Exalgo

Generic Name: hydromorphone (oral) (HYE droe MOR fone)
Brand Names: Dilaudid, Dilaudid-5, Exalgo

What is Exalgo?

Exalgo (hydromorphone) is in a group of drugs called narcotic pain relievers, also called opioids. It is similar to morphine.

Exalgo is used in people who are opioid tolerant, to manage moderate to severe pain that continues around-the-clock and is expected to last for a long period of time.

Exalgo is a federally controlled substance (CII) because it contains a strong opioid pain medicine that can be a target for people who abuse prescription medicines or street drugs.

Exalgo may also be used for other purposes not listed in this medication guide.

Important information about Exalgo

Exalgo may be habit-forming and should be used only by the person it was prescribed for. Never share Exalgo with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Do not drink alcohol. 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.

Video: Rheumatoid Arthritis

Learn the signs of RA and how to relieve the pain.

Never take Exalgo in larger amounts, or 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.

Exalgo may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop using Exalgo suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using Exalgo.

Before using Exalgo

Do not use Exalgo 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 Exalgo if you are having an asthma attack or if you have a bowel obstruction called paralytic ileus. Exalgo may be habit-forming and should be used only by the person it was prescribed for. Never share Exalgo with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

If you have any of these other conditions, you may need a Exalgo dose adjustment or special tests:

• asthma, COPD, sleep apnea, or other breathing disorders;

• liver or kidney disease;

• underactive thyroid;

• curvature of the spine;

• a history of head injury or brain tumor;

• epilepsy or other seizure disorder;

• low blood pressure;

• gallbladder disease;

• 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. It is not known whether Exalgo will harm an unborn baby. Exalgo may cause addiction or withdrawal symptoms in a newborn if the mother takes the medication during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while using Exalgo. Hydromorphone can pass into breast milk and may harm a nursing baby. Do not use Exalgo without telling your doctor if you are breast-feeding a baby.

See also: Exalgo pregnancy and breastfeeding warnings (in more detail)

You should not use Exalgo if youare not already regularly taking opioid pain medicine and your body is not used to taking these medicines for your pain. This means you are not opioid tolerant. 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 Exalgo?

Take Exalgo exactly as prescribed. Never take Exalgo in larger amounts, or 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 Exalgo tablet with a full glass of water. Do not crush, chew, or break an Exalgo tablet. Swallow the tablet whole. Breaking the tablet may cause too much of the hydromorphone to be released at one time.

Do not stop using Exalgo suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using Exalgo.

Store Exalgo at room temperature, away from heat, moisture, and light. Keep track of the amount of medicine used from each new bottle.

Exalgo is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

After you have stopped using this medication, flush any unused tablets down the toilet. For more information see How to Dispose of Unused Medicines.

What happens if I miss a dose?

If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. 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 Exalgo?

Do not drink alcohol. 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. Exalgo may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Exalgo side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Exalgo: 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;

• seizure (convulsions);

• cold, clammy skin;

• confusion;

• severe weakness or dizziness; or

• feeling light-headed, fainting.

Less serious Exalgo side effects are more likely to occur, such as:

• nausea, vomiting, constipation, loss of appetite;

• warmth, tingling, or redness under your skin;

• dizziness, headache;

• dry mouth;

• sweating; or

• itching.

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.

See also: Exalgo side effects (in more detail)

What other drugs will affect Exalgo?

Do not take Exalgo 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 Exalgo, 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 Exalgo, or you may need dosage adjustments or special tests during treatment.

This list is not complete and other drugs may interact with Exalgo. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Exalgo.