µg/kg/hr (max 20mg/24hr)

Dose - For children who are on opioids already: Convert using OME (Oral Morphine Equivalent). see appropriate conversion chart below.

N.B. In children morphine can metabolized more rapidly than in adults, in infants less rapidly.