Abstract
Novel methods of administration of morphine for the alleviation of pain in terminally ill patients with cancer who are unable to swallow tablets or capsules or eat or drink have been investigated in in vitro studies. The drug-release rate of Kapanol™, a pelletised sustained-release morphine sulfate capsule, was not altered when the pellets were poured onto foodstuffs (including jam, yoghurt, apple sauce and ice-cream) and liquids (orange juice, milk and water). In addition, the drug-release profile of Kapanol™ pellets was not altered when pellets were flushed with water through a 16 French gastrostomy tube. However, the pellets were too large to pass through a 12 French nasogastric tube. Although clinical studies are needed to determine patient acceptance, these data suggest that sprinkling Kapanol™ pellets onto soft food or liquids or through a gastrostomy tube may be recommended as an alternative method of administration of morphine sulfate.
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