The Use of Self-Mixed Morphine Gel 0.125% for Topical Pain Control in Painful Cancer Lesions

Abstract

Context:

Pain control for localized cancer lesions remains challenging, with systemic opioids often providing inadequate relief with significant side effects. Compounded morphine gel has shown efficacy, but its high-cost limits use.

Objective:

To explore the feasibility of a patient-mixed 0.125% morphine gel recipe, providing patients with an accessible, affordable option for improved pain control.

Methods:

This study recruited 13 cancer patients with painful cutaneous lesions, instructing them to mix 100 mg of liquid morphine in 80 g of hydrogel to produce a 0.125% morphine gel and apply it directly to the painful area. Likert scales assessed ease of mixing and satisfaction, while the Edmonton Symptom Assessment Scale assessed pain scores. The total oral morphine equivalent per day (OMED) was compared before and after gel use.

Results:

Briefly, 91% of participants found the gel easy to mix and helpful for pain control, with pain scores decreasing by 61.8%. OMED was also significantly reduced (p = 0.008).

Conclusion:

This small study suggests that self-mixed 0.125% morphine gel is a safe, effective, and affordable option to control pain in cancer lesions. Larger studies are needed to confirm these results.

Keywords

cancer pain morphine gel palliative care

Get full access to this article

View all access options for this article.

References

1. Zeppetella

, Ribeiro

. Morphine in intrasite gel applied topically to painful ulcers. J Pain Symptom Manage 2005;29(2):118–119; doi: 10.1016/j.jpainsymman.2004.12.006

2. Krasowska

, Lesniak

, Pieczonka

, et al. Efficacy and safety of topical morphine: A narrative review. Pharmaceutics 2022;14(7):1499; doi: 10.3390/pharmaceutics14071499

3. Zeppetella

, Joel

, Ribeiro

. Stability of morphine sulphate and diamorphine hydrochloride in intrasite gel. Palliat Med 2005;19(2):131–136; doi: 10.1191/0269216305pm985oa

4. Bruera

, Kuehn

, Miller

, et al. The Edmonton Symptom Assessment System (ESAS): A simple method for the assessment of palliative care patients. J Palliat Care 1991;7(2):6–9; doi: 10.1177/082585979100700202

5. Nielsen

, Degenhardt

, Hoban

, et al. A synthesis of Oral Morphine Equivalents (OME) for opioid utilisation studies. Pharmacoepidemiol Drug Saf 2016;25(6):733–737; doi: 10.1002/pds.3945

6.R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing: Vienna, Austria; 2021. Available from: https://www.R-project.org/

7. McPherson

, Fontane

, Iyengar

, et al. Utilization and costs of compounded medications for commercially insured patients, 2012–2013. J Manag Care Spec Pharm 2016;22(2):172–181; doi: 10.18553/jmcp.2016.22.2.172

8. Ciałkowska-Rysz

, Dzierżanowski

. Topical morphine for treatment of cancer-related painful mucosal and cutaneous lesions: A double-blind, placebo-controlled cross-over randomized trial. Arch Med Sci 2019;15(1):146–151; doi: 10.5114/aoms.2018.72566

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.59 MB

0.00 MB