MST CONTINUS TABLET 10 MG [SIN05506P]

Product Info

MST CONTINUS TABLET 10 MG

[SIN05506P]

Therapeutic indications

Prolonged relief of severe pain

Posology and method of administration

Route of administration: oral

MST CONTINUS® tablets should be swallowed whole and not broken, chewed or crushed. The administration of broken, chewed or crushed tablets may lead to a rapid release and absorption of a potentially fatal dose of morphine (refer to Overdose – please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information).

MST CONTINUS® tablets should be used at 12-hourly intervals. The dosage is dependent upon the severity of the pain, the patient's age and previous history of analgesic requirements.

Adults:
A patient presenting with severe pain should normally be started on 1–2 MST CONTINUS® tablets 10mg 12 hourly. Patients previously on normal release oral morphine should be given the same total daily dose as MST CONTINUS® tablets but in divided doses at 12-hourly intervals.

Increasing severity of pain will require an increased dosage of the tablets. Higher doses should be made, where possible in 25–50% increments as required.

Patients receiving MST CONTINUS® tablets in place of parenteral morphine should be given a sufficiently increased dosage to compensate for any reduction in analgesic effects associated with oral administration. Usually such increased requirement is of the order of 50–100%. In such patients individual dose adjustments are required.

Post-operative pain

MST CONTINUS® tablets are not recommended in the first 24 hours post-operatively or until normal bowel function has returned; thereafter it is suggested that the following dosage schedule be observed at the physician's discretion:

1. MST CONTINUS® tablets 20 mg 12 hourly to patients under 70 kg

2. MST CONTINUS® tablets 30 mg 12 hourly to patients over 70 kg

3. Elderly – a reduction in dosage may be advisable in the elderly

4. Children – not recommended

Supplemental parenteral morphine may be given if required but with careful attention to the total dosages of morphine, and bearing in mind the prolonged effects of morphine in this prolonged release formulation.

Treatment goals and discontinuation

Before initiating treatment with MST CONTINUS® tablets, a treatment strategy including treatment duration and treatment goals, and a plan for end of the treatment, should be agreed together with the patient, in accordance with pain management guidelines. During treatment, there should be frequent contact between the physician and the patient to evaluate the need for continued treatment, consider discontinuation and to adjust dosages if needed. When a patient no longer requires therapy with MST CONTINUS® tablets, it may be advisable to taper the dose gradually to prevent symptoms of withdrawal. In absence of adequate pain control, the possibility of hyperalgesia, tolerance and progression of underlying disease should be considered (see Special warnings and precautions for use – please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information).

Duration of treatment

MST CONTINUS® tablets should not be used longer than necessary.

Discontinuation of Therapy

An abstinence syndrome may be precipitated if opioid administration is suddenly discontinued. Therefore, the dose should be gradually reduced prior to discontinuation.

Contraindications

Hypersensitivity to the active substance or to any of the constituents listed in list of excipients – please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information.
Severe respiratory depression with hypoxia and/or hypercapnia, severe bronchial asthma, head injury, paralytic ileus, biliary cholic, acute abdomen, delayed gastric emptying, severe chronic obstructive pulmonary disease, cardiac arrhyrhmias, known morphine sensitivity, acute hepatic disease, concurrent administration of monoamine oxidase inhibitors or within two weeks of discontinuation of their use.

MST CONTINUS® Tablets are not recommended for paediatric use and in pregnancy. Pre-operative administration of MST CONTINUS® Tablets is not recommended and is not an approved indication.
MST CONTINUS® Tablets are also not recommended for use within the first 24 hours post-operatively.