Hydromorphone hydrochloride
Generic name: Hydromorphone hydrochloride
Brand names: Dilaudid
Why is Hydromorphone hydrochloride prescribed?
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Dilaudid, a narcotic analgesic, is prescribed for the relief of moderate to severe pain such as that due to:
Biliary colic (pain caused by an obstruction in the gallbladder or bile duct)
Burns
Cancer
Heart attack
Injury (soft tissue and bone)
Renal colic (sharp lower back and groin pain usually caused by the passage of a stone through the ureter)
Surgery
Most important fact about Hydromorphone hydrochloride
High dose tolerance leading to mental and physical dependence can occur with the use of Dilaudid when it is taken repeatedly. Physical dependence (need for continual doses to prevent withdrawal symptoms) can occur after only a few days of narcotic use, although it usually takes several weeks.
How should you take Hydromorphone hydrochloride?
Take Dilaudid exactly as prescribed by your doctor. Never increase the amount you take without your doctor's approval.
--If you miss a dose...
Take the forgotten dose as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Never try to "catch up" by doubling the dose.
--Storage instructions...
Tablets and liquid should be stored at room temperature. Protect from light and extreme cold or heat. Suppositories should be stored in the refrigerator.
What side effects may occur?
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Dilaudid.
- More common side effects may include:
Anxiety, constipation, dizziness, drowsiness, fear, impairment of mental and physical performance, inability to urinate, mental clouding, mood changes, nausea, restlessness, sedation, sluggishness, troubled and slowed breathing, vomiting
Why should Hydromorphone hydrochloride not be prescribed?
If you are sensitive to or have ever had an allergic reaction to Dilaudid or narcotic painkillers, you should not take Hydromorphone hydrochloride. Make sure that your doctor is aware of any drug reactions that you have experienced.
Additionally, you should not take Dilaudid if you suffer from severe, uncontrolled breathing difficulties or uncontrolled asthma.
Dilaudid cannot be used in pregnant women during labor or delivery.
Special warnings about Hydromorphone hydrochloride
Do not stop taking Hydromorphone hydrochloride without your doctor's approval. Abruptly stopping Dilaudid could cause withdrawal symptoms within the first 24 hours, including restlessness, tearing or watery eyes, dilated pupils, runny nose, yawning, sweating, goosebumps, and restless sleep. These symptoms could increase during the next 72 hours, and new withdrawal symptoms may appear, including irritability, anxiety, weakness, muscle spasms, severe backache, stomach or leg pain, insomnia, vomiting, and diarrhea.
Dilaudid may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery.
Dilaudid should be used with caution if you are in a weakened condition or if you have a severe liver or kidney disorder, hypothyroidism (underactive thyroid gland), Addison's disease (adrenal gland failure), severe lung problems, an enlarged prostate, a urethral stricture (narrowing of the urethra), low blood pressure, or a head injury.
It's important to tell the doctor if you've ever suffered from alcoholism or other drug dependencies. Abusing Dilaudid, or combining it with other nervous system depressants, can cause serious--and possibly life-threatening--side effects.
Dilaudid suppresses the cough reflex; therefore, the doctor will be cautious about prescribing Dilaudid after an operation or for patients with a lung disease.
High doses of Dilaudid may produce labored or slowed breathing. This drug also affects centers that control breathing rhythm and may produce irregular breathing. People who already have breathing difficulties should be very careful about taking Dilaudid. Be especially cautious if you have chronic obstructive pulmonary disease or a condition that reduces oxygen to the tissues (hypoxia) or causes an excess of carbon dioxide in the blood (hypercapnia).
Let the doctor know if you're scheduled to have any surgical procedures involving the biliary tract, since Dilaudid could increase the chance of muscle spasms in this area.
Narcotics such as Dilaudid may mask or hide the symptoms of sudden or severe abdominal conditions, making diagnosis and treatment difficult.
Dilaudid can cause seizures when taken in high doses and, if you have a seizure disorder, can make the seizures worse.
Be sure to tell the doctor if you're sensitive to sulfites (preservatives commonly found in red wine), since Dilaudid contains this substance.
Possible food and drug interactions when taking Hydromorphone hydrochloride
Dilaudid is a central nervous system depressant and intensifies the effects of alcohol. Do not drink alcohol while taking Hydromorphone hydrochloride.
If Dilaudid is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Dilaudid with the following:
Antiemetics (drugs that prevent or lessen nausea and vomiting such as Compazine and Phenergan)
Antihistamines such as Benadryl
General anesthetics
Opioid antagonists such as naloxone (Narcan) and nelmefene (Revex)
Other central nervous system depressants such as Nembutal, Restoril
Other narcotic analgesics such as Demerol and Percocet
Phenothiazines such as Thorazine
Sedative/hypnotics such as Valium, Halcion
Tranquilizers such as Xanax
Tricyclic antidepressants such as Elavil and Tofranil
Special information if you are pregnant or breastfeeding
Do not take Dilaudid if you are pregnant or plan to become pregnant unless you are directed to do so by your doctor. Drug dependence occurs in newborns when the mother has taken narcotic drugs regularly during pregnancy. Withdrawal signs include irritability and excessive crying, tremors, overactive reflexes, increased breathing rate, increased stools, sneezing, yawning, vomiting, and fever. Dilaudid may appear in breast milk and could affect a nursing infant. If Hydromorphone hydrochloride is essential to your health, your doctor may advise you to discontinue breastfeeding your baby until your treatment is finished.
Recommended dosage
ADULTS
Tablets
The usual starting dose of Dilaudid tablets is 2 to 4 milligrams every 4 to 6 hours as determined by your doctor. Severity of pain, your individual response, and your size are used to determine your exact dosage.
Liquid
The usual dose of Dilaudid liquid is one-half to 2 teaspoonfuls every 3 to 6 hours. In some cases, the dosage may be higher.
Suppositories
Dilaudid suppositories (3 milligrams) may provide relief for a longer period of time. The usual adult dose is 1 suppository inserted rectally every 6 to 8 hours or as directed by your doctor.
CHILDREN
The safety and effectiveness of Dilaudid have not been established in children.
OLDER ADULTS
Be very careful when using Dilaudid. Your doctor will prescribe a dose individualized to suit your needs.
Overdosage
- Symptoms of Dilaudid overdose include:
Bluish tinge to skin, cold and clammy skin, constricted pupils, coma, extreme sleepiness progressing to a state of unresponsiveness, labored or slowed breathing, limp, weak muscles, low blood pressure, slow heart rate
In severe overdosage, the patient may stop breathing. Shock, heart attack, and death can occur.
If you suspect an overdose, seek emergency medical treatment immediately.
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