Duramorph

Duramorph treats pain that is not relieved by non narcotic pain relievers.

Duramorph Overview

Updated: 

Duramorph is a prescription medication used to treat pain that is not relieved by non narcotic pain relievers.

It belongs to a group of drugs called opioid narcotics. These work by changing the way the brain and nervous system respond to pain.

Duramorph is available as an injectable to be administered epidurally (into the epidural space) or intrathecally (within the spinal canal) and is given by a healthcare professional.

Common side effects of Duramorph include constipation, nausea, itchiness, and sleepiness. Do not drink alcohol or any foods or medications containing alcohol while receiving Duramorph as alcohol increases the risk that you will experience breathing problems or other serious, life-threatening side effects.

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  • Dyspnea
  • Pain, Intractable

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Duramorph Cautionary Labels

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Uses of Duramorph

Duramorph is a prescription medication used to treat pain that is not relieved by non narcotic pain relievers.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. 

Manufacturer

Duramorph Drug Class

Duramorph is part of the drug class:

Side Effects of Duramorph

This medication may cause serious side effects. See "Drug Precautions".

Common side effects include:

  • itching
  • injection site pain
  • dizziness
  • drowsiness
  • nausea
  • vomiting
  • constipation
  • diarrhea
  • loss of appetite
  • weight loss
  • dry mouth
  • sweating
  • weakness
  • headache
  • agitation
  • nervousness
  • mood changes
  • confusion
  • small pupils (black circles in the middle of the eyes)
  • flu symptoms
  • difficulty urinating or pain when urinating

Call your healthcare provider if you have any of these symptoms and they are severe.

Get emergency medical help if you have:

  • trouble breathing
  • shortness of breath
  • fast heartbeat
  • chest pain
  • swelling of your face
  • tongue or throat
  • extreme drowsiness, or you are feeling faint

These are not all the possible side effects of Duramorph. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. 

Duramorph Interactions

Tell your doctor about all the medications you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven)
  • antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil)
  • antihistamines (found in cold and allergy medications)
  • beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal)
  • buprenorphine (Butrans, Subutex, in Suboxone)
  • butorphanol (Stadol)
  • cimetidine (Tagamet)
  • diuretics ('water pills')
  • medications for anxiety, seizures, depression, mental illness, or nausea
  • monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), procarbazine (Matulane), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate)
  • muscle relaxants
  • nalbuphine (Nubain)
  • other narcotic pain medications
  • pentazocine (Talwin)
  • quinidine  
  • sedatives, sleeping pills, or tranquilizers

This is not a complete list of Duramorph drug interactions. Ask your doctor or pharmacist for more information.

Duramorph Precautions

Duramorph may be habit-forming.There is a greater risk that you will overuse Duramorph if you have or have ever had depression or another mental illness, or if you have abused alcohol, used street drugs, or overused prescription medications.

Duramorph may cause slowed or stopped breathing, especially when you begin your treatment and any time your dose is increased. Tell your doctor if you have slowed breathing and if you have or have ever had lung disease such as asthma, chronic obstructive pulmonary disease (COPD; a group of diseases including chronic bronchitis and emphysema that cause difficulty breathing), or other breathing problems. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: slowed breathing, long pauses between breaths, or shortness of breath.

Taking certain other medications during your treatment with Duramorph may increase the risk that you will experience breathing problems or other serious, life-threatening side effects.

Do not receive Duramorph if you have:

  • severe asthma, trouble breathing, or other lung problems.
  • a bowel blockage or have narrowing of the stomach or intestines.

While receiving Duramorph do not:

  • Drive or operate heavy machinery, until you know how Duramorph affects you. Duramorph can make you sleepy, dizzy, or lightheaded.
  • Drink alcohol or use prescription or over-the-counter medicines that contain alcohol.

Duramorph Food Interactions

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Duramorph there are no specific foods that you must exclude from your diet when receiving this medication.

Inform MD

Before receiving this medication, tell your doctor if you:

  • have severe asthma, trouble breathing, or other lung problems.
  • have a bowel blockage or have narrowing of the stomach or intestines.
  • have a history of head injury, seizures.
  • have liver, kidney, thyroid, pancreas, or gallbladder problems.
  • have problems urinating.
  • are pregnant or planning to become pregnant. 
  • are breastfeeding. 
  • are taking prescription or over-the-counter medicines, vitamins, or herbal supplements.
  • have a history of abuse of street or prescription drugs, alcohol addiction, or mental health problems.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Duramorph and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Duramorph falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, Duramorph may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Duramorph and Lactation

Tell your healthcare provider if you are breastfeeding. Duramorph passes into human breast milk and may harm your baby.

Duramorph Usage

Duramorph is available as an injectable to be administered epidurally (into the epidural space) or intrathecally (within the spinal canal) and is given by a healthcare professional.

If you feel that your pain is not controlled, tell your doctor. 

Duramorph Dosage

Take Duramorph exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. 

The dose your doctor recommends may be based on the following:

  • the type and severity of the pain you have
  • other medical conditions you have
  • how you respond to this medication
  • your weight

Duramorph Overdose

Duramorph is usually administered by a healthcare provider in a medical setting making it unlikely for an overdose to occur. However, if overdose is suspected, seek emergency medical attention.

Other Requirements

Do not miss your follow-up appointment with your doctor.

Duramorph FDA Warning

Duramorph may be habit forming. Overdoses may cause respiratory depression, coma and death.

Duramorph administration should be limited to use by those familiar with the management of respiratory depression. Rapid intravenous administration may result in chest wall rigidity.

Prior to any epidural or intrathecal drug administration, the physician should be familiar with patient conditions (such as infection at the injection site, bleeding diathesis, anticoagulant therapy, etc.) which call for special evaluation of the benefit versus risk potential.

SEVERE RESPIRATORY DEPRESSION UP TO 24 HOURS FOLLOWING EPIDURAL OR INTRATHECAL ADMINISTRATION HAS BEEN REPORTED.

In the case of epidural or intrathecal administration, Duramorph should be administered by or under the direction of a physician experienced in the techniques and familiar with the patient management problems associated with epidural or intrathecal drug administration. Because epidural administration has been associated with less potential for immediate or late adverse effects than intrathecal administration, the epidural route should be used whenever possible. 

BECAUSE OF THE RISK OF SEVERE ADVERSE EFFECTS WHEN THE EPIDURAL OR INTRATHECAL ROUTE OF ADMINISTRATION IS EMPLOYED, PATIENTS MUST BE OBSERVED IN A FULLY EQUIPPED AND STAFFED ENVIRONMENT FOR AT LEAST 24 HOURS AFTER THE INITIAL DOSE.

THE FACILITY MUST BE EQUIPPED TO RESUSCITATE PATIENTS WITH SEVERE OPIATE OVERDOSAGE, AND THE PERSONNEL MUST BE FAMILIAR WITH THE USE AND LIMITATIONS OF SPECIFIC NARCOTIC ANTAGONISTS (NALOXONE, NALTREXONE) IN SUCH CASES.

PATIENTS SOMETIMES MANIFEST UNUSUAL ACCELERATION OF NEURAXIAL DURAMORPH REQUIREMENTS, WHICH MAY CAUSE CONCERN REGARDING SYSTEMIC ABSORPTION AND THE HAZARDS OF LARGE DOSES; THESE PATIENTS MAY BENEFIT FROM HOSPITALIZATION AND DETOXIFICATION. TWO CASES OF MYOCLONIC-LIKE SPASM OF THE LOWER EXTREMITIES HAVE BEEN REPORTED IN PATIENTS RECEIVING MORE THAN 20 MG/DAY OF INTRATHECAL DURAMORPH. AFTER DETOXIFICATION, IT MIGHT BE POSSIBLE TO RESUME TREATMENT AT LOWER DOSES, AND SOME PATIENTS HAVE BEEN SUCCESSFULLY CHANGED FROM CONTINUOUS EPIDURAL DURAMORPH TO CONTINUOUS INTRATHECAL DURAMORPH. REPEAT DETOXIFICATION MAY BE INDICATED AT A LATER DATE. THE UPPER DAILY DOSAGE LIMIT FOR EACH PATIENT DURING CONTINUING TREATMENT MUST BE INDIVIDUALIZED.