Morphine can be given orally and subcutaneously. Given its oral bioavailability, a subcutaneous dose of morphine should be around one-third to one-half of the oral dose.
Dosing in an opioid naïve patient is age related and typical starting doses may be:
Age
Type
Typical starting dose
Young and middle aged adult
Oral immediate release
10mg for breakthrough pain
Oral modified release
10mg twice daily
Subcut stat
5mg for breakthrough pain
CSCI
15mg over 24 hours
Elderly adult
Oral immediate release
5mg for breakthrough pain
Oral modified release
5mg twice daily
Subcut stat
2.5mg for breakthrough pain
CSCI
10mg over 24 hours
Equianalgesic doses
1mg of subcut morphine
= 3mg or oral morphine
= 1mg of SC oxycodone
= 2mg of oral oxycodone
= 0.2mg of subcut hydromorphone
= 0.6mg of oral hydromorphone
= 15 microgs of subcut fentanyl
See the table in the +Opioid equivalence page for quick reference table helpful for converting morphine doses to other opioids and vice versa. Equivalence tables only give approximate doses and it is always wise to use caution and be conservative in dosing when undertaking a conversion.
Morphine can be mixed safely with a large combinations of other medications in a continuous subcutaneous infusion. Tables that list morphine compatibilities are available in the +Continuous Subcutaneous Infusions page.
Indications
Pharmacokinetics
Pharmacodynamics
Dosing and routes of administration