Hydromorphone

Pronunciation

Generic Name: hydromorphone (HYE-droe-MOR-fone)
Brand Name: Dilaudid-HP

This product contains a very large amount of hydromorphone. It should only be used by patients who have already been taking a narcotic pain medicine and are tolerant to its effects. Do not confuse this product with other injectable forms of hydromorphone or other injectable narcotic pain medicines. If you have any questions about whether you should use this product or another injectable form of hydromorphone, contact your doctor or other health care provider.

Hydromorphone is a narcotic pain reliever that may become habit-forming. Do NOT take more than the recommended dose, take for longer than prescribed, or take more often than prescribed without checking with your doctor.

Hydromorphone may also cause severe breathing problems. This effect may be worse if you take it with alcohol, with other narcotic pain relievers, or with certain other medicines. Ask your doctor or pharmacist if you have questions about which medicines may add to this effect. Contact your doctor right away if you experience slow or shallow breathing.


Hydromorphone is used for:

Treating moderate to severe pain in narcotic-tolerant patients who require larger than usual doses to provide adequate pain relief.

Hydromorphone is an opioid (narcotic) analgesic. It works in the brain and nervous system to reduce pain.

Do NOT use hydromorphone if:

  • you are allergic to any ingredient in hydromorphone
  • you are NOT already receiving large amounts of narcotics
  • you have difficult or slowed breathing, severe asthma, or you are having an asthma attack
  • you have known or suspected bowel blockage (paralytic ileus)
  • you are taking sodium oxybate (GHB)

Contact your doctor or health care provider right away if any of these apply to you.

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Before using hydromorphone:

Some medical conditions may interact with hydromorphone. Tell your health care provider if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances, including latex or sulfites
  • if you have had an allergic reaction to any other narcotic pain relievers (eg, codeine, morphine, oxycodone)
  • if you have a history of chronic obstructive pulmonary disease (COPD) or other lung or breathing problems (eg, asthma, emphysema, bronchitis, sleep apnea), seizures (eg, epilepsy), adrenal gland problems (eg, Addison disease), an enlarged prostate, heart problems (eg, cor pulmonale), low blood pressure, dehydration, low blood volume, thyroid problems, urinary blockage or trouble urinating, curvature of the spine, low blood oxygen levels (hypoxia), or high blood carbon dioxide levels (hypercapnia)
  • if you have severe drowsiness, a recent head injury, growths in the brain (eg, lesions, tumors), or increased pressure in the head
  • if you have liver or kidney problems, gallbladder problems, pancreas problems, or stomach or bowel problems (eg, inflammation, pseudomembranous colitis), or if you have had recent stomach or bowel surgery
  • if you drink alcohol or have symptoms of alcohol withdrawal
  • if you have a personal or family history of mental or mood problems (eg, depression), suicidal thoughts or attempts, alcohol abuse, or other substance abuse or dependence
  • if you have stomach pain; if you are in poor health; if you will be having surgery; or if you are in shock caused by heart problems, blood vessel problems, or severe bleeding
  • if you are taking a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) or have taken one within the last 14 days

Some MEDICINES MAY INTERACT with hydromorphone. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Anticholinergics (eg, scopolamine, oxybutynin) because the risk of trouble urinating and severe constipation may be increased
  • Phenothiazines (eg, chlorpromazine) because the risk of low blood pressure may be increased
  • MAOIs (eg, phenelzine), other narcotic pain relievers (eg, codeine, morphine, oxycodone), sodium oxybate (GHB), or tricyclic antidepressants (eg, amitriptyline) because the risk of severe drowsiness may be increased
  • Agonist/antagonist analgesics (eg, buprenorphine, butorphanol, pentazocine) or naltrexone because they may decrease hydromorphone's effectiveness and withdrawal may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if hydromorphone may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use hydromorphone:

Use hydromorphone as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Hydromorphone is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using hydromorphone at home, a health care provider will teach you how to use it. Be sure you understand how to use hydromorphone. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
  • Do not use hydromorphone if it is cloudy or discolored, or if the vial is cracked or damaged.
  • Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • If you are using hydromorphone for persistent pain, use it on a regular schedule to help control the pain more effectively.
  • If you have been using hydromorphone regularly, do NOT suddenly stop using it without checking with your doctor. If you have been using hydromorphone for more than a few weeks and your doctor tells you to stop using it, your dose may need to be gradually lowered as directed by your doctor to avoid side effects.
  • If hydromorphone is no longer needed, dispose of it as soon as possible. Ask your doctor or pharmacist how to dispose of hydromorphone properly.
  • If you miss a dose of hydromorphone and you are using it regularly, use it as soon as possible. If it is nearing time for the next dose, do not double the dose to catch up, unless advised by your health care provider. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use hydromorphone.

Important safety information:

  • Hydromorphone may cause drowsiness, dizziness, blurred vision, or light-headedness. These effects may be worse if you take it with alcohol, other opiate pain medicines, or certain other medicines. Use hydromorphone with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol while you use hydromorphone.
  • Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you take hydromorphone; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Hydromorphone may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • This product contains a very large amount of hydromorphone. Do not confuse this product with other injectable forms of hydromorphone. If you have any questions about whether you should use this product or another injectable form of hydromorphone, contact your doctor or other health care provider.
  • The risk of hydromorphone becoming habit-forming may be greater if you use it in high doses or for a long time. Do NOT use more than the recommended dose or use for longer than prescribed without checking with your doctor. Do NOT change your dose or use more often than prescribed without checking with your doctor.
  • Hydromorphone may cause constipation. To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. Talk to your doctor about using laxatives or stool softeners to prevent or treat constipation while you use hydromorphone.
  • If your pain continues or becomes worse or if you have side effects that concern you, contact your doctor.
  • Hydromorphone may contain sulfites, which can cause allergic reactions in certain individuals (eg, asthma patients). If you have previously had allergic reactions to sulfites, contact your doctor or pharmacist to determine if the medicine you are taking contains sulfites.
  • Tell your doctor or dentist that you use hydromorphone before you receive any medical or dental care, emergency care, or surgery.
  • Use hydromorphone with caution in the ELDERLY; they may be more sensitive to its effects, especially drowsiness and breathing problems.
  • Hydromorphone should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using hydromorphone while you are pregnant. Hydromorphone is found in breast milk. Do not breast-feed while using hydromorphone.

When used for long periods of time or at high doses, hydromorphone may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if hydromorphone stops working well. Do not use more than prescribed.

Some people who use hydromorphone for a long time may develop a need to continue using it. People who use high doses are also at risk. This is known as DEPENDENCE or addiction. Dependence is unlikely to be an issue in terminally ill patients where comfort is more important. If you are using hydromorphone regularly, do not suddenly stop using it without checking with your doctor. WITHDRAWAL symptoms have occurred when hydromorphone is suddenly stopped and may include anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea and vomiting; pain; rigid muscles; seeing, hearing, or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping. Contact your doctor if you notice any of these symptoms after stopping hydromorphone.

Possible side effects of hydromorphone:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; dizziness, drowsiness; dry mouth; flushing; light-headedness; nausea; sweating; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; fainting; fast, slow, or irregular heartbeat; hallucinations; mental or mood changes; seizure; severe or persistent constipation, headache, stomach pain, or vomiting; severe or persistent dizziness or drowsiness; shallow, slowed, or difficult breathing; tremor; trouble urinating; uncontrolled eye movements; uncoordinated muscle movements; vision changes (eg, blurred vision).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include bluish skin; chest pain; cold and clammy skin; coma; difficult, slow, or shallow breathing; excessive sweating; fainting; limp muscles; nausea and vomiting; pinpoint pupils; seizures; severe drowsiness or dizziness; slow or irregular heartbeat.

Proper storage of hydromorphone:

Hydromorphone is usually handled and stored by a health care provider. If you are using hydromorphone at home, store hydromorphone as directed by your pharmacist or health care provider. Keep hydromorphone out of the reach of children and away from pets.

General information:

  • If you have any questions about hydromorphone, please talk with your doctor, pharmacist, or other health care provider.
  • Hydromorphone is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take hydromorphone or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about hydromorphone. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to hydromorphone. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using hydromorphone.

Issue Date: July 2, 2014
Database Edition 14.3.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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