Morphine for use in breathlessness

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There are a variety of treatments that may be recommended for helping with breathlessness, one of these is morphine. You may be prescribed immediate release morphine (e.g. Oramorph®) or sustained release morphine in very small doses for the relief of breathlessness.

Why is morphine used?

Morphine can help you to feel less breathless. Patients have told us they find morphine very helpful in relieving their breathlessness. Many say it has allowed them to sleep better and to cope better with daily activities. Patients who find morphine helpful can then continue on it long term.Before starting morphine you will be carefully assessed. This is to ensure that this is the correct treatment for you and we have not missed something else causing increased breathlessness.

Isn’t morphine only used for pain relief?

You might recognise this as a medicine used for pain, including when someone has cancer. However, it has also been used for many years for breathlessness, and is proven to be safe and effective.

The doses of morphine used for breathlessness are very small (much smaller than would be used for pain), and the side effects are usually minimal. For most people the positive effects outweigh the negative.

Are there any side effects from taking morphine for breathlessness?

Sleepiness:

Should this affect you, it is most likely to occur when you first take morphine or when the dose is increased. It should improve after a few days.

Constipation:

This can be a common side effect. It is important to drink plenty of fluids and always take a laxative regularly as prescribed by your doctor. The dose of laxative can be used to make sure you pass a soft bowel motion regularly.

Sickness:

Should this affect you, it is most likely to occur when you first take morphine. It should improve after a few days. If you feel sick when you first start to take morphine for breathlessness, try taking it with food. Your doctor may need to give you some anti-sickness medicine for a few days until the sickness goes away.

You may notice that the package information leaflet includes a warning stating that it is dangerous to take morphine when you have a breathing problem. Morphine will not be dangerous when prescribed and taken appropriately.

Will I become addicted to morphine and be unable to stop taking it?

No. This small amount of morphine used to treat breathlessness does not cause addiction. If you no longer need to take morphine for breathlessness you can stop after discussion with your doctor or nurse.

Will the morphine always relieve my breathlessness completely?

Although it is very effective, other treatments may be needed and suggested by your doctor or nurse so please let them know if your breathlessness is not being controlled.

Can oxygen be used to help my breathlessness?

If your oxygen level is normal, extra oxygen does not provide any benefit. Any medical benefit from oxygen would have already been assessed.

You may feel unwell in one or more of these ways:

• Feel more sleepy than usual
• Restlessness or jumpiness
• Feeling sick most of the time
• Have hallucinations

Do not worry if this happens. Tell your doctor or nurse. Your doctor may reduce the dose, or change to a different medication.

Can I drive?

Once you get used to taking morphine for your breathlessness and do not feel sleepy or unwell you may be able to drive. You must discuss this with your doctor first. You must not drive if you feel that your driving may be impaired by pain, your condition or medication. Following recent advice from the Department of Transport please carry evidence that you have been prescribed morphine by a doctor, in case you are stopped by the Police.

Can I drink alcohol?

A small glass of wine, beer, sherry or whisky is usually permitted, but you should discuss this with your doctor. It is best to avoid more than a small drink otherwise you may become too drowsy.

Any questions?

If you have any questions about your morphine for breathlessness, or other medicines, please ask your hospital ward doctor or nurse, your GP or community palliative care nurse, if you have one. You can also contact the hospital Medicines Information Centre on Monday to Friday, 10am to 5pm via: 01444 454388.