Comparison of a once-a-day sustained-release morphine formulation with standard oral morphine treatment for cancer pain
Broomhead A, Kerr R, Tester W, O'Meara P,
Maccarrone C, Bowles R, Hodsman P.
F.H. Faulding & Co. Limited,
Adelaide, Australia.
J Pain Symptom Manage 1997 Aug;14(2):63-73


Kadian/Kapanol (K) is a capsule formulation of morphine designed for 12- or 24-hourly dosing. This double-blind study compared the efficacy and safety of K every 24 hr to K every 12 hr and MS Contin tablets (MSC) every 12 hr. One hundred fifty-two patients with cancer pain were titrated to adequate analgesia with immediate-release morphine (IRM) solution. Stabilized patients were randonized to one of the three treatments for 7 +/- 1 days. Rescue medication was IRM tablets. Efficacy and safety were assessed by time to first remedication and total dose of rescue medication, pain scores, global assessments, and incidence of morphine-related side effects. Fifty-four patients were treated with K every 24 hr. 45 with K every 12 hr. and 53 with MSC every 12 hr. Mean age was 61 years and mean total daily dose of morphine was 138 mg. Forty-six percent of the K every 24 hr patients, 51% of the K every 12 hr patients, and 55% of the MSC every 12 hr patients required rescue medication on the final day. Time to remedication was 16.0 hr for K every 24 hr, 9.1 hr for K every 12 hr and 8.7 hr for MSC every 12 hr (P = 0.0010). Patient global assessment significantly favored K every 24 hr over MSC every 12 hr (P = 0.018). There were no statistically significant differences among the treatments for any morphine-related side effects when adjusted for baseline. K had efficacy and safety profiles similar to MSC every 12 hr but had the advantage of 12- or 24-hourly administration.
Intravenous rush
Wilhelm Sertürner
Morphine: structure
Endogenous morphine
Fentanyl and ketamine
Morphine and serotonin
Is morphine a smart drug?
Opioids, mood and cognition
Oxycodone controlled-release
Is morphine an antidepressant?
Depression, opioids and the HPA
Methadone, morphine and heroin
Tolerance, sensitization and dependence
Opioids, depression and learned helplessness

and further reading

Future Opioids
BLTC Research
Utopian Surgery?
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World

The Good Drug Guide
The Good Drug Guide

The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family