The U.S. Food and Drug Administration (FDA) has approved morphine sulfate extended-release tablets (Arymo ER), which is formulated with abuse-deterrent properties, for the management of pain severe enough to require daily, long-term opioid treatment for which alternative treatment options are inadequate.1

Arymo ER was developed using Guardian Technology, a physical and chemical barrier approach to abuse deterrence without the use of an opioid antagonist. This technology makes it difficult to dissolve and inject Arymo ER.

Oncology clinicians should be particularly aware that moistened Arymo ER tablets may become sticky, leading to difficulty in swallowing the tablets, which may also predispose patients to intestinal obstruction and exacerbation of diverticulitis. Patients with underlying gastrointestinal disorders such as esophageal cancer or colon cancer with a small gastrointestinal lumen are at a greater risk for developing these complications.

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The most common adverse reactions with morphine sulfate extended-release formulations are constipation, dizziness, sedation, nausea, sweating, dysphoria, and euphoric mood.


  1. Egalet receives FDA approval for Arymo ER (morphine sulfate) C-II, an extended-release morphine product formulated with abuse-deterrent properties for treatment of chronic pain. Egalet website. Published January 9, 2017. Accessed January 10, 2017.