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Intrathecal administration of Infumorph® vs compounded morphine for treatment of intractable pain using the Prometra®

Steven M Rosen1, Todd A Bromberg, Gurpreet Padda

  • 1Fox Chase Pain Management Associates, Jenkintown, Pennsylvania 19046, USA. foxchasepain@aol.com

Pain Medicine (Malden, Mass.)
|April 11, 2013
PubMed
Abstract

Insights

Compounded morphine sulfate effectively treats chronic pain with comparable accuracy and safety to Infumorph. Higher doses of compounded morphine showed greater improvements in pain and disability.

Area of Science:

  • Pain Management
  • Pharmacology
  • Neurosurgery

Background:

  • Intrathecal morphine sulfate is an alternative to oral opiates for chronic pain.
  • Infumorph is the only FDA-approved morphine sulfate for continuous intraspinal administration.
  • Compounded morphine is used when patient needs exceed commercially available concentrations.

Purpose of the Study:

  • To compare the accuracy, safety, and efficacy of Infumorph and compounded morphine sulfate.
  • To evaluate performance in patients implanted with the Prometra programmable pump.

Main Methods:

  • Collected accuracy, safety, and efficacy data from clinical trials.
  • Compared results in 154 subjects implanted with the Prometra programmable pump.
  • Analyzed data for subjects receiving Infumorph, compounded morphine, or both.

Main Results:

  • Drug delivery accuracy was comparable: 100.1% for Infumorph and 97.4% for compounded morphine.
  • Device-related serious adverse event (DRSAE) rates were similar between groups.
  • Compounded morphine showed statistically significant improvements in pain and disability, while Infumorph improved only pain.

Conclusions:

  • The Prometra system accurately delivers both Infumorph and compounded morphine.
  • Compounded morphine effectively treats chronic pain patients.
  • Higher doses of compounded morphine may offer better pain relief, balancing against granuloma risk.

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