The goal of this clinical trial is to test a treatment strategy for individuals with opioid use disorder (OUD) who use fentanyl. Participants will receive medically-administered doses of intravenous (IV) fentanyl at intervals until they are comfortable and do not have withdrawal symptoms. They then will be given opioid agonist therapy (OAT) once daily by mouth, which is the current standard treatment for OUD. In this trial, each participant's starting dose of OAT will be tailored to meet their opioid needs, based on the amount of IV fentanyl they received.
The main questions this trial aims to answer are:
Is the IV fentanyl protocol feasible and safe for use in a community clinic setting?
Will the protocol result in higher-than-standard starting doses of OAT? Are these doses safe, and will they enable participants to stay on OAT for a longer time?

Start Date29 Jan 2024

Sponsor / Collaborator-

IRCT20210415050976N13 / RecruitingPhase 1/2IIT

comparison of post-operative pain during 2 weeks after rotator cuff repair surgery between patients received interscalene block alone and patients received interscalene block and intravenous morphin

Start Date08 Jan 2024

Sponsor / Collaborator

Jahrom University

NCT06172920 / Not yet recruitingPhase 4IIT

Comparison of the Analgesic Effects of Tramadol, Pethidine and Morphine Under Erector Spinae Plane (ESP) Block in the Treatment of Pain After Elective Thoracic Surgery

Comparison of analgesic effects of tramadol, aldolan and morphine under thoracic surgery

Start Date31 Dec 2023

Sponsor / Collaborator

Baskent University

100 Clinical Results associated with Morphine Hydrochloride Hydrate

100 Translational Medicine associated with Morphine Hydrochloride Hydrate

100 Patents (Medical) associated with Morphine Hydrochloride Hydrate

400

Literatures (Medical) associated with Morphine Hydrochloride Hydrate

01 Feb 2024·Acta neurologica Belgica

High doses of opioids usage for amyotrophic lateral sclerosis patients with non-invasive ventilation

Article

Author: Shimizu, Toshio ; Nakayama, Yuki ; Morishima, Ryo ; Saotome, Takako ; Kimura, Hideki ; Takahashi, Kazushi ; Bokuda, Kota

INTRODUCTION:

While opioids have been found to be useful in relieving suffering in amyotrophic lateral sclerosis (ALS), there is a lack of evidence concerning how and how much to use them in practice. This study was conducted to clarify how opioids were used for patients with ALS.

METHODS:

We performed a retrospective case-based analysis at a single tertiary neurology center in Tokyo from 2010 to 2018. We enrolled patients with ALS who had died before the end of 2018. We examined the opioid dosage equivalent of morphine hydrochloride and patients' clinical backgrounds, focusing on ventilatory support.

RESULTS:

Morphine was administered in 110 patients with ALS, and 84 were followed up until their death. Of these 84 patients, 57 (69.9%) did not use mechanical ventilation until death (no-MV group), and 21 (22.9%) utilized only non-invasive ventilation (NIV group). Final morphine dosage in the NIV group was significantly higher (mean 65.7 mg [SD 54.6], range 10-200 mg) than in the no-MV group (mean 31.7 mg [SD 26.9], range 0-120 mg; p = 0.015, Welch's t-test). The NIV group needed psychotropic drugs more frequently than the no-MV group (62% [n = 13] vs. 35% [n = 20]).

CONCLUSION:

Patients in the NIV group used opioids for a statistically significantly longer time and at a higher dose than those in the no-MV group. Symptom control with opioids alone may be difficult, and the development of multifaceted evaluation and care is desirable.

01 Mar 2024·World neurosurgery

Efficacy of Paravertebral Injection of Interferon-α2b Combined with High-Voltage, Long-Term Pulsed Radiofrequency in DRG in Mitigation of Postherpetic Neuralgia: A Retrospective Study

Article

Author: Pan, Jie ; Huang, Bing ; Fei, Yong ; Liu, Beibei ; Yao, Ming ; Xu, Longsheng

OBJECTIVE:

This investigation aims to evaluate the effectiveness of the paravertebral injection of recombinant human interferon-α2b in conjunction with high-voltage, long-term, pulsed radiofrequency (PRF) in the dorsal root ganglion for the mitigation of postherpetic neuralgia (PHN).

METHODS:

This retrospective study included 84 individuals with acute PHN. The participants were divided into 3 groups. Group H was treated with interferon-α2b combined with high-voltage long-term PRF. Group C was treated with a combination of high-voltage, long-term PRF and a paravertebral injection (without recombinant human interferon-α2b), and group I was treated with interferon-α2b only. All the patients in the 3 groups were orally administered a 5-mg morphine hydrochloride quick-release tablet when a burst of pain occurred during treatment. The numerical rating scale for pain score, the interleukin-6 and galectin-3 levels, and the incidence of PHN were documented before and after therapy.

RESULTS:

The pain intensity of all individuals decreased after therapy. Compared with group C, the numerical rating scale scores for group H were significantly reduced at 4, 8, and 12 weeks following therapy, and the PHN incidence was significantly lower. Compared with prior treatment, the recommended dosage of gabapentin capsules and immediate-release morphine hydrochloride tablets was reduced for group H. Compared with group C, the requirement for orally administrated gabapentin capsules and morphine hydrochloride tablets in group H was reduced significantly after treatment. No serious adverse reactions occurred in any of the 3 groups.

CONCLUSIONS:

Within the context of treatment of acute PHN, the injection of interferon-α2b in conjunction with high-voltage, long-term application of PRF is more effective than PRF or the injection of interferon-α2b alone.

10 Oct 2023·Medicina (Kaunas, Lithuania)

Tapentadol Immediate Release (IR) versus Morphine Hydrochloride for Postoperative Analgesia of Patients Undergoing Total Abdominal Hysterectomy-A Prospective Cohort Study.

Article

Author: Bojanić-Popovicki, Milica ; Golijanin, Danica ; Tomas Petrović, Ana ; El Farra, Suzana ; Škorić-Jokić, Svetlana ; Mihalek, Nora ; Dugandžija, Tihomir ; Starčević, Sanja ; Radovanović, Dragana

Background and Objectives: This study aimed to examine the efficacy of tapentadol immediate release (IR) and morphine hydrochloride in the treatment of acute postoperative pain after total abdominal hysterectomy, as well as to examine the frequency of opioid-related side effects in observed patients. Materials and Methods: The prospective observational study was conducted over five months, and it included a total number of 100 patients. The two cohorts had different types of postoperative analgesia, and the effects were observed for 24 h postoperatively, by following the pain scores on NRS (Numerical Pain Scale), contentment with analgesia, and opioid-related side effects. Results: Statistical significance was found when assessing pain 24 h after surgery while coughing, where patients in the tapentadol IR group had significantly higher mean pain scores (p < 0.01). The subjective feeling of satisfaction with postoperative analgesia was statistically significant in the tapentadol IR group (p = 0.005). Vertigo appeared significantly more in patients from the morphine group (p = 0.03). Conclusions: Tapentadol IR (immediate release) and morphine hydrochloride are both effective analgesics used in the first 24 h after total transabdominal hysterectomy. Overall satisfaction of patients with analgesia was good. The frequency of side effects was higher in the morphine group, with statistical significance regarding the vertigo.

News (Medical) associated with Morphine Hydrochloride Hydrate

03 Jan 2023

·www.biospace.com

Wex Pharmaceuticals Inc. Enrolls the First Patient in The Phase 2b Clinical Trial Evaluating the Efficacy and Safety of Halneuron(R) In the Treatment of Chemotherapy-Induced Neuropathic Pain

VANCOUVER, BC / ACCESSWIRE / January 3, 2023 / WEX Pharmaceuticals Inc. ("WEX" or the "Company"), a biotechnology company developing Halneuron® (Tetrodotoxin or TTX) for pain, announced that the first patient has been dosed in its Phase 2B clinical trial evaluating the efficacy and safety of Tetrodotoxin in the treatment of Chemotherapy-Induced Neuropathic Pain (the "Clinical Trial"). The Clinical Trial is a randomized, double-blind, placebo-controlled, multinational, multicenter study evaluating the efficacy and safety of Halneuron® in 222 patients with moderate-to-severe Chemotherapy-Induced Neuropathic Pain ("CINP"). Patients will be randomized to receive either Halneuron or a placebo in addition to any concomitant medication they are taking for their CINP. The primary objective will be to determine the duration of pain relief experienced with Halneuron as measured by a Numeric Pain Response Scale (NPRS). Secondary objectives include determining the efficacy of TTX compared to placebo in the improvement of quality of life for subjects and determining the safety of TTX compared to placebo in subjects with CINP. WEX recently announced it had received authorizations from the regulatory authorities of China, Singapore, Taiwan, Korea, USA, and Canada to conduct the Clinical Trial in these countries. Mr. Walter Korz, Chief Operating Officer of WEX stated, "We continually receive feedback from key pain opinion leaders and physicians that new non-opioid pain therapies are needed and dosing the first patient in the Clinical Trial is a vital step towards the evaluation of TTX for the treatment of CINP. We look forward to the Clinical Trial's continued advancement." This is the first time Halneuron® will be evaluated in an Asian patient population outside China, and WEX expects the Clinical Trial will provide additional information towards the conduct of the Phase 3 CINP clinical trial being planned. About Halneuron® Halneuron® (TTX, Tetrodotoxin), a selective sodium channel blocker, produces analgesia either by decreasing the propagation of action potentials by sodium channels and/or by blocking ectopic discharges associated with chronic pain. Halneuron® is an injectable formulation of Tetrodotoxin, a novel small molecule with action exclusively on the peripheral nervous system. Halneuron does not cross the blood-brain barrier and therefore is without the common side effects of euphoria, addiction, tolerance, sedation, and confusion experienced by opioids and other analgesics. Pharmacology studies revealed that TTX is a more potent analgesic than standard analgesic agents such as aspirin, morphine, or meperidine, with potential applications in many moderate to severe neuropathic pain conditions. About WEX Pharmaceuticals Inc. WEX Pharmaceuticals Inc. is a late-stage drug development company dedicated to the development, manufacture, and commercialization of innovative drug products to treat pain. WEX is a leader in research in the field of sodium channel blockers and has programs in various stages of development based on the Halneuron® platform. WEX has conducted late-stage multinational clinical trials in cancer pain and chemotherapy-induced neuropathic pain. WEX is a wholly owned subsidiary of CK Life Sciences Int'l., (Holdings) Inc. ("CKLS"). CKLS is engaged in the business of research and development, manufacturing, commercialization, marketing, sale of, and investment in products and assets which fall into three core categories - nutraceuticals, pharmaceuticals and agriculture-related. CKLS is a member of the CK Hutchison Group. For additional information, please visit . This news release contains forward-looking statements within the meaning of the U.S. Private Securities Litigation Reform Act of 1995 and applicable Canadian securities laws, including statements regarding the objectives and potential results of the Clinical Trial, the planned Phase 3 CINP clinical trial and the safety and therapeutic utility of Halneuron® as a peripheral-acting, non-opioid analgesic. Statements in this document regarding future expectations, beliefs, goals, plans, or prospects constitute forward-looking statements that involve risks and uncertainties, which may cause actual results to differ materially from the statements made. For this purpose, any statements that are contained herein that are not statements of historical fact may be deemed to be forward-looking statements. Without limiting the foregoing, the words "believes", "anticipates", "plans", "intends", "will", "should", "expects", "projects", "reduces," "affirms", "acceptable", "accepts", "establishes", "continued advancement", and similar expressions are intended to identify forward-looking statements. You are cautioned that such statements are subject to a multitude of risks and uncertainties that could cause actual results, future circumstances, or events to differ materially from those projected in the forward-looking statements. These risks include, but are not limited to: those associated with the success of research and development programs, the Company's ability to raise additional funding and the potential dilutive effects thereof, the regulatory approval process, competition, securing and maintaining corporate alliances, market acceptance of the Company's products, the availability of government and insurance reimbursements for the Company's products, the strength of intellectual property, reliance on subcontractors and key personnel and other risks detailed from time-to-time in the Company's public disclosure documents and other filings with the U.S. Securities and Exchange Commission and Canadian securities regulatory authorities. Forward-looking statements are developed based on assumptions about such risks, uncertainties and other factors, including, but not limited to: obtaining positive results of clinical trials, obtaining regulatory approvals, TTX is a more potent analgesic than standard analgesics, safety of product, effectiveness of drug, general business and economic conditions, the Company's ability to successfully develop and commercialize new products, the assumption that the Company's current good relationships with third parties will be maintained, the availability of financing on reasonable terms, the Company's ability to attract and retain skilled staff, market competition, the products and technology offered by the Company's competitors, no known competing drugs specifically for CINP, and the Company's ability to protect patents and proprietary rights. Forward-looking statements are made as of the date hereof, and the Company disclaims any intention and has no obligation or responsibility, except as required by law, to update or revise any forward-looking statements, whether as a result of new information, future events, or otherwise. For further information contact: WEX Pharmaceuticals Inc. Mr. Walter Korz Chief Operating Officer Phone: (604) 683-8880 Fax: (604) 683-8868 E-mail: wex@wexpharma.com Internet: SOURCE: WEX Pharmaceuticals Inc. View source version on accesswire.com:

Phase 2Phase 3

22 Dec 2022

·www.sciencedaily.com

Treating gut pain via a Nobel prize-winning receptor

Targeting a receptor responsible for our sense of touch and temperature, which researchers have now found to be present in our colon, could provide a new avenue for treating chronic pain associated with gastrointestinal disorders such as irritable bowel syndrome. A team examining the colon identified the presence of Piezo2, the subject of the 2021 Nobel Prize in Physiology or Medicine, now known to be responsible for sensing light touch on our skin. Targeting a receptor responsible for our sense of touch and temperature, which researchers have now found to be present in our colon, could provide a new avenue for treating chronic pain associated with gastrointestinal disorders such as irritable bowel syndrome. A team examining the colon, led by Professor Hongzhen Hu at Washington University and Professor Nick Spencer at Flinders University, identified the presence of Piezo2, the subject of the 2021 Nobel Prize in Physiology or Medicine, now known to be responsible for sensing light touch on our skin. "In discovering that this receptor is also in our gut, there's the potential that selectively targeting these channels could be used for long-term silencing of pain sensations from internal organs, without the need for frequent consumption of opiate pain medications," says Professor Spencer, a Matthew Flinders Professor in the College of Medicine and Public Health. Professor Nick Spencer said, "Chronic pain from internal organs, such as the gut or bladder, is notoriously difficult to treat. Opiates, including morphine and their derivates have been commonly used to treat a variety of types of pain but visceral pain doesn't respond well to the treatment and the drugs are highly addictive with a multitude of side effects." The authors say the availability of selective pain medications for the gut has been hindered by a lack of understanding about how sensory nerves communicate pain sensations from the gut to the brain. "It was previously known that many different ion channels are located on the 'pain-sensing' neurons that communicate from the gut to the brain, but our study, published in the journal Neuron, has now identified the major ion channel in the colon that responds to mechanical stimulation leading to the sensation of pain," says Professor Spencer. "Furthermore, we have discovered that the major ion channel that responds to this mechanical pain is a member of the Piezo ion channel, specifically Piezo2. "From this knowledge we can focus on targeting these channels to silence the pain sensations and hopefully produce a treatment for visceral pain, common in conditions such as irritable bowel syndrome, endometriosis or abdominal cancers, while avoiding the devastating side effects of opioids." The research was funded by grants from the US National Institutes of Health and the National Health and Medical Research Foundation.

21 Dec 2022

·medcitynews.com

ISO: What You Need To Know About The Deadly New Drug

One of the most dangerous and deadly drugs to ever hit the market could be hiding in plain sight, and if we don’t take swift action, we could be facing another devasting wave of overdose deaths among unsuspecting users. It’s called ISO, short for isotonitazine, a deadly synthetic opioid that is 100X to 1000X stronger than morphine and 20X more potent than fentanyl. As of this writing, it’s been detected in at least 180 deceased individuals who likely died from ISO overdose in 18 states around the country. However, it’s widely assumed this number is grossly underestimated because most standard toxicology screenings don’t yet include ISO detection. There could be countless more deaths miscategorized as non-opioid related, simply because the coroner didn’t know or have the means to test for ISO. ISO: The facts What makes ISO so dangerous, aside from its extreme potency? ISO can be present in powder, tablet or solution form and can be snorted, injected and inhaled by smoking or vaporizing. Like fentanyl, ISO is often mixed into other drugs like heroin or even counterfeit Xanax pills, so users have absolutely no idea they’re ingesting it. That means a casual or experimental user might show up at a party, take a Xanax that’s offered to them just to relax and have a good time, and end up in the ER fighting for their life. Because no one is aware the ISO was present, bystanders may be ill-equipped to respond. Narcan can counteract the effects of ISO, but because ISO is still so new, there is no currently established protocol for dosing. Even first responders may not know exactly how to treat ISO overdose, or worse, may not be able to respond quickly enough or have enough Narcan on hand to reverse ISO’s immediate and deadly effects. A deadly concoction For those unfamiliar with the drug trade, you might be wondering why illicit drug manufacturers would lace their product with something so deadly? Wouldn’t they want to keep their customers alive? The answer is poor or careless compounding. ISO belongs to a family of synthetic opioids investigated as potential analgesics in the 1950s, but ISO was determined to have no clinical value. Authorities believe this most recent formulation was produced by a Chinese vendor in anticipation of a fentanyl production ban. So, while ISO itself is created by highly skilled chemists, those who are mixing it into the end product aren’t likely as sophisticated. The goal of blending ISO (or fentanyl, for that matter) is to increase the effect of the primary drug and to deliver a better high or to enhance its addictive properties to keep users coming back for more. But because dealers are more concerned with profits than quality, their products get cut and blended with other substances. And because it takes such a miniscule amount of ISO to have devastating effects, imperfect blending can lead to deadly results. This is compounded by the fact that the user may have never ingested ISO before, so they have zero tolerance, making an overdose even more likely. Tighter controls led to unintended consequences But how do drugs like ISO even become desirable? Simply put, through the law of supply and demand. Few would argue that clamping down on opioid prescriptions was a necessary step toward reducing the plague of opioid addiction. But tighter opioid controls have actually had devastating unintended consequences, as opioid-addicted individuals turned to other drugs. This shift paved the way for more dangerous drugs like heroin, fentanyl and ISO to fill the void, driving an unprecedented overdose death rate that, tragically, shows no signs of slowing down. The path forward It is impossible to avoid what can’t be seen. There is no identifiable way to determine whether or not a drug has been adulterated with ISO, or any other substance for that matter. As a result, counterfeit Adderall, Xanax, oxycodone and others are becoming less and less likely to be the particular substance that is advertised. Taking a pill of any kind that was given and not prescribed is a lethal gamble. Unfortunately, these stories are becoming more and more commonplace. The best way to reduce the adverse effects of a substance many may not know about, let alone be able to detect, would be to stay away from it completely. In our haste to save lives, we may have oversimplified the issue by trying to solve a very complex problem with a single-point solution: cutting off access to the drug. In hindsight—and in real-time—there’s much more that needs to be done to curb the epidemic of addiction in our country.

100 Deals associated with Morphine Hydrochloride Hydrate

External Link

KEGG	Wiki	ATC	Drug Bank
D02271	Morphine Hydrochloride Hydrate	N02AA01	DB00295

R&D Status

Approved

10 top approved records.

to view more data

Indication	Country/Location	Organization	Date
Anesthesia	JP	Sumitomo Pharma Co., Ltd.	01 Dec 1991
Cough	JP	Sumitomo Pharma Co., Ltd.	01 Dec 1991
Diarrhea	JP	Sumitomo Pharma Co., Ltd.	01 Dec 1991
Cancer Pain	JP	Sumitomo Pharma Co., Ltd.	01 Dec 1991

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Chronic Pain	Phase 1	CN	Southwest Pharmaceutical Group Co. Ltd.	09 Aug 2022

Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


DRKS00010712 (SROMOS study, Pubmed \| J Subst Abuse Treat)	Not Applicable	opioid dependence methadone	180	Slow-release oral morphine (SROM)	scpcrcbibl(uciujgdalw) = significantly decreased xkjvzomsni (dfkakxxykg ) View more	-	01 Aug 2021
NCT02990910 (CTgov)	Not Applicable	Analgesia	280	Individualized opioid analgesia (Individualized Opioid Analgesia)	ltidccwcur(wcbyvpuqon) = ljomqwkspx premowmwoi (zrgnhvuccg, kuafybvuon - jfieahymtu) View more	-	09 Aug 2017
				conventional opioid analgesia (Conventional Opioid Analgesia)	ltidccwcur(wcbyvpuqon) = qiputddmmg premowmwoi (zrgnhvuccg, zvtmefadzs - qscahdeoqq) View more
NCT02046772 (CTgov)	Phase 4	Hemorrhoids	63	Morphine Chloride+Bupivacaine low dose (Bupivacaine + Morphine Chloride)	ergbjztyha(ecoimeyepj) = bnhsowpncj rnfpiucgth (jxquirjgss, zsryeocuca - jxsrdgewmg) View more	-	01 Sep 2014
				Bupivacaine standard dose (Bupivacaine Standard Dose)	ergbjztyha(ecoimeyepj) = klbmnljfzp rnfpiucgth (jxquirjgss, jbvjeskytw - frkbaxfunl) View more
Pubmed \| Clinics (Sao Paulo)	Not Applicable	-	-	Intrathecal Morphine	xwftijelha(erbzbvirqc) = xjdrnhqlao pvfesozbpo (girupommkh )	Positive	01 Apr 2009
NCT00803114 (CTgov)	Phase 4	Pain	228	Preservative-free epidural morphine (Epidural Morphine)	jidfuzrems(ckdywjidjm) = tmipjnfxyi pegaudjvpc (uzjthzhzrz, rppbmdnozf - cdmjfnmljz) View more	-	05 Dec 2008
				Placebo (Placebo)	jidfuzrems(ckdywjidjm) = fxeidggwyz pegaudjvpc (uzjthzhzrz, jokhocalfl - urtsonyikf) View more
Pubmed \| Anesth Analg	Not Applicable	Pain, Postoperative	-	Epidural analgesia group	nfjtrvfrbr(pxivcsvnwn) = cpzqfvybmd ffeozinifo (yavuworuue ) View more	Positive	01 Apr 2006
				Intrathecal analgesia group	nfjtrvfrbr(pxivcsvnwn) = kksnzysxhm ffeozinifo (yavuworuue ) View more

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