Intravaginal morphine: an alternative route of administration

The availability of various dosage forms allows morphine to be administered in a number of ways. However, if the oral and rectal routes are not feasible, the parenteral one may appear to be the only viable option. Morphine was administered by the intravaginal route in a 44-year-old woman as an alternative to intravenous patient-controlled analgesia. The dosage forms included sustained- and immediate-release tablets as well as regular suppositories. The initial dosage was calculated according to guidelines for switching to oral administration and titrated to response. Adequate pain control was achieved, but due to unpredictable bioavailability, close monitoring was essential.