Not sure I understand your question. You want to know if you can take immediate release dilaudid along with the Extended Release (ER) Exalgo? They are both dilaudid just differing release times. Taking the immediate release on top of already taking 16mg ER seems a bit much though.
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I take exalgo 12mg every 24hours and dilaudid 4mg 2 three times a day. is this too much or is it ok?
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