Diamorphine Hydrochloride 5mg, 10mg, 30mg, 100mg, 250mg and 500mg for Injection
Read all of this leaflet carefully before you start using this medicine.
- Keep this leaflet. You may need to read it again.
- If you have further questions, please ask your doctor, nurse or pharmacist.
- This medicine has been prescribed for you personally and you should not pass it on to others. It may harm them, even if their symptoms are the same as yours.
- If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor, nurse or pharmacist.
In this leaflet:
- 1. What Diamorphine Injection is and what it is used for
- 2. Before you are given Diamorphine Injection
- 3. How Diamorphine Injection should be given
- 4. Possible side effects
- 5. How to store Diamorphine Injection
- 6. Further information
What Diamorphine Injection Is And What It Is Used For
Diamorphine is one of a group of medicines called opioid analgesics which are used to relieve moderate to severe pain. Diamorphine is used for the relief of severe pain associated with surgical procedures, heart attack and pain in terminally ill patients. It is also used to treat breathlessness caused by fluid in the lungs.
Before You Are Given Diamorphine Injection
Diamorphine Injection should not be given if you:
- have ever had a reaction to or been told that you are allergic to diamorphine or morphine
- have been told you have a tumour of the adrenal gland near your kidney called phaeochromocytoma
- have severe problems with breathing
- have increased pressure on the brain, have just had a head injury or if you are unconscious
- are suffering from acute alcoholism
- are at risk from a blocked intestine
- have severe stomach cramps caused by a condition known as biliary colic
- are suffering from severe diarrhoea
- are pregnant or breast-feeding.
Speak to your doctor before Diamorphine Injection is given if you:
- are using drugs or have used drugs in the past
- suffer from asthma (your doctor may decide to administer Diamorphine Injection if your asthma is controlled. However, you should not be given this medicine if you are having an acute asthma attack)
- suffer from bronchitis (an inflammation of the lining of the tubes in the lungs, resulting in coughing spells accompanied by thick phlegm and breathlessness) or emphysema (a lung condition which leaves you struggling for breath)
- suffer from cor-pulmonale (a type of heart failure)
- are severely obese
- have a severely deformed spine
- are suffering from mental illness brought on by an infection
- have liver problems
- have kidney problems
- have problems with your bile duct
- suffer from an enlarged prostate gland (in men) or have difficulty passing urine
- have an under-active thyroid or adrenal gland
- have low blood pressure
- are in a state of severe shock
- are very run down
- have bowel disease, such as Crohn’s disease or ulcerative colitis
- suffer from convulsions (fits)
- are a child or elderly
- are feeling weak and feeble
If any of the above apply to you, speak to your doctor or nurse before Diamorphine Injection is given to you.
Taking other medicines
It is very important that you inform your doctor if you are taking or have taken any other medicines, as some medicines may affect the way Diamorphine Injection works.
In particular, tell your doctor if you are taking any of the following:
- monoamine oxidase inhibitors (MAOIs) such as moclobemide or phenelzine used in the treatment of depression. You must also tell your doctor if you have stopped taking any of these or related medicines in the last two weeks.
- tricyclic antidepressants, which are used in the treatment of depression
- tranquillising drugs or sleeping tablets such as diazepam, nitrazepam and temazepam.
- medicines used to treat mental illnesses, including schizophrenia (e.g. chlorpromazine, haloperidol).
- medicines used for diarrhoea (e.g. loperamide, kaolin).
- medicines which are used as premedication before operations and after heart attacks such as atropine.
- medicines used to treat nausea and vomiting, such as metoclopramide or domperidone
- mexiletine, used to control heart rhythm.
- cimetidine, used to treat stomach ulcers and indigestion
- ritonavir, used to treat HIV (a viral infection)
Food and drink and Diamorphine Injection
You should not drink alcohol whilst being given Diamorphine Injection as it will increase its effects.
Pregnancy and breast-feeding
You should not be given diamorphine if you are pregnant or think you might be pregnant unless you have discussed this with your doctor first. If you are given diamorphine during pregnancy and become dependent on it, there is a risk that the new-born baby may also be dependent and suffer from withdrawal symptoms following delivery. If you are given diamorphine during labour there is a risk that you could be sick and have breathing difficulties, or the baby could have difficulty starting breathing.
Do not breast-feed whilst being given Diamorphine Injection
Driving and using machines
You may feel drowsy and confused when you are being given Diamorpine Injection so you should not drive or operate machinery.
How Diamorphine Injection Should Be Given
- Diamorphine injection must be used immediately after preparation.
- The usual adult dose for treatment of acute or chronic pain is 5mg to 10mg every four hours, given by injection under the skin or into muscle or 1.25 to 5mg every four hours given directly into a vein for acute pain. The dose will be adjusted to suit your needs.
- For a heart attack, 5mg is usually given into a vein followed, if needed, by another 2.5 to 5mg.
- For fluid on the lungs, 2.5 to 5mg is given into a vein.
- If you are elderly, a child, are severely run down including feeling weak and feeble, or have liver and kidney problems the dose will be lower. You may also be given a reduced dose if you suffer from any of the conditions listed in section 2 entitled “Speak to your doctor before Diamorphine Injection is given if you:”
- Your doctor will decide the dose that is best for you. If you do not understand what you are being given, or are in any doubt, ask your doctor or nurse.
If you miss a dose of Diamorphine Injection
If you think that an injection has been missed, speak to your doctor or nurse.
If treatment with Diamorphine Injection is stopped
You should always check with your doctor before the treatment is stopped. It is possible that you could become dependent on diamorphine and have withdrawal symptoms if it is stopped suddenly. This is more likely if you have a tendency for drug abuse or if you become dependent on Diamorphine Injection
Possible Side Effects
Like all medicines, diamorphine can cause side effects, but not everybody gets them. Tell your doctor or nurse immediately if you experience the following serious side effect:
- A severe allergic reaction, such as breathing difficulties, shock or low blood pressure. If you suffer such a reaction, you should not be given anymore diamorphine. Your doctor will decide on the appropriate treatment for allergic reactions.
Difficulty in breathing and physical and psychological dependence are possible serious side effects.
It is possible that you could become dependent on diamorphine.
Side effects that are common include:
- drowsiness
- feeling sick or being sick
- constipation
- sweating.
Apart from constipation, these side effects tend to disappear with time.
Side effects that are less common include:
- dizziness
- feeling faint on standing up
- small pupils (in the eye)
- blurred vision
- double vision or other changes in vision
- mental clouding or confusion
- mood changes
- feeling extremely happy for no particular reason
- imagining things (hallucinations)
- headache
- vertigo
- facial flushing
- dry mouth
- difficulty or pain in passing urine
- passing less urine than usual
- biliary spasm (causing pain in the right side of your abdomen, particularly after eating a meal, which may spread towards your right shoulder)
- palpitations
- slower or faster pulse
- skin rash
- wheals or itching
- reduced sexual drive or impotence after long term use.
It is important to tell your doctor or nurse if you suffer from any of these or any other undesirable effects which are not listed above.
How To Store Diamorphine Injection
Keep out of the reach and sight of children.
Store the ampoules below 25ºC. Keep the ampoule in its outer carton, in order to protect it from light.
Do not use Diamorphine Injection if the powder in the ampoule or resulting solution shows signs of discolouration.
Do not use Diamorphine Injection after the expiry date which is stated on the carton. The expiry date refers to the last day of that month.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
Further Information
What Diamorphine Injection contains
The active substance is diamorphine hydrochloride. There are no other ingredients present.
What Diamorphine Injection looks like and contents of the pack
The injection is a white to off-white, sterile, freeze dried powder for reconstitution for injection.
Diamorphine Injection is available in six strengths (5 mg, 10 mg, 30 mg, 100 mg, 250 mg, or 500 mg of diamorphine hydrochloride) in packs of 5, 10 or 50 ampoules.
Not all strengths and pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder:
Manufacturer:
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To listen to or request a copy of this leaflet in Braille, large print or audio please call, free of charge:
0800 198 5000 (UK Only)
Please be ready to give the following information:
- Diamorphine Hydrochloride 5mg for Injection: 29831/0062
- Diamorphine Hydrochloride 10mg for Injection: 29831/0063
- Diamorphine Hydrochloride 30mg for Injection: 29831/0064
- Diamorphine Hydrochloride 100mg for Injection:29831/0061
- Diamorphine Hydrochloride 250mg for Injection: 29831/0229
- Diamorphine Hydrochloride 500mg for Injection: 29831/0060
This is a service provided by the Royal National Institute of Blind People.
This leaflet was last approved in January 2008.
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