Discussions that mention morphine

Pain Management board

You must take the ER of the MS Contin because this is what keeps the levels of morphine in your blood steady. Please continue to take the ER MS Contin 2x/day. Think of it like this and I know the numbers are probably not accurate but for illustrative purpose.

The MS Contin ER will release a steady amount of morphine let's say
5mg/hour. Then your pain gets bad and you need the BT med(MS Contin IR). This will push it up to say 8mg/hour for 4-6 hours and then it goes back down to 5mg/hour. The goal of the LA med is to always have that 5mg/hour. Then the IR form pushes it over that for a short amount of time. As I have learned you really should not be relying on the MAX Amount of BT med everyday. The LA med is supposed to control the pain enough that you only take the BT med as needed. However follow the directions the doctor gave you. I hope that made sense.


The ER formula releases half of the dose immediately, just as if you took a 15mg IR tablet. The remainder gets released later in the dosing cycle. It used to be that the remaining 15mg got released at the half-way point, but I've read recently that the "contin" formula may have changed to a more steady release for the last 15mg.

The IR formula just releases the whole dose immediately. So taking two 15mg tabs of the IR formula naturally hits harder.

But the idea behind ER formulas is that it provides consistency of the blood level of morphine. That's why it's critical to take the ER exactly as prescribed. Without that consistent blood level you will have many lows and need way more than the allotted doses of BT meds.

You may not have a problem telling your doc that you took two BT doses instead of the ER dose, but I sure wouldn't want to tell my doc about that. But I wouldn't do it (take two BT doses instead of ER dose) anyway. My doc would probably consider throwing me out of the practice. In most arrangements this is a violation of the contract. And, it's no good for the management of your pain, either.

I'm glad your doc is moving your dosing to three times per day. That's how I take my Morphine ER and it works much better.