Antidiarrhoeal (kaolin) + opioid Pregnancy: §4.6: should not be used in pregnancy or whilst breastfeeding unless recommended by a doctor.

Kaolin with morphine

Brand names: Kaolin and Morphine Mixture BP

Used in: Burns

Kaolin with morphine is a compound preparation combining an adsorbent (kaolin) with a small amount of the opioid morphine, traditionally used for short-term symptomatic relief of acute diarrhoea.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Two 5 ml spoonfuls

Route: Oral (shake the bottle before use)

Frequency: May be repeated 3 times daily, or as directed

eMC §4.2 (Kaolin and Morphine Mixture BP): adults and children over 12 years — two 5 ml spoonfuls; the dose may be repeated 3 times daily or as directed. Children under 12 years: not recommended. No maximum daily dose is stated in the retrieved §4.2. §4.4: contains sodium hydrogen carbonate — must not be given in metabolic or respiratory alkalosis, hypocalcaemia or hypochlorhydria, and use with caution in congestive heart failure, renal impairment, hepatic cirrhosis, hypertension and in patients on corticosteroids; as with other morphine-containing preparations use with care in the elderly or debilitated (the dose should be reduced), in prostatic hypertrophy, hypotension, hypothyroidism and where respiratory reserve is reduced (avoid during an asthma attack), and do not give if paralytic ileus is likely. Repeated use can lead to tolerance and opioid use disorder. §4.5 interactions were not retrieved in this fetch.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Intestinal obstruction (kaolin component)
Respiratory depression; obstructive airways disease; reduced respiratory reserve
Known morphine sensitivity; hypersensitivity to any of the excipients
Acute hepatic disease; acute alcoholism
Head injuries, coma, convulsive disorders, or where intracranial pressure is raised
Concurrent administration with monoamine oxidase inhibitors, or within 2 weeks of stopping them

Side effects

Nausea, vomiting and constipation
Drowsiness and confusion
Stomach cramps and flatulence (sodium hydrogen carbonate component)
Tolerance and dependence with prolonged/repeated use
Dry mouth, sweating, headache, facial flushing, vertigo
Bradycardia, tachycardia or palpitation; postural hypotension
Acute generalised exanthematous pustulosis (AGEP); central sleep apnoea syndrome; pancreatitis; spasm of the sphincter of Oddi

Clinical monograph

How it works

Morphine reduces intestinal motility through opioid receptors in the gut, while kaolin acts as an adsorbent; together they reduce stool frequency.

Prescribing in practice

It is unsuitable as routine diarrhoea management and should be avoided where antimotility agents are contraindicated, such as acute inflammatory bowel disease or suspected infective or antibiotic-associated colitis, where it may worsen outcomes.
It contains an opioid, so it carries opioid-related precautions and is a potential source of misuse.
Oral rehydration to correct fluid and electrolyte losses is the priority in acute diarrhoea.

Monitoring

Monitor symptom resolution and hydration status, and reassess if diarrhoea is severe, bloody, febrile or persistent.

Counselling the patient

Maintain fluid intake and use rehydration solutions, especially in vulnerable patients.
Seek medical advice if there is blood in the stool, high fever or symptoms that do not settle.

Evidence & guidelines

The mainstay of acute diarrhoea management is rehydration, consistent with NICE and general gastroenterology guidance; antimotility opioid preparations have only a limited adjunctive role.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways