Written by Rajwant Minhas, Medication Safety Pharmacist, Pharmacy

On May 9, 2018, a new morphine long-acting medication, KADIAN, will be available for prescribers to give to their patients for opioid use disorder or severe chronic pain relief.

"Something felt wrong as I approached my patient. I noticed she was drowsy with a respiratory rate of eight breaths per minute. I quickly gave her a dose of naloxone. What happened? She had never reacted to KADIAN, morphine long acting medication, before.

I reviewed her Medication Administration Record. I had accidentally given my patient M-ESLON, 100 mg for two days. As KADIAN is released over 24 hours instead of 12 hours as it is for M-ESLON, I had given my patient double the morphine dose, putting her at risk of an overdose. Slowing down and following the Seven Rights of Medication Safety (right medication, right client, right dose, right time, right route, right reason and right documentation) would have prevented my error."

On May 9, 2018, a new morphine long-acting capsule - KADIAN - will be available for prescribers to give to their patients. The key differences between M-ESLON and KADIAN are:

Released over 12 hours 24 hours
Formulary indication(s) Pain management Opioid use disorder
and pain management
Available strengths 10 mg, 15 mg, 30 mg, 60 mg, 100 mg, 200 mg 10 mg, 20 mg, 50 mg, 100 mg

Please note:

  • 10 mg and 100 mg are overlapping strengths
  • KADIAN cannot be substituted with other morphine long-acting capsules such as
    M-ESLON. Be careful not to select a medication based on the administration frequency of the order because KADIAN can be prescribed for a patient every 24, 12 or even 8 hours. Similarly, M-ESLON can be prescribed every 24 hours.
  • Prescribers must specify the medication’s brand name when ordering morphine long-acting; otherwise, they will be contacted for clarification for the intended medication.

For further information please contact our medication safety pharmacist (rajwant.minhas@fraserhealth.ca) or clinical practice consultant (jenny.misar@fraserhealth.ca).

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