Actimorph in the Emergency Department (ED)
Date issued: October 2026
Review date: October 2028
Leaflet section: Emergency Department
PDF: Actimorph in the Emergency Department (ED).pdf [pdf] 231KB
Emergency Department (Adult)
What is Actimorph?
Actimorph has the active substance morphine sulphate, which is a strong painkiller (or analgesic). You will likely have been prescribed this to manage your pain. Actimorph comes in a tablet form and is available in the same doses as Oramorph liquid solution. It is an immediate release preparation, meaning it works quickly. Actimorph can also be dissolved into a liquid for those that struggle to swallow tablets.
Why have we moved from liquid Oramorph to tablet Actimorph?
Previously, the Emergency Department has used liquid Oramorph for pain relief. We are making this change because Actimorph tablets are easier for our nursing staff to prepare and administer. This may help reduce the time you wait to receive pain relief.
Using tablets also allows doses to be recorded and monitored more easily, helping us to provide your medication safely. The change may also reduce our environmental impact by reducing the use of single-use plastic syringes needed to measure and administer liquid medication. It may also reduce the cost of providing this medication.
Oramorph vs Actimorph: What’s the difference?
| Oramorph | Actimorph | |
|---|---|---|
| Formulation | Liquid | Orodispersible tablet (can be dissolved into liquid) |
| Active ingredient | Morphine sulphate | Morphine sulphate |
| Dosing | 1mg, 2.5mg, 5mg, 10mg, 20mg, 30mg | 1mg, 2.5mg, 5mg, 10mg, 20mg, 30mg |
| Onset of action | Immediate release | Immediate release |
| Estimated carbon footprint for one 10mg dose (including materials for administration) | 67.34 g CO2e | 36.53 g CO2e |
Actimorph on the inpatient wards
The use of tablet Actimorph in the ED is new as of October 2026. We are pioneering this project in our trust on the back of research from Newcastle, as such this change has not yet reached the inpatient wards. If you are admitted to a ward from the ED, then you may see that you are receiving liquid Oramorph again instead of tablet Actimorph. As outlined in the above table, they have the same active ingredient and have equivalent doses, so the only change is the formulation.
Opiate safety
Opioids (Oramorph and Actimorph) can help with short-term pain after surgery or injury. They are effective for roughly 1 in 4 people. They have side effects like drowsiness, nausea and constipation. Evidence shows that they work best when you have taken other pain relief such as paracetamol and anti-inflammatory medications.
Over time, opioids become less effective (called opioid tolerance). If this happens, you may have been taking them too long and reducing and stopping them is important.
You can become dependent on opioid medicines if you take them for more than 2 weeks (called opioid dependence). This means that if you stop taking the drug suddenly, or lower the dose too quickly, you can get symptoms of withdrawal. You may experience symptoms that include worsening pain, anxiety or agitation, tiredness, sweating, a runny nose, stomach cramps, diarrhoea, & aching muscles.
If you take opioids for a short period, you will not develop tolerance or dependence.
If you feel you need strong opioids for more than five days, you will need to be reviewed by your GP. It is important to discuss your reasons for taking opioids with your prescriber.
Patient feedback
We would be very grateful to hear your thoughts on this switch to tablet Actimorph. Please fill out our form to tell us your opinions. Oramorph solution to Actimorph tablet switch - Patient feedback form
Other formats
If you need this leaflet in another format such as Braille, large print, high contrast, British Sign Language or translated into another language, contact the Patient Advice and Liaison Service (PALS):
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01752 439694
