morphine

Interactions

Drug-Drug

• Use with extreme caution in patients receiving MAO inhibitors within 14 days prior (may result in unpredictable, severe reactions–↓ initial dose of morphine to 25% of usual dose).
• ↑ CNS depression with alcohol, sedative/hypnotics, clomipramine, barbiturates, tricyclic antidepressants, and antihistamines.
• Administration of partial-antagonist opioid analgesics may precipitate opioid withdrawal in physically dependent patients.
• Buprenorphine, nalbuphine, butorphanol, or pentazocine may ↓ analgesia.
• May ↑ the anticoagulant effect of warfarin.
• Cimetidine ↓ metabolism and may ↑ effects.
• Epidural test dose of lidocaine/epinephrine may alter release of liposomal injection.
• Use of liposomal injection after bupivacaine may ↑ levels of morphine (↑ dosing interval between 2 drugs to >30 min).

Drug-Natural Products:

Concomitant use of kava-kava, valerian, or chamomile can ↑ CNS depression.