GEES LINCTUS (OPIATE SQUILL LINCTUS)
MORPHINE; SQUILL OXYMEL
What it does
Morphine is a strong pain relief medicine used to treat moderate to severe pain.
Commonly used for: severe pain, pain after surgery, pain from cancer
Read more in plain English ↓Plain-language summary for general understanding - not medical advice. Always follow your pharmacist/doctor.
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Answers come only from this medicine's registration record, BNF monograph and interaction data - not medical advice.
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Sourcing - Kenya onlyRegistration & product details
Source: Medicines Control Authority of Zimbabwe · fetched 2026-04-18 08:22:07 · updated 2026-09-16 04:30:07
Drug Interactions
64Pharmacodynamic Warnings
Morphine appears in TABLE 11: Drugs with CNS depressant effects
Severe (6)
Opioids - decreases concentration
Brigatinib potentially decreases the concentration of opioids (alfentanil, fentanyl). Avoid. Also see TABLE 6 p. 1518
Opioids - increases exposure
Ceritinib is predicted to increase the exposure to opioids (alfentanil, fentanyl). Avoid. Theoretical → Also see TABLE 6 p. 1518
Opioids - increases risk of cnstoxicity
Ritonavir increases the risk of CNS toxicity when given with opioids (pethidine). Avoid.
Opioids - decreases exposure
Lorlatinib is predicted to decrease the exposure to opioids (alfentanil, fentanyl). Avoid.
Opioids - increases risk of adverse effects
Selegiline increases the risk of adverse effects when given with opioids (pethidine). Avoid. Also see TABLE 13 p. 1520
Opioids - increases exposure
Selpercatinib is predicted to increase the exposure to opioids (alfentanil, buprenorphine). Avoid.
Moderate (31)
Opioids - increases exposure
Dronedaroneispredictedtoincreasetheexposuretoopioids (alfentanil,buprenorphine,fentanyl,oxycodone).Monitorand adjustdose.oStudy →AlsoseeTABLE6p.1518
Opioids - increases concentration
Amiodarone is predicted to increase the concentration of opioids (fentanyl). Monitor and adjust dose. Also see TABLE 6 p. 1518.
Opioids - decreases concentration
Carbamazepine decreases the concentration of opioids (tramadol). Adjust dose.
Opioids - increases exposure
Miconazole is predicted to increase the exposure to opioids (alfentanil). Use with caution and adjust dose.
Opioids - increases exposure
Antifungals, azoles (fluconazole, isavuconazole, posaconazole) are predicted to increase the exposure to opioids (alfentanil, buprenorphine, fentanyl, oxycodone). Monitor and adjust dose.
Unknown (27)
Drugs That Cause Serotonin Syndrome - increases risk of serotonin syndrome
Opioids (tapentadol) are predicted to increase the risk of serotonin syndrome when given with drugs that cause serotonin syndrome (see TABLE 13 p. 1520). Theoretical drugs that reduce serum potassium.
Morphine - decreases concentration
Ritonavirispredictedtodecreasetheconcentrationofopioids (morphine).oTheoretical
Morphine - decreases concentration
Nirmatrelvir boosted with ritonavir is predicted to decrease the concentration of opioids (morphine).
Morphine - decreases exposure
Pitolisantispredictedtodecreasetheexposuretomorphine. nTheoretical
Morphine - decreases exposure
Rifampicin decreases the exposure to opioids (codeine, morphine).
Data from BNF 85 (British National Formulary). This is not a substitute for professional medical advice. Matched via: class
About morphine
Morphine is a strong pain relief medicine used to treat moderate to severe pain.
What it treats
- severe pain
- pain after surgery
- pain from cancer
How it works
Morphine works by blocking pain signals in the brain and changing how your body feels and responds to pain.
Who it's for
Morphine is for adults and may be used for children in certain cases, as directed by a doctor.
Drug class
Opioids
Cautions
- • Be careful if taking other medicines that can cause drowsiness or slow down your breathing.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About oxymel
Oxymel is a mixture that can help soothe sore throats and coughs. It is made by combining honey and vinegar.
What it treats
- sore throat
- cough
- respiratory discomfort
How it works
Oxymel works by providing a soothing effect on the throat and helping to reduce irritation.
Who it's for
Oxymel is generally suitable for adults and children experiencing throat discomfort or cough.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About squill
Squill is a natural remedy that is used to help with certain heart and respiratory conditions.
What it treats
- heart failure
- congestive heart failure
- difficulty breathing
How it works
Squill helps improve heart function and can aid in breathing by promoting the elimination of excess fluid from the body.
Who it's for
Adults experiencing heart problems or respiratory issues.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: Morphine
BNF-referencedMorphine is a potent opioid analgesic used primarily for the relief of severe pain. It is classified as an opioid drug and acts on the central nervous system (CNS) to alleviate pain. Morphine is particularly effective due to its ability to bind to mu and kappa opioid receptors, providing both analgesic effects and a sense of euphoria, which can contribute to its potential for abuse and dependence. It is important to administer morphine with caution, especially in patients with impaired hepatic or renal function, and those with a history of substance use disorders.
Indications
Mechanism of action
Morphine and its metabolites act as agonists at the mu and kappa opioid receptors. The mu-opioid receptor is responsible for morphine's analgesic effects and its action on the reward pathway in the brain, primarily affecting the ventral tegmental area. Morphine-6-glucuronide, a major metabolite, is responsible for a significant portion of morphine's analgesic effect, with approximately 85% of the response attributed to it. Additionally, morphine modulates pain transmission by blocking nociceptive signals and inhibiting primary afferent nociceptors in the spinal cord.
Pharmacodynamics
Morphine binding to opioid receptors blocks the transmission of nociceptive signals, modulating pain pathways within the spinal cord. Its onset of action ranges from 6 to 30 minutes, with effects varying based on individual factors such as sex; for instance, the EC50 for analgesia is lower in women than in men. Chronic use can lead to alterations in neuroplasticity, affecting synaptic structures and potentially leading to tolerance or dependence. Morphine's analgesic effects also include respiratory depression, which is a significant risk associated with its use.
Pharmacokinetics
Morphine is absorbed through various routes, including oral and intravenous administration, with its bioavailability being significantly lower when taken orally due to first-pass metabolism. The drug is extensively metabolized in the liver, primarily to morphine-3-glucuronide and morphine-6-glucuronide. The elimination half-life of morphine ranges from 2 to 4 hours, but can be prolonged in patients with renal or hepatic impairment. Morphine is excreted mainly via the kidneys, necessitating dose adjustments in patients with renal dysfunction to prevent accumulation and increased risk of adverse effects.
Contra-indications
- Severe respiratory depression
- Acute or severe bronchial asthma
- Known or suspected gastrointestinal obstruction
- Hypersensitivity to morphine or any component of the formulation
Adverse effects
- Diarrhoea
- Gastrointestinal disturbances
- Drowsiness
- Depression
- Hypotension
- Nausea
- Vomiting
- Constipation
- Erectile dysfunction
- Visual impairment
- Tremors
- Hyperalgesia
- Seizures
- Withdrawal syndrome
Interactions
- Ritonavir may decrease morphine concentration
- Nirmatrelvir boosted with ritonavir may decrease morphine concentration
- Pitolisant may decrease morphine exposure
- Rifampicin may decrease morphine exposure
Precautions
- Caution in patients with pancreatitis
- Caution in patients with hepatic impairment
- Caution in patients with renal impairment
- Caution in patients with a history of substance use disorder
- Monitor for signs of respiratory depression
- Dose adjustments may be necessary in the elderly or those with comorbidities
Pregnancy
Use only if potential benefit outweighs risk, as morphine may affect fetal development
Breast-feeding
Use with caution; avoid if possible due to lack of information on excretion in breast milk
Storage
Store in a cool, dry place away from direct light. Keep out of reach of children.
Formulations
- Oral solution
- Modified-release capsules
- Injection solution
- Tablets
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: oxymel
Oxymel is a traditional preparation made from a mixture of honey and vinegar, often used as a remedy for coughs and respiratory conditions. It is thought to have soothing and expectorant properties, making it beneficial for treating upper respiratory tract infections. The formulation typically combines the antimicrobial properties of honey with the acetic acid in vinegar, which may aid in digestion and enhance the absorption of nutrients.
Indications
- Cough
- Upper respiratory tract infections
- Sore throat
- Digestive discomfort
Dosage
Children: Refer to established guidelines and consider individual needs and product formulations, as specific dosing may vary.
Adults: Refer to established guidelines and consider individual needs and product formulations, as specific dosing may vary.
Mechanism of action
The mechanism of action of oxymel is not precisely defined but is believed to involve the combined effects of its constituents. Honey has natural antibacterial and anti-inflammatory properties, which may help soothe irritated mucous membranes and reduce coughing. Vinegar, particularly apple cider vinegar, is thought to have antimicrobial effects and may assist in breaking down mucus, facilitating easier breathing.
Pharmacodynamics
Oxymel is primarily used for its soothing effects on the throat and its potential to act as an expectorant. Honey can also stimulate the immune system and has been shown to possess antiviral properties. The presence of acetic acid in vinegar may help to alter the pH in the stomach, potentially enhancing digestive processes and nutrient absorption, indirectly supporting overall health during illness.
Pharmacokinetics
Due to its natural composition, the pharmacokinetics of oxymel are not extensively studied. However, the individual components, honey and vinegar, are rapidly absorbed in the gastrointestinal tract. Honey is metabolized primarily in the liver, while acetic acid is rapidly absorbed and metabolized through the Krebs cycle, providing energy and influencing metabolic pathways. The effects of oxymel are generally observed shortly after ingestion, depending on individual factors.
Pregnancy
Oxymel is traditionally used as a remedy and lacks extensive clinical studies to assess its safety during pregnancy. Caution is advised, and consultation with a healthcare provider is recommended.
Breast-feeding
Due to a lack of comprehensive studies, it is advisable to consult a healthcare professional before using oxymel while breastfeeding.
Storage
Store in a cool, dry place away from direct sunlight. Ensure the container is tightly closed to prevent contamination.
Formulations
- Syrup
- Liquid preparation
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: squill
BNF-referencedSquill is an herbal remedy derived from the bulbs of the Urginea (or Scilla) species, particularly Urginea maritima. Traditionally, it has been used for its cardiotonic and diuretic properties. The active compounds in squill are glycosides, which are believed to exert their effects primarily on the heart and kidneys. Due to its potent effects, squill should be used with caution and under medical supervision.
Indications
- Heart failure
- Edema
- Hypertension
- Congestive heart failure
Dosage
Children: Refer to the BNF for Children for specific dosage information regarding squill in paediatric patients.
Adults: Refer to the BNF for specific dosage information regarding squill in adults.
Mechanism of action
Squill contains cardiac glycosides, which inhibit the Na+/K+ ATPase enzyme. This inhibition leads to an increase in intracellular sodium levels, which causes an increase in intracellular calcium levels via the sodium-calcium exchanger. This results in enhanced myocardial contractility (positive inotropic effect) and a reduction in heart rate (negative chronotropic effect). Additionally, squill promotes diuresis by increasing renal blood flow and glomerular filtration rate.
Pharmacodynamics
The positive inotropic effect of squill enhances cardiac output and is useful in the management of certain heart conditions. The diuretic effect aids in fluid management, making it beneficial for patients with heart failure or edema. However, the therapeutic window is narrow, and toxicity can occur with overdose, leading to arrhythmias and gastrointestinal disturbances.
Pharmacokinetics
The pharmacokinetics of squill have not been extensively studied. However, it is generally understood that the active glycosides are absorbed in the gastrointestinal tract, with peak plasma concentrations occurring within a few hours after ingestion. The elimination half-life is variable and depends on the specific glycoside. The metabolites are primarily excreted via the kidneys.
Pregnancy
The safety of squill during pregnancy has not been established. Use only if clearly needed and prescribed by a healthcare provider.
Breast-feeding
It is not known whether squill is excreted in human milk. Caution should be exercised when administering to breastfeeding women.
Storage
Store in a cool, dry place, away from direct sunlight and moisture. Keep out of reach of children.
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Molecular reference: Morphine
PubChem CID 5288826Molecular formula: C17H19NO3
Mechanism of action
Morphine-6-glucuronide is responsible for approximately 85% of the response observed by morphine administration. Morphine and its metabolites act as agonists of the mu and kappa opioid receptors. The mu-opioid receptor is integral to morphine's effects on the ventral tegmental area of the brain. Morphine's activation of the reward pathway is mediated by agonism of the delta-opioid receptor in the nucleus accumbens, while modification of the respiratory system and addiction disorder are mediated by agonism of the mu-opioid receptor. Visual analysis of the direct electroencephalograph has revealed that morphine /slowed/ the predominant frequency and /increased/ high-voltage delta activity.
Pharmacodynamics
Morphine binding to opioid receptors blocks transmission of nociceptive signals, signals pain-modulating neurons in the spinal cord, and inhibits primary afferent nociceptors to the dorsal horn sensory projection cells. Morphine has a time to onset of 6-30 minutes. Excess consumption of morphine and other opioids can lead to changes in synaptic neuroplasticity, including changes in neuron density, changes at postsynaptic sites, and changes at dendritic terminals. Intravenous morphine's analgesic effect is sex dependent. The EC<sub>50</sub> in men is 76ng/mL and in women is 22ng/mL. Morphine-6-glucuronide is 22 times less potent than morphine in eliciting pupil constriction.
Biological pathways
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
Molecular reference: squill
PubChem CID 441871Molecular formula: C32H44O12
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
This drug in other countries
The same active ingredient registered across other registries we cover - including different brands.
- BIOCOF EXPECTORANT · Biodeal Laboratories
- MORPHIA FORTE SOLUTION FOR INJECTION · Tasa Pharma
- MORPHIA SOLUTION FOR INJECTION · Tasa Pharma
- MORPHINE SULPHATE FRESENIUS PF · Surgipharm
- MORPHINE SULPHATE INJECTION BP 10MG IN 1ML · Laborex Kenya
- MORPHINE SULPHATE INJECTION BP 30MG IN 1ML · Laborex Kenya
- BLUTHOREX COUGH MIXTURE (Each 5ml contains Ammonium Chloride / Sodium Citrate / Menthol / Squill Tincture - 200mg / 100mg / 15.5mg / 0.002ml) · Prowill Pharmaceuticals
- MENTHOX CHILDREN'S COUGH SYRUP · Kinapharma
- MORPHINE HCL 10MG/ML INJECTION (Each 1ml contains Morphine Hydrochloride 10mg) · Laboratoires Sterop
- MORPHINE HCL STEROP INJECTION ( Morphine Sulfate USP 10mg/ml ) · Laboratoires Sterop
- MORPHINE SULFATE 10MG/ML INJECTION (Each ml contains Morphine Sulphate 10mg) · Forte Proma
- MORPHINE SULFATE INJECTION (Each ml contains Morphine Sulfate USP 10mg) · Intravenous Infusion
- MORPHINE SULFATE KALCEKS · Hbm Pharma
- MORPHINE SULPHATE 10MG/ML SOLUTION FOR INJECTION · Macarthys Laboratories
- MORPHINE SULPHATE- FRESENIUS PF · Fresenius Kabi
- MORPHINE SULPHATE- FRESENIUS PF · Fresenius Kabi
- Morphine Medis
- Morphine Oral Solution · Macfarlan Smith
- Go Coff Cough syrup · Vardhman Exports
- Kofex Cough Syrup Baby · Ciron Drugs
- MORPHINE SULPHATE · Yash Life Sciences
- Morphine Sulphate 15mg in 1ml Solution for Injection · Macarthys Laboratories
- Morphine Sulphate Injection · Macarthys Laboratories
- Morphine sulphate 10 injection · Fresenius Kabi