Kadian

Kadian is a medication that can be prescribed to treat chronic moderate to severe pain. It is a long-acting drug that is meant to be taken on a schedule, rather than as needed. The capsules, which are taken once or twice a day, contain tiny extended-release pellets that release morphine slowly and evenly throughout the day. Potential side effects of Kadian include nausea, drowsiness, and constipation.

 

What Is Kadian?

Kadian® (morphine sulfate ER) is a long-acting prescription medication approved to treat moderate to severe pain when continuous, around-the-clock use of painkillers is necessary for an extended period of time. It is not approved for short-term or "as needed" (not around-the-clock) use. It is a narcotic and is classified as a controlled substance, which means that special laws and regulations control its sale and use.
 
(Click Kadian Uses for more information, including possible off-label uses.)
 

Who Makes Kadian?

Kadian is made by Actavis Elizabeth LLC and is marketed and distributed by Alpharma Pharmaceuticals LLC.
 

How Does It Work?

Kadian capsules contain tiny extended-release pellets that contain morphine. These pellets are specially designed to release the morphine evenly throughout the day, whether Kadian is taken once a day or twice a day.
 
Morphine is an opioid narcotic medication. It binds to opioid receptors throughout the body and produces a number of different effects. These effects include, but are not limited to:
 
  • Pain relief
  • Cough suppression
  • Unusual unpleasant feelings (dysphoria) or unusual pleasant feelings (euphoria)
  • Drowsiness
  • Decreased breathing (slow or shallow breathing)
  • Slowing of the digestive tract
  • Certain changes in the circulatory system
  • Release of histamine (which often causes itching)
  • Physical dependence.
     

Abuse Potential

Kadian contains morphine, a commonly abused drug. It is a good idea to keep this medication in a safe place, where it is unlikely to be stolen by others. Never let someone else take your medication. This medication provides a high dose of morphine that could easily result in death in someone who is not used to the medication. Also, it is very dangerous to inject this medication, as it contains inactive ingredients that can be quite harmful when injected into the bloodstream. Because Kadian is a highly desired drug of abuse, people try to obtain it through illegal means, such as from foreign countries or online sources that do not require a prescription. People who abuse Kadian and suddenly stop using it are likely to experience withdrawal symptoms.
 
For more information, visit the following eMedTV articles:
 

When and How to Take Kadian

General considerations include the following:
 
  • The medication comes in capsule form. It is taken by mouth, usually once or twice a day, around-the-clock. It is not meant to be taken "as needed" (at unscheduled times and only when needed for pain).
     
  • Never crush, chew, or dissolve the capsules, as this would release a dangerous amount of morphine. It is also dangerous to inject this medication, as it contains inactive ingredients that can cause damage when injected directly into the bloodstream.
     
  • Most people swallow the capsules whole. However, if you have difficulty swallowing, your healthcare provider may recommend taking it with applesauce. To do this, open the capsule and sprinkle the pellets on a small amount of room temperature (or colder) applesauce. Swallow the applesauce immediately and completely, without chewing. Rinse your mouth and swallow to make sure there are no pellets remaining in your mouth.
     
  • This medication can also be given in a stomach tube (a gastrostomy tube) but not in a gastric tube (that goes through the nose). Ask your healthcare provider for specific instructions for giving this medication through a stomach tube.
     
  • You can take the medication with food or on an empty stomach. If it bothers your stomach, try taking the capsules with food.
     
  • For the medication to work properly, it must be taken as prescribed. Do not increase your dose without your healthcare provider's approval. Do not suddenly stop taking Kadian, especially if you have taken it regularly for more than several weeks (see Kadian Withdrawal).
     

Dosing Information for Kadian

The dose of Kadian that your healthcare provider recommends will vary, depending on a number of factors, including:
 
  • The type and dose of other painkillers you have taken
  • The type and severity of your pain
  • How you respond to Kadian
  • Other medications you are taking
  • Other medical conditions you may have.
     
As is the case with any medication, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
 
(Click Kadian Dosage for more information.)
 

Side Effects of Kadian

As with any medicine, Kadian can cause side effects. However, not everyone who takes the drug will experience side effects. Most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
 
Common side effects of Kadian include, but are not limited to:
 
(Click Kadian Side Effects to learn more, including potentially serious side effects that you should report immediately to your healthcare provider.)
 

Drug Interactions With Kadian

Kadian can potentially interact with several other medicines (see Kadian Drug Interactions).
 

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Kadian if you have:
 
  • A history of drug or alcohol dependence
  • Gallbladder or pancreas disease
  • Liver disease, such as cirrhosis, liver failure, or hepatitis
  • Kidney disease, such as kidney failure (renal failure)
  • A head injury or high intracranial pressure
  • Severe abdominal (stomach) pain
  • Hypothyroidism
  • Asthma
  • Addison's disease
  • Low blood pressure (hypotension)
  • An enlarged prostate (benign prostatic hypertrophy, or BPH)
  • Lung disease of any sort
  • Seizures or epilepsy
  • Any allergies, including allergies to foods, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 
(Click Kadian Warnings and Precautions to learn more, including information on who should not take the drug.)
 

What If I Take an Overdose?

An overdose may be quite dangerous and can cause symptoms including:
 
  • Difficulty breathing (slow and shallow breathing)
  • Extreme drowsiness
  • Limp muscles
  • Cold, clammy skin
  • Small pupils
  • Fluid in the lungs
  • A slow heart rate (bradycardia)
  • Low blood pressure (hypotension)
  • Death.
     
If you happen to overdose on Kadian, seek immediate medical attention.
 
(Click Kadian Overdose for more information.)
 

Storage Methods

Kadian capsules should be stored at room temperature, away from moisture and heat. Keep this and all other medications out of the reach of children. Because Kadian is a highly desired drug of abuse, make sure to keep it in a safe place.
 

What Should I Do If I Miss a Dose?

If it is almost time for your next dose, it may be best to simply skip the missed dose and continue with your regular schedule. However, if it is still awhile until your next scheduled dose, it may be a good idea to take your missed dose as soon as possible in order to prevent excessive pain. However, you will then need to adjust your normal schedule for taking the medication, so that you do not take the next dose too soon. For instance, if you take Kadian once a day and take your missed dose at 10 a.m. instead of 6 a.m., you should take the medication at 10 a.m. from now on.
 

Strengths

Kadian capsules are available in the following strengths:
 
  • Kadian 10 mg
  • Kadian 20 mg
  • Kadian 30 mg
  • Kadian 50 mg
  • Kadian 60 mg
  • Kadian 80 mg
  • Kadian 100 mg
  • Kadian 200 mg.
     

Generic Availability

This medication is not available in generic form (see Generic Kadian).
 
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;