Molecular structure of morphine
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Morphine (INN), the principal active agent in opium, is a powerful opioid analgesic drug. Like other opiates, morphine acts directly on the central nervous system (CNS) to relieve pain, and at synapses of the arcuate nucleus, in particular. Side effects include impairment of mental performance, euphoria, drowsiness, lethargy, and blurred vision. It also decreases hunger, inhibits the cough reflex, and produces constipation. Morphine is usually highly addictive, and tolerance and physical and psychological dependence develop quickly. more...

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Patients on morphine often report insomnia and nightmares.

The word derives from Morpheus, the god of dreams in Greek mythology.

Medical use

Administration

Morphine may be given parenterally as subcutaneous, intravenous, or epidural injections. The military sometimes issues morphine loaded in an autoinjector. Morphine can also be administered through a slow-release transdermal patch.

Orally, it comes as an elixir, concentrated solution, powder (for compounding) or in tablet form. Morphine is rarely supplied in suppository form. Due to its poor oral bioavailability, oral morphine is only one-sixth to one-third of the potency of parenteral morphine. Morphine is available in extended-release capsules for chronic administration, as well as immediate-release formulations.

Uses

Morphine is used legally:

  • analgesic in hospital settings for
    • Pain after surgery
    • Pain associated with trauma
  • In the relief of moderate to severe chronic pain
    • Cancer pain
    • Tooth extraction
  • As an adjunct to general anesthesia
  • In epidural anesthesia
  • For palliative care (i.e. to alleviate pain without curing the underlying reason for it)
  • As an antitussive for severe cough
  • As an antidiarrheal in chronic conditions (e.g., for diarrhea associated with AIDS)

Contraindications

  • Acute pancreatitis (this may be a result of morphine use as well)
  • Renal failure (due to accumulation of the metabolite morphine-6-glucuronide)

Pharmacology

Morphine is an opioid agonist whose main effect is binding to the µ-receptors in the central nervous system. This is thought to be the reason behind the analgesia, euphoria, physical dependence and respiratory depression. Morphine also binds with k-receptors, which are thought to mediate spinal analgesia, miosis and sedation.

Legal classification

  • In the United Kingdom, morphine is listed as a Class A drug under the Misuse of Drugs Act 1971.
  • In the United States, morphine is classified as a Schedule II drug under the Controlled Substances Act.
  • Internationally, morphine is a Schedule I drug under the Single Convention on Narcotic Drugs.

History

Morphine was first isolated in 1804 by the German pharmacist Friedrich Wilhelm Adam Sertürner, who named it "morphium" after Morpheus, the Greek god of dreams. But it was not until the development of the hypodermic needle (1853) that its use spread. It was used for pain relief, and as a "cure" for opium and alcohol addiction. Its extensive use during the American Civil War resulted in over 400,000 sufferers from the "soldier's disease" (addiction), though some believe this to be erroneous .

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AVINZA® Second Manufacturing Source Approved by FDA; Diversifies Supply Chain and Increases Production Capacity
From Business Wire, 8/18/05

SAN DIEGO -- Ligand Pharmaceuticals Incorporated (Nasdaq:LGNDE) announced today that the company has received approval from the FDA for the production of AVINZA(R) (morphine sulfate extended-release capsules) at the Cardinal Health (NYSE:CAH) facility located in Winchester, Kentucky. Ligand and Cardinal Health also have a productive, long-standing relationship for the finished-product production of Targretin(R) soft-gel capsules. AVINZA(R) is currently being manufactured for Ligand by Elan Corporation plc in its Gainesville, Georgia facilities.

Under the terms of an agreement announced in 2004, manufacturing of AVINZA will commence for a five-year term. Ligand has an option to extend for an additional two-year period. Financial terms of the contract were not disclosed.

"The FDA approval of the Cardinal Health facility for the manufacture of AVINZA(R) represents an important step toward realizing its full potential by providing us with a second source of supply to meet future patient demand. This significantly increases AVINZA production capacity and diversifies our supply chain, which we believe is necessary to fully support the long-term success of AVINZA," said Taylor Crouch, senior vice president, operations and president, international. "We are especially pleased with the rapid progress Ligand and Cardinal Health have jointly made on an accelerated time line to accomplish the technology transfer and facility approval. Cardinal Health has been a good manufacturing partner of Ligand, and we are pleased that this relationship now includes AVINZA. We expect to begin purchases under this agreement in early 2006 in addition to our current supplier."

About AVINZA

AVINZA (oral morphine sulfate extended-release capsules) is the first true once-a-day treatment for chronic moderate-to-severe pain in patients who require continuous, around-the-clock opioid therapy for an extended period of time. Approved by the FDA in March 2002, AVINZA consists of two components: an immediate-release component that rapidly achieves plateau morphine concentrations in plasma, and an extended-release component that maintains plasma concentrations throughout a 24-hour dosing interval. Ligand co-promotes AVINZA with Organon Pharmaceuticals USA Inc. in the United States. www.organonusa.com.

About Ligand

Ligand discovers, develops and markets new drugs that address critical unmet medical needs of patients in the areas of cancer, pain, skin diseases, men's and women's hormone-related diseases, osteoporosis, metabolic disorders, and cardiovascular and inflammatory diseases. Ligand's proprietary drug discovery and development programs are based on its leadership position in gene transcription technology, primarily related to Intracellular Receptors (IRs). For more information, go to www.ligand.com.

Caution Regarding Forward-Looking Statements

This news release contains certain forward-looking statements by Ligand that involve risks and uncertainties and reflect the company's judgment as of the date of this release. These statements include commencement of manufacturing, manufacturing capacity, diversity of supply chain, term of the agreement, options to extend the agreement, AVINZA sales, supply and success potential and purchase of products. Actual events or results may differ from Ligand's expectations. There can be no assurance that AVINZA will reach its potential or expectations, that manufacturing at the new site will be continuous or successful, that the agreement will continue for any particular time period, that supply will be diversified, that purchases will be made or fulfilled, or that our suppliers will be able to deliver products adequately and reliably in the future. Additional information concerning these and other risk factors affecting Ligand's business can be found in prior press releases as well as in the company's public periodic filings with the Securities and Exchange Commission, which are available via www.ligand.com. Ligand disclaims any intent or obligation to update these forward-looking statements beyond the date of this release. This caution is made under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995.

COPYRIGHT 2005 Business Wire
COPYRIGHT 2005 Gale Group

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