Morphine sulfate extended-release capsules for the treatment of chronic, moderate-to-severe pain

Background: Morphine sulfate extended-release capsules (KADIAN (R)) contain polymer-coated morphine sulfate pellets that are formulated to deliver sustained plasma morphine levels with minimal fluctuation. Morphine sulfate extended-release capsules, the only opioid formulation indicated in the US for both once- and twice-daily (every 12 and every 24 h) dosing, is approved in eight dosage strengths and is effective against pain from diverse sources in a variety of patient types. The formulation of morphine sulfate extended-release capsules allows flexible dosing options: capsules can be taken whole or the contents can be sprinkled on apple sauce or delivered via a gastrostomy tube. Morphine sulfate extended-release capsules have no immediate-release component and no components that would limit high doses. Results/conclusion: The bioavailability, of morphine sulfate extended-release capsules is not compromised when taken with food and dose dumping (immediate elevations in dose) does not occur when morphine sulfate extended-release capsules are taken concomitantly with alcohol. Nearly all patients taking morphine sulfate extended-release capsules for pain relief adhere to the recommended dosing frequency. The flexibility available with morphine sulfate extended-release capsules may offer clinical advantages for pain management.