Abstract
The rapid initial absorption and the subsequent prolonged absorption of morphine were obtained simultaneously by using sustained-release suppository (MA), which can be prepared simply by mixing sodium alginate with morphine hydrochloride in VOSCO® H-15 base, in rabbits. The clinical effects of MA were evaluated in patients with severe pain such as the terminal cancer patients. Of 35 patients receiving MA, 21 and 13 could achieve acceptable analgesia on a twice and a once daily dose schedule, respectively. Conventional morphine suppository without alginic acid, however, relieved pain only for 8 hours on the same single-dose. The efficacy of MA is also supported by the sustained plasma morphine level in six female operating patients receiving MA. The MA dosing interval lengthened to every 12 to 24 hours resulted in a decrease in the total daily morphine requirement below 40 mg, The clinically desirable sedation was obtained during night and day in all patients, and the side effects such as vomitting and constipation observed in 29 percent of the patients were mild and controlled by simptomatic treatment. The advantage of less frequent dosing by MA may lead to improvement of the quality of life of terminal patients with pain.
