Slow-release oral morphine

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Dosing

BC OUD Guidelines

  • Increase doses q48h
  • When transitioning from methadone, the eventual dose will usually be 6- to 8-times higher, but generally should start with a 4-times higher dose to be safe
  • For other opioids, start with dose of 30 to 60 mg
  • Average stable doses are 60 to 1200 mg daily

Missed doses

Number missed Action
1 no change
2 40% reduction
3 60% reduction
4 40 mg or starting dose
5 re-initiate

St. Michael's Protocol

Day Slow-release morphine Instant-release morphine
1 200-300 mg 30-50 mg po q2h while awake + 30-50 mg po q3h prn
2 SR dose from Day 1 + 50% of IR dose from Day 3 30-50 mg po q2h while awake + 30-50 mg po q3h prn
3 SR dose from Day 2 30-50 mg po q3h prn
4 SR dose from Day 3 + 50% of IR dose from Day 3 30-50 mg po q3h prn
5 SR dose from Day 4 30-50 mg po q3h prn
6 SR dose from Day 5 + 50% of IR dose from Day 5 30-50 mg po q3h prn