Morphine Interaction

(Pharmaceutics)
Freezing Solutions Morphine sulfate 1 and 2 mg/mL in
dextrose 5% and sodium chloride 0.9% in PVC bags
exhibited no loss during 14 weeks of frozen storage at
-20 C
Syringes morphine sulfate is stated to remain within
acceptable limits of degradation for at least 69 days at
room temperature.
The stability of morphine hydrochloride 1, 5, and 10
mg/mL in dextrose 5% and 0.9% sodium chloride
packaged in 50-mL polypropylene syringes degradation
products being less than 2% of the concentration when
stored at 37 C for two days
Morphine hydrochloride (Centrafarm) 0.5, 1.5, and 2.5
mg/mL in sodium chloride 0.9% was packaged in
PVC/Kalex, stored at 32 C, no morphine decomposition
after 60 days of storage.
Trissel, 2011

Morphine Solution Compatibility

Solution

Cons

Remark

Compatibil
ity

Dextrose 5%

5g

No morphine loss in 30 days at 23 C

Sodium chloride
0.9%

5g

No morphine loss in 30 days at 23 C

Sterile water for

injection

50 g

Physically compatible with little or no

morphine loss by HPLC in 60 days at 23 C
under fluorescent light. Slight yellow
discoloration
not indicative of decomposition
Additive Compatibility

Drug

Remark

Compatibi
lity

Dobutamine HCl

Physically compatible for 24 hr at 21 C

Furosemide

Physically compatible for 72 hr at 15 and 30 C

Meropenem

Visually compatible for 4 hr at room temperature

Phenobarbital

Physically incompatible

Y-Site Injection Compatibility

Drug

Remark

Compatibi
lity

Digoxin

Physically compatible for 4 hr at 25 C

Furosemide

White precipitate forms within 1 hr at 25 C under

fluorescent light

Meropenem

Visually compatible for 4 hr at room temperature

C
Trissel,
2011

Phenobarbital Interaction
(Pharmacology)
Drug

Onse
t

Severity

Documenta
tion

Mechanism

Prednisone delay
ed

Moderate

Established

Stimulated
corticosteroid
metabolism (6-betahydroxylation)
secondary to
barbiturate induction
of liver enzymes

Digoxin

delay
ed

Moderate

possible

Will decrease or
effect of digoxin by
P-GP efflux
transporter

Furosemid

delay
ed

Minor

Unlikely

unknown

Parker and Larissa, 2011 & Tatto, 2

(Pastalos & Perucca,

2003)

Morphine Interaction
(Pharmaceutics)
Administration Phenobarbital sodium is
administered by intramuscular injection into a
large muscle and slow intravenous injection. Do
not administer subcutaneously. When given
intravenously, the rate of injection should not
exceed 60 mg/min.
Stability Phenobarbital sodium injection in
intact containers should be stored at controlled
room temperature and protected from light.
The stability of phenobarbital sodium, diluted to
a 10-mg/mL concentration in sodium chloride
0.9% for use in infants. When stored at 4 C, the
dilution was physically compatible with no loss
of phenobarbital during the 28-day
Trissel, 2011

Morphine Solution Compatibility

Solution

Cons

Remark

Compatibil
ity

Dextrose 5%

320g

Physically compatible

Dextrose 10%

320g

Physically compatible

Ringer's injection,
lactated

320g

Physically compatible

Additive Compatibility
Drug

Remark

Compatibi
lity

Meropenem

Visually compatible for 4 hr at room temperature

Morphine sulfate

Physically incompatible

Y-Site Injection Compatibility

Drug

Remark

Compatibi
lity

Meropenem

Visually compatible for 4 hr at room temperature

Morphine sulfate

Physically compatible with no change in measured haze

or increase in particle content in 48 hr at 22 C

Trissel, 2011