MS Contin Dosage

Generic name: morphine (oral)
Brand names: Kadian, MS Contin
Drug class: Narcotic analgesics

Medically reviewed by  A Ras MD.

Recommended Adult Dosing

Dosage forms:  ER TAB: 15 mg, 30 mg, 60 mg, 100 mg, 200 mg

Pain, mod-severe chronic

[opioid-naive pts]

Dose: individualize dose PO q8-12h; Start: 15 mg PO q8-12h, may incr. dose q1-2 days; Info: use lowest effective dose, shortest effective tx duration; consider low start dose, titrate slowly in pts 65 yo and older; do not cut/crush/chew/dissolve tab; >60 mg/dose, >120 mg/day, 100 mg tab, 200 mg tab for use in opioid-tolerant pts only; taper total daily dose by no more than 10-25% q2-4wk to D/C if long-term use

[opioid-nontolerant pts]

Dose: individualize dose PO q8-12h; Start: 15 mg PO q12h, may incr. dose q1-2 days; Info: use lowest effective dose, shortest effective tx duration; consider low start dose, titrate slowly in pts 65 yo and older; do not cut/crush/chew/dissolve tab; >60 mg/dose, >120 mg/day, 100 mg tab, 200 mg tab for use in opioid-tolerant pts only; taper total daily dose by no more than 10-25% q2-4wk to D/C if long-term use

[opioid-tolerant pts]

Dose: individualize dose PO q8-12h; Start: individualize based on current opioid intake, see pkg insert for conversion; Info: use lowest effective dose, shortest effective tx duration; may incr. dose q1-2 days; consider low start dose, titrate slowly in pts 65 yo and older; do not cut/crush/chew/dissolve tab; taper total daily dose by no more than 10-25% q2-4wk to D/C if long-term use

Renal dosing

CrCl 10-50: decr. usual dose by 25%, titrate slowly; CrCl <10: avoid use

HD/PD: avoid use

Hepatic dosing

[adjust dose amount]

cirrhosis: decr. usual start dose, titrate slowly

Recommended Peds Dosing

Dosage forms:  ER TAB: 15 mg, 30 mg, 60 mg, 100 mg, 200 mg

Pain, mod-severe chronic

[0.3-0.6 mg/kg/dose PO q12h]

Start: individualize dose based on current opioid intake; Info: use lowest effective dose, shortest effective tx duration; do not crush/chew/dissolve tab; 100 mg tab, 200 mg tab for use in opioid-tolerant pts only; taper dose gradually to D/C

Renal dosing

[adjust dose amount]

CrCl 10-50: decr. usual dose by 25%; CrCl <10: decr. usual dose by 50%; Info: titrate slowly

HD: decr. usual dose by 50%; supplement after dialysis not defined; PD: decr. usual dose by 50%; supplement not defined; Info: titrate slowly

Hepatic dosing

[adjust dose amount]

cirrhosis: decr. start dose, titrate slowly

SRC: NLM .