Controlled-release morphine tablets in patients with chronic cancer pain

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Abstract
BACKGROUND Controlled‐release (CR) morphine tablets have become routine therapy in the management of cancer pain. Compared with immediate‐release (IR) morphine, this formulation provides the benefit of dosing every 12 hours. METHODS This study reviewed the 10 published, well controlled, repeated‐dose, comparative studies with CR morphine tablets administered every 12 hours to patients with cancer pain. RESULTS CR morphine tablets were uniformly effective; 98% of patients completed a treatment course of every‐12‐hours therapy. Although the effective analgesic dose varied considerably from study to study (range, 90‐330 mg per day), pain was well controlled with CR morphine tablets as the primary analgesic. Mean pain scores, converted to a common 10‐point scale, ranged from 1.1‐2.9 across all studies. There was only occasional need for IR morphine rescue medication (range, 2‐39 mg per day). The mean discontinuation rate because of side effects or lack of every‐12‐hours efficacy was 2%. In seven studies that used IR morphine as the comparative agent, CR morphine tablets were found to be equally effective as IR morphine. CONCLUSIONS Twice‐daily dosing of CR morphine provides convenient, safe, and effective relief of cancer pain. Cancer 1998;82:2299‐2306. © 1998 American Cancer Society.