Generic name: hydromorphone (oral) (HYE droe MOR fone)
Brand name: Dilaudid, Exalgo
Dosage forms: oral liquid (1 mg/mL); oral tablet (2 mg; 4 mg; 8 mg); oral tablet, extended release (12 mg; 16 mg; 32 mg; 8 mg)
Drug class: Narcotic analgesics
Hydromorphone is an opioid medication used to treat moderate to severe pain.
The extended-release form of hydromorphone is for around-the-clock treatment of moderate to severe pain, not for use on an as-needed basis for pain.
Hydromorphone may also be used for purposes not listed in this medication guide.
Warnings
MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it.
Taking opioid medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.
Fatal side effects can occur if you use opioid medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.
Before taking this medicine
You should not take hydromorphone if you have ever had an allergic reaction to hydromorphone or other narcotic medicines, or if you have:
- severe asthma or breathing problems;
- a blockage in your stomach or intestines; or
- a bowel obstruction called paralytic ileus.
Do not use hydromorphone if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
Tell your doctor if you have ever had:
- a head injury, brain tumor, or seizures;
- breathing problems, sleep apnea;
- alcoholism, drug addiction, or mental illness;
- urination problems;
- liver or kidney disease;
- a sulfite allergy; or
- problems with your gallbladder, pancreas, or thyroid.
If you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on opioids may need medical treatment for several weeks.
Do not breast-feed. Hydromorphone can pass into breast milk and may cause drowsiness or breathing problems in a nursing baby.
How should I use hydromorphone?
Follow the directions on your prescription label and read all medication guides. Never use hydromorphone in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to take more of this medicine.
Never share opioid medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away opioid medicine is against the law.
Stop taking all other around-the-clock narcotic pain medications when you start taking hydromorphone.
Swallow the capsule or tablet whole to avoid exposure to a potentially fatal overdose. Do not crush, chew, break, open, or dissolve.
Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).
Do not stop using hydromorphone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using hydromorphone.
Never crush or break a hydromorphone pill to inhale the powder or mix it into a liquid to inject the drug into your vein. This can cause in death.
Store at room temperature away from moisture, heat, and light. Throw away any unused liquid after 90 days.
Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.
Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush the unused medicine down the toilet.
What happens if I miss a dose?
Since hydromorphone is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next dose. Do not use two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A hydromorphone overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, very slow breathing, or coma.
What should I avoid while using hydromorphone?
Do not drink alcohol. Dangerous side effects or death could occur.
Avoid driving or hazardous activity until you know how hydromorphone will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.
Hydromorphone side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.
Call your doctor at once if you have:
- noisy breathing, sighing, shallow breathing, breathing that stops during sleep;
- a slow heart rate or weak pulse;
- confusion, feelings of extreme happiness or sadness;
- severe weakness or drowsiness;
- a light-headed feeling, like you might pass out;
- low cortisol levels--nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Serious side effects may be more likely in older adults and those who are malnourished or debilitated.
Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.
Common side effects may include:
- drowsiness, tiredness;
- dizziness;
- headache; or
- constipation, nausea, vomiting, stomach pain.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect hydromorphone?
Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:
- other narcotic medications--opioid pain medicine or prescription cough medicine;
- a sedative like Valium--diazepam, alprazolam, lorazepam, Xanax, Klonopin, Versed, and others;
- drugs that make you sleepy or slow your breathing--a sleeping pill, muscle relaxer, medicine to treat mood disorders or mental illness; or
- drugs that affect serotonin levels in your body--a stimulant, or medicine for depression, Parkinson's disease, migraine headaches, serious infections, or nausea and vomiting.
This list is not complete. Other drugs may affect hydromorphone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.