Generic Name: hydromorphone (oral) (HYE droe MOR fone)Brand Names: Dilaudid, Dilaudid-5
What is hydromorphone?
Hydromorphone is in a group of drugs called narcotic pain relievers, also called opioids. It is similar to morphine.
Hydromorphone is used to treat moderate to severe pain. The extended-release form of this medication is for around-the-clock treatment of pain.
Hydromorphone may also be used for purposes other than those listed in this medication guide.
What is the most important information I should know about hydromorphone?
Hydromorphone may be habit-forming and should be used only by the person it was prescribed for. Hydromorphone should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Do not drink alcohol while you are taking hydromorphone. Dangerous side effects or death can occur when alcohol is combined with a narcotic pain medicine. Check your food and medicine labels to be sure these products do not contain alcohol. Never take more than your prescribed dose of hydromorphone. Tell your doctor if the medicine seems to stop working as well in relieving your pain. Hydromorphone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Do not stop using hydromorphone suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.
What should I discuss with my healthcare provider before using hydromorphone?
Do not use this medication if you have ever had an allergic reaction to a narcotic medicine (examples include codeine, methadone, morphine, Oxycontin, Darvocet, Percocet, Vicodin, Lortab, and many others). You should also not take hydromorphone if you are having an asthma attack or if you have a bowel obstruction called paralytic ileus. Hydromorphone may be habit-forming and should be used only by the person it was prescribed for. Hydromorphone should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.
Before using hydromorphone, tell your doctor if you are allergic to any drugs, or if you have:
asthma, COPD, sleep apnea, or other breathing disorders;
- liver or kidney disease;
curvature of the spine;
a history of head injury or brain tumor;
epilepsy or other seizure disorder;
low blood pressure;
Addison's disease or other adrenal gland disorders;
enlarged prostate, urination problems;
mental illness; or
a history of drug or alcohol addiction.
FDA pregnancy category C. This medication may be harmful to an unborn baby, and could cause addiction or withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Hydromorphone can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
You should not use an extended-release form of hydromorphone (such as Palladone) unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.
Older adults may be more sensitive to the effects of this medicine.
How should I use hydromorphone?
Take this medication exactly as it was prescribed for you. Never take hydromorphone in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Take the pill form of this medicine with a full glass of water. Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow the pill whole. It will release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time.
Measure the liquid form of hydromorphone with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. Avoid getting hydromorphone liquid on your skin. It can be absorbed through your skin, and you may get too large a dose.
Do not stop using hydromorphone suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication. Store this medication at room temperature, away from heat, moisture, and light.
Keep track of how many tablets have been used from each new bottle of this medicine. Hydromorphone is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.
After you have stopped using this medication, flush any unused pills down the toilet.
Throw away any unused liquid hydromorphone that is older than 90 days.
What happens if I miss a dose?
Since hydromorphone is sometimes used as needed, you may not be on a dosing schedule. If you are using the medication regularly, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.
Extended-release hydromorphone is not for use on an as-needed basis for pain.
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. An overdose of hydromorphone can be fatal.
Overdose symptoms may include extreme drowsiness, pinpoint pupils, confusion, cold and clammy skin, weak pulse, shallow breathing, fainting, or breathing that stops.
What should I avoid while using hydromorphone?
Do not drink alcohol while you are taking this medication. Dangerous side effects or death can occur when alcohol is combined with hydromorphone. Check your food and medicine labels to be sure these products do not contain alcohol. Hydromorphone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Hydromorphone side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
shallow breathing, slow heartbeat;
cold, clammy skin;
severe weakness or dizziness; or
feeling light-headed, fainting.
Less serious side effects are more likely to occur, such as:
nausea, vomiting, constipation, loss of appetite;
warmth, tingling, or redness under your skin;
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Hydromorphone Dosing Information
Usual Adult Dose for Pain:
Oral: 2 mg every 4 to 6 hours as needed. Titrate dose in 1 mg increments. Affect usually occurs in 30 minutes.Rectal: 3 mg every 6 to 8 hours as needed.IM, subcutaneous, intravenous: 1 to 2 mg every 4 to 6 hours as needed. Titrate dose in 1 to 2 mg increments.
Usual Adult Dose for Cough:
1 mg orally every 3 to 4 hours as needed.
Usual Pediatric Dose for Pain:
Oral: 0.03 to 0.08 mg/kg/dose every 4 to 6 hours as needed. Maximum dose: 5 mg/dose.Intravenous: 0.015 mg/kg/dose every 4 to 6 hours as needed.
Usual Pediatric Dose for Cough:
6 to 12 years: 0.5 mg orally every 3 to 4 hours as needed.> 12 years: 1 mg orally every 3 to 4 hours as needed.
What other drugs will affect hydromorphone?
Do not take hydromorphone with other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.
Before taking hydromorphone, tell your doctor if you are using pentazocine (Talwin), nalbuphine (Nubain), butorphanol (Stadol), or buprenorphine (Buprenex, Subutex). If you are using any of these drugs, you may not be able to use hydromorphone, or you may need dosage adjustments or special tests during treatment.
This list is not complete and there may be other drugs that can interact with hydromorphone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
Where can I get more information?
- Your pharmacist can provide more information about hydromorphone.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
- Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 5.09. Revision Date: 4/12/2009 4:36:42 PM.
- Hydromorphone MedFacts Consumer Leaflet (Wolters Kluwer)
- Hydromorphone Prescribing Information (FDA)
- Dilaudid Prescribing Information (FDA)
- Dilaudid Consumer Overview
- Dilaudid Detailed Consumer Information (PDR)
- Dilaudid-HP MedFacts Consumer Leaflet (Wolters Kluwer)
- Dilaudid-HP Prescribing Information (FDA)
- Palladone Prescribing Information (FDA)
- Palladone Extended-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)