What is Roxanol?

Morphine sulfate, also known as Roxanol and "liquid morphine," is the gold standard in the treatment of pain and shortness of breath in end-of-life care. It’s a valuable tool for symptom management in the hospice setting.

So what is Roxanol? Well, let’s start with the basics of morphine. Morphine is a drug that hospice nurses are well-versed in, and it’s a safe and effective medication when given in appropriate doses. The doses should be administered at prescribed intervals, and increased slowly to address escalating pain. The medication can only be given by order of a primary care physician or the hospice medical director.

What is Roxanol?

Morphine sulfate, known under the brand name Roxanol, is a short-acting, immediate release, morphine in liquid form.

What is Roxanol Used For?

Roxanol is used in the hospice emergency kit and allows for pain to be more rapidly addressed in a crisis. Some patients shy away from using liquid morphine (and other opioid medications) because of a preconceived notion that it does more harm than good; that addiction is imminent. Here are some facts about liquid morphine sulfate, and how it can help hospice patients during their end-of-life care:

1. Administration: Morphine sulfate is available in tablet form. Roxanol is always a liquid form of immediate release morphine, used when the patient has difficulty swallowing.

2. Time: Onset is rapid so symptoms are managed more quickly. It can also be used in conjunction with a long-acting pain medication, MS Contin for example, to address any breakthrough pain that occurs between doses of a long-acting pain medication.

3. Dependency: It’s important to remember a patient may become dependent on medication for pain relief but dependence is not synonymous with addiction. A person can be dependent on Tylenol to relieve a headache but they are not addicted to the Tylenol and do not take it compulsively in the absence of a headache. A person in pain will rarely compulsively seek pain medication in the absence of pain.

4. Safety: Overdose with use of Roxanol should not be a concern when used exactly as prescribed by the physician. Morphine sulfate, in both its long-acting and immediate-acting forms, is a safe and effective medication in the management of pain. The hospice nurse will educate the patient and family regarding the correct dose, how frequently to give the medication, and the correct technique for safe administration.  Remember: the hospice nurse partners with the patient, family and under the direction of the physician in providing safe and effective pain management.

If you have questions about the use of Roxanol or about the care of hospice patients, please visit our hospice care tips and guides section to learn more. You can also give us a call at 888-564-3405.

Sally Mattingly Pharmacy Nurse Consultant RN CHPN Crossroads Hospice

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