Prolonged oral morphine therapy for severe angina pectoris

Patients with intractable angina pectoris despite optimal drug therapy who are not candidates for revascularization procedures, pose a very difficult problem. We evaluated the role of chronic opioid therapy in four such patie nts. The patients (mean age 79.5 years) were treated by [oto noses (mean 40 mg/day) of controlled-release oral morphine (CRM) for 1 to 5 years. The tr eatment was followed by a marked decline in the rate of admissions and hosp italization periods, The number of admissions decreased from a mean of 6 du ring the year prior to CRM therapy to 1.5 the following year. The duration of hospitalization for angina pectoris during these periods decreased from a mean of 42 +/- 35 days to 6 +/- 10 days (p < 0.05). Sine effects were neg ligible and consisted mainly of lactulose-responsive constipation. We sugge st that prolonged oral morphine therapy may be administered with good effic acy and no significant side effects in selected patients with intractable a ngina pectoris. (C) U.S. Cancer Pain Relief Committee 2000.