Morphine sulphate should be used with caution with patients with known severe renal or hepatic impairment - smaller doses may be used carefully and titrated to effect.
Use with extreme caution (minimal doses) during pregnancy. NOTE: Not to be used in labour pain where entonox is the analgesic of choice.
Use morphine WITH GREAT CAUTION in patients with chest injuries, particularly those with respiratory difficulty, although if respiration is inhibited by pain, analgesia may actually improve respiratory status.
Morphine should be used with caution in any patient with other respiratory problems, e.g. Asthma, COPD.
Morphine sulphate should be used with caution in patients suffering head injury, Agitation following head injury may be due to acute brain injury, hypoxia or pain. The decision to administer analgesia to an agitated head injured patient is a clinical one. It is vital that if such a patient receives opioids they are closely monitored since opioids can cause disproportionate respiratory depression, which may ultimately lead to an elevated intracranial pressure through a raised arterial pCO2
Morphine Sulphate should be used with caution in the case of acute alcohol intoxication. All opioid drugs potentiate the central nervous system depressant effects of alcohol and they should therefore be used with great caution in patients who have consumed significant quantities of alcohol
Morphine sulphate should be used with caution in patients prescribed antidepressants, sedatives or major tranquilisers as they may potentiate the effects of respiratory and cardiovascular depressant effects of morphine.