What exactly is MS Contin?

Thankfully this is the last day with this dose of oxy. While it works great the dose needs to be changed to reflect the tolerance I have developed. My only concern now is that while I will be starting a new med for the pain there is the chance of the physical withdrawal symptoms from oxy. Slim chance, but I have such crappy luck...

Since I am switching the meds tomorrow, I thought I would put up a little more information on what exactly is MS Contin. Interestingly when I popped the lid on the bottle they are little capsules which is not at all what I was expecting for a time release pill. The capsule is made from what I can only guess is some form of gelatin but once that hits the acids in your digestive tract I would have thought your body would absorb all the medication. Curiosity got the best of me so I had to look this one up to see how they prevent that from happening. It seems that the capsule itself is irrelevant and that the medication inside it is what is time released. Pretty cool or at least I thought so, but that's the chemistry geek in me.

I did some searching and found what appears to be the answer in this patent application. It is a bit boring of a read but it does make an interesting point on the fact that if you suffer from decreased digestive function, that is something that could hamper the drugs ability to properly dose you resulting in a lack of pain relief for some people.

[0008] For solving these problems, sustained release preparations of morphine have been developed, including MS CONTIN tablet (trade name by Shionogi & Co. Ltd.) and capsules and sticks of KADIAN (trade name by Faulding Co.) which are prepared by matrix formation with a water-insoluble polymer compound or by film coating. MS Contin tablets are film-coated tablets of about 7.1 mm in diameter and about 4.4 mm in thickness, prepared by coating with a higher alcohol film the granules where morphine sulfate is formed into matrix with a gel-forming polymer compound such as hydroxyethylcellulose. MS Contin tablets are sustained release tablets as the basic unit designed so that morphine in the tablet is released gradually by water that has penetrated through the higher alcohol film into the tablet to maintain the analgesic effect by twice-a-day administration. However, oral administration is difficult in some cases and fine adjustment of the dose is impossible because one tablet is the basic unit of the sustained release. In addition, because the tablets, when broken, lose their sustained releaseability, much morphine may be released at a time when the patient has crunched the tablet in the mouth, so that the blood concentration may be increased rapidly to cause serious adverse reactions such as dyspnea and disturbance of consciousness. KADIAN is a preparation of which units are sustained release pellets (particles) of 1.0 to 1.7 mm in average particle size. These sustained release pellets are filled in hard capsules to prepare KADIAN capsules (No.2 or No.4 capsules), or divided and packaged to prepare KADIAN sticks. The mechanism of sustained release of KADIAN is pH-dependent control of release of morphine by the coating of the hybrid type consisting of a water-insoluble polymer compound, an acid-soluble polymer compound, and an enteric polymer compound. However, in patients with decreased digestive function, sustained release of the type that is dependent on the pH in the digestive tract may not be effective enough. Furthermore, there are some additional disadvantages in respect of easiness of administration, such as bulkiness of preparations with high content of morphine, and being unable to be prescribed in the form of a suspension, paste, or syrup by addition of an adequate amount of water, an aqueous solution etc. before administration.

Some information on morphine (MS Contin) from the D.E.A's website.

Morphine

Morphine is the principal constituent of opium and can range in concentration from 4 to 21 percent. Commercial opium is standardized to contain 10-percent morphine. In the United States, a small percentage of the morphine obtained from opium is used directly (about 15 tons): the remaining is converted to codeine and other derivatives (about 120 tons). Morphine is one of the most effective drugs known for the relief of severe pain and remains the standard against which new analgesics are measured. Like most narcotics, the use of morphine has increased significantly in recent years. Since 1990, there has been about a 3-fold increase in morphine products in the United States.

Morphine is marketed under generic and brand name products including "MS-Contin®," Oramorph SR®," MSIR®," Roxanol®," Kadian®," and RMS®." Morphine is used parenterally (by injection) for preoperative sedation, as a supplement to anesthesia, and for analgesia. It is the drug of choice for relieving pain of myocardial infarction and for its cardiovascular effects in the treatment of acute pulmonary edema. Traditionally; morphine was almost exclusively used by injection. Today, morphine is marketed in a variety of forms, including oral solutions, immediate and sustained-release tablets and capsules, suppositories, and injectable preparations. In addition, the availability of high-concentration morphine preparations (i.e., 20-mg/ml oral solutions, 25-mg/ml injectable solutions, and 200-mg sustained-release tablets) partially reflects the use of this substance for chronic pain management in opiate-tolerant patients.