Hello,

We had a request from palliative care to compound morphine gel. We wanted to see how other hospitals operationalize it. Would love to see some suggestions on the following:
- How to dispense it? Some use small jars, others use blister packs?
- What directions are provided to nurses as to how much to apply to the wound?
- How to discard any extra amount that is left? Does anyone use CsRx to dispose of the unused amount?
Any help is appreciated.
Thank you
Viktoriya

Our institution currently makes a morphine PF 0.5 mg/ml from the parenteral product. However, I am used to using the 0.4 mg/ml concentration and would like to change to this (as well as being aligned with ASHP).

I realize there is an oral recipe diluting the commercially available Morphine 2 mg/ml oral solution. However, this product has sodium benzoate and sorbitol which is not recommended for use in pediatric and neonatal patients (if possible). Hence, why I am looking for a recipe for using the parenteral product.

Does anyone have electronic or other tools in place to help prevent ADRs associated with morphine use in patients with severe renal dysfunction? I'm thinking maybe focused alerts for ER formulations, opioid-native patients, high doses, and/or patients who are receiving frequent prn doses?  There's no specific manufacturer recommendations, but Lexicomp provides some general guidance on dosing, etc.  

Thanks!