MST Continus 20 mg, 30 mg, 60 mg, 100 mg and 200 mg prolonged-release suspensions
Morphine sulphate
Read all of this leaflet carefully before you start taking this medicine.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or pharmacist.
- This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
- If any of the side effects become serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
In this leaflet:
1. What MST Continus suspension is and what it is used for
2. Before you take MST Continus suspension
3. How to take MST Continus suspension
4. Possible side effects
5. How to store MST Continus suspension
6. Further information
What MST Continus suspension is and what it is used for
This suspension has been prescribed for you by your doctor to relieve severe pain over a period of 12 hours. It contains the active ingredient morphine which belongs to a group of medicines called strong analgesics or ‘painkillers’.
Before you take MST Continus suspension
Do not take MST Continus suspension if:
- you are allergic (hypersensitive) to morphine or any of the other ingredients of the suspension (see section 6 ‘Further Information’);
- you have breathing problems, such as obstructive airways disease or respiratory depression. Your doctor will have told you if you have these conditions. Symptoms may include breathlessness, coughing or breathing more slowly or weakly than expected;
- you have a head injury that causes a severe headache or makes you feel sick. This is because the suspensions may make these symptoms worse or hide the extent of the head injury;
- you have a condition where the small bowel (part of your gut) does not work properly (paralytic ileus), your stomach empties more slowly than it should (delayed gastric emptying) or you have severe pain in your abdomen;
- you have recent onset liver disease;
- you are taking a type of medicine known as a monoamine oxidase inhibitor (examples include tranylcypromide, phenelzine, isocarboxazid, moclobemide and linezolid), or you have taken this type of medicine in the last two weeks;
- the patient is under one year of age.
If you are going to have an operation, please tell the doctor at the hospital that you are taking this suspension.
Take special care with MST Continus suspension
Before treatment with the suspension tell your doctor or pharmacist if you:
- have breathing problems, such as impaired lung function. Your doctor will have told you if you have this condition. Symptoms may include breathlessness and coughing;
- have an under-active thyroid gland (hypothyroidism), kidney or long-term liver problems as you may need a lower dose;
- have a severe headache or feel sick as this may indicate that the pressure in your skull is increased;
- suffer from, or have ever suffered from epilepsy, seizures, fits or convulsions;
- have low blood pressure;
- have a severe heart problem after long-term lung disease (severe cor pulmonale);
- have inflammation of the pancreas (which causes severe pain in the abdomen and back) or problems with your gall bladder;
- have an inflammatory bowel disorder;
- have prostate problems;
- have poor adrenal gland function (your adrenal gland is not working properly which may cause symptoms including weakness, weight loss, dizziness, feeling or being sick);
- are or have ever been addicted to alcohol or drugs;
- have previously suffered from withdrawal symptoms such as agitation, anxiety, shaking or sweating, upon stopping taking alcohol or drugs.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. If you take the suspension with some other medicines, the effect of the suspension or the other medicine may be changed.
The suspension must not be used together with a monoamine oxidase inhibitor, or if you have taken this type of medicine in the last two weeks (see section 2 ‘Do not take…’)..
If you need to take a medicine for indigestion, do not take it for 2 hours after taking your suspension.
Tell your doctor or pharmacist if you are taking:
- medicines to help you sleep (for example tranquillisers, hypnotics or sedatives);
- medicines to treat psychiatric or mental disorders (such as phenothiazines);
- muscle relaxants;
- medicines to treat high blood pressure;
- cimetidine to treat stomach ulcers, indigestion or heartburn;
- certain types of medicines to stop you feeling or being sick;
- medicines used to prevent or relieve the symptoms of an allergy (antihistamines);
- other strong analgesics or ‘painkillers’ (such as buprenorphine, nalbuphine or pentazocine);
- rifampicin to treat tuberculosis;
- ritonavir to treat HIV;
- medicines to treat Parkinson’s disease.
Also tell your doctor if you have recently been given an anaesthetic.
Taking MST Continus suspension with alcohol
Drinking alcohol during your treatment with the suspension may make you sleepy. If you are affected you should avoid drinking alcohol.
Pregnancy and breastfeeding
Do not take the suspension if you are pregnant or breastfeeding.
Ask your doctor or pharmacist for advice before taking any medicine.
Driving and using machines
The suspension may cause a number of side effects such as drowsiness which could affect your ability to drive or use machinery (see section 4 for a full list of side effects). These are usually most noticeable when you first start taking the suspension, or when changing to a higher dose. If you are affected you should not drive or use machinery.
Important information about some of the ingredients of MST Continus suspension
These suspensions contain ponceau 4R (E124) which may cause allergic reactions.
How to take MST Continus suspension
Always take the suspension exactly as your doctor has told you. The label on your medicine will tell you how much suspension to take and how often.
The usual way to take the suspension is to put the following amount of water into a measuring cup:
For one 20 mg sachet, use 10 ml water
For one 30 mg sachet, use 10 ml water
For one 60 mg sachet, use 10 ml water
For one 100 mg sachet, use 20 ml water
For one 200 mg sachet, use 30 ml water
Cut or tear the top off the sachet. Empty the contents of the sachet into the measuring cup of water. Stir with a spoon for 10 seconds. The suspension contains tiny beads (granules) that will not dissolve. Swallow all the suspension at once. If any suspension remains in the beaker rinse with a little more water and swallow.
If you prefer, you can sprinkle the granules on to cold soft food, such as yogurt.
You must only take the suspension by mouth. Do not crush, chew or inject the granules.
MST Continus suspension is designed to work properly over 12 hours. The granules must be suspended in water and drunk immediately. If the granules are crushed or chewed, the entire 12-hour dose may be absorbed rapidly into your body. This can be dangerous, causing serious problems such as an overdose, which may be fatal.
You should take your suspension every 12 hours. For instance, if you take a dose at 8 o’clock in the morning, you should take the next dose at 8 o’clock in the evening.
Adults
The usual starting dose is 20 mg to 30 mg taken every 12 hours. However, the dose will depend on your age, weight and the severity of your pain.
Children over one year of age
Children over one year of age can take the suspension. The required dose will depend on their weight and severity of pain. This should be discussed with your doctor or pharmacist.
If you find that you are still in pain whilst taking the suspension discuss this with your doctor.
Do not exceed the dose recommended by your doctor. You should check with your doctor or pharmacist if you are not sure.
If you take more MST Continus suspension than you should or if someone accidentally swallows your suspension
Call your doctor or hospital straight away. People who have taken an overdose may feel very sleepy, sick or dizzy. They may also have breathing difficulties leading to unconsciousness or even death and may need emergency treatment in hospital. When seeking medical attention make sure that you take this leaflet and any remaining suspensions with you to show to the doctor.
If you forget to take MST Continus suspension
If you remember within 4 hours of the time your suspension was due, take it straight away. Take your next dose at your normal time. Do not take a double dose to make up for a forgotten dose.
If you stop taking MST Continus suspension
You should not suddenly stop taking this suspension unless your doctor tells you to. If you want to stop taking your suspension, discuss this with your doctor first. They will tell you how to do this, usually by reducing the dose gradually so you do not experience unpleasant effects. Withdrawal symptoms such as agitation, anxiety, shaking or sweating may occur if you suddenly stop taking the suspension.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Possible side effects
Like all medicines, the suspension can cause side effects, although not everybody gets them.
All medicines can cause allergic reactions, although serious allergic reactions are uncommon. Tell your doctor immediately if you get any sudden wheeziness, difficulties in breathing, swelling of the eyelids, face or lips, rash or itching especially those covering your whole body.
The most serious side effect is a condition where you breathe more slowly or weakly than expected (respiratory depression).
As with all strong painkillers, there is a risk that you may become addicted or reliant on the suspension.
Common side effects (probably affecting more than 1 in 100 people taking the suspension)
- Constipation (your doctor can prescribe a laxative to overcome this problem).
- Feeling or being sick (this should normally wear off after a few days, however your doctor can prescribe an anti-sickness medicine if it continues to be a problem).
- Drowsiness (this is most likely when you first start taking your suspension or when your dose is increased, but it should wear off after a few days).
- Dry mouth, loss of appetite, indigestion, abdominal pain or discomfort.
- Headache, confusion, difficulty in sleeping, abnormal thoughts.
- A feeling of unusual weakness.
- Difficulty in breathing or wheezing, decreased cough reflex.
- Involuntary muscle contractions or spasms.
- An increase in the severity of symptoms associated with inflammation of the pancreas (severe pain in the abdomen and back).
- Rash or itchy skin.
- Sweating.
Uncommon side effects (probably affecting fewer than 1 in 100 people taking the suspension)
- Colic (waves of sudden severe abdominal pain), gastrointestinal disorders (e.g. upset stomach), changes in taste.
- A feeling of dizziness or ‘spinning’, fainting, seizures, fits or convulsions.
- Agitation, unpleasant or uncomfortable mood, mood changes, hallucinations, a feeling of extreme happiness.
- Generally feeling unwell.
- Tingling or numbness.
- Difficulty in passing urine.
- Impotence, decreased sexual drive, absence of menstrual periods.
- High or low blood pressure, facial flushing (redness of the face).
- A fast or slow heart beat, palpitations.
- Swelling of the hands, ankles or feet.
- Blurred vision, reduction in size of the pupils in the eye.
Uncommonly, the suspension may affect the results of blood tests to check that your liver is working properly.
If any of the side effects become serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
How to store MST Continus suspension
Keep out of the reach and sight of children.
Do not use the suspension after the expiry date which is stated on the sachet and carton.
EXP 08 2010 means that you should not take the suspension after the last day of that month i.e. August 2010.
Do not store your suspension above 25°C.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
Further information
What MST Continus suspensions contain
The active ingredient is morphine sulphate. Each sachet contains 20 mg, 30 mg, 60 mg, 100 mg or 200 mg of morphine sulphate.
The other ingredients are:
- Cationic exchange resin
- Xylitol
- Xanthan gum
- Raspberry flavour
- Ponceau 4R (E124)
What MST Continus suspensions look like and the contents of the pack
The suspension sachets contain pink granules with an odour of raspberries. The sachets are coloured as follows: 20 mg - blue, 30 mg – dark purple, 60 mg - orange, 100 mg - grey, 200 mg – teal green.
In each box there are 30 sachets.
Marketing Authorisation Holder and Manufacturer
The suspensions are made by Bard Pharmaceuticals Limited for the marketing authorisation holder
For UK only:
This leaflet is also available in large print, Braille or as an audio CD. To request a copy, please call the RNIB Medicine Information line (free of charge) on:
0800 198 5000
You will need to give details of the product name and reference number.
These are as follows:
Product name: MST Continus suspension
Reference number: 16950/0030
This leaflet was last revised in 06/2009
MST Continus suspensions are protected by European Patent (UK) Nos. 0368682 and 0847273.
MST, Continus, MST Continus and the NAPP device (logo) are Registered Trade Marks.
© 2009 Napp Pharmaceuticals Limited
P0073-A R2V1 UK AW 04-03-09
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