Hydromorphone Hydrochloride

Uses

Hydromorphone hydrochloride is used to relieve moderate to severe pain. Hydromorphone hydrochloride is indicated to provide temporary relief from some acute and chronic medical conditions, including postoperative pain, cancer and acute trauma. Your doctor may have prescribed this medicine to treat your gallbladder pain, burns, heart attack or kidney stone. This drug may also be given to provide analgesia during diagnostic and orthopedic procedures.

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Administration/Dosage

Hydromorphone hydrochloride is available in a tablet to be taken by mouth or as an injection. Hydromorphone is also known by its brand name, Dilaudid.

Tablets are available in 2 mg, 4 mg and 8 mg doses. The typical oral prescription calls for 2 mg to 4 mg by mouth every four to six hours as needed for pain.

Nurses inject 1 mg to 4 mg hydromorphone hydrochloride into a vein, muscle or just under the skin every four to six hours as needed; onset of pain relief is usually 15 minutes after injection. Mechanical pumps may deliver hydromorphone hydrochloride for around-the-clock pain relief. A 3 mg suppository may be given every six to eight hours as needed to control pain.

The safety and efficacy of this drug has not been established in children. Talk with your pediatrician to find out if hydromorphone hydrochloride is the right medicine to treat your child's pain.

Physicians should start geriatric patients on small doses of hydromorphone hydrochloride and monitor older patients closely in the first few hours of treatment. Elderly patients experience a greater frequency of medical conditions, such as liver, kidney and heart problems, that may increase the patient's sensitivity to opiates and risk for side effects.

Hydromorphone hydrochloride is typically prescribed on an as-needed basis rather than on a regular schedule. If you are taking this drug on a firm schedule to provide complete coverage for chronic pain and you miss a dose, take the missing dose as soon as you think of it. However, if it is nearly time to take another dose and you can tolerate the pain, skip the missing dose and resume your normal schedule. Read More About Hydromorphone Hydrochloride Administration and Dosage

Action

Hydromorphone hydrochloride works in the brain and central nervous system. This drug binds with pain receptors in nerve endings to replace a message of pain with one of euphoria and pleasure - it changes the way your brain perceives pain. Hydromorphone hydrochloride also suppresses cough by working on your medulla, the part of your brain stem responsible for coughing. Hydromorphone also works on smooth muscle in such a way that slows down your digestive tract. More About How Hydromorphone Hydrochloride Works

Precautions

An allergic reaction is a serious, potentially life-threatening medical emergency. Give your doctor a complete list of all allergies, especially any allergies to prescription or over-the-counter medications. Tell your doctor if you have ever suffered an allergic reaction to Dilaudid or other narcotic drugs like codeine, methadone, morphine, Oxycontin, Darvocet, Percocet, Vicodin and Lortab.

You may not be able to take hydromorphone hydrochloride if you have a history of certain medical conditions. Tell your doctor about any serious or chronic illnesses including:

  • Head Injury, Brain Tumors or Seizures.
  • Liver or Kidney Disease.
  • History of Alcoholism.
  • Lung or Thyroid Disease.
  • Heart Disease.
  • Prostate or Urinary Problems.
  • Personal or Family History of Mental Illness, Depression or Other Mood Disorders.
  • Personal of Family History of Drug or Alcohol Abuse.

Hydromorphone hydrochloride may make you drowsy or interfere with your ability to make decisions. Do not operate heavy machinery or drive a car until you know how this drug affects you. Avoid engaging in risky behaviors that require you be alert and awake.

Do not consume alcohol while taking hydromorphone hydrochloride. This drug intensifies the effects of alcohol.

Your doctor may order laboratory tests to measure the effectiveness of treatment and look for signs of serious side effects. Keep all doctor and laboratory appointments and alert your physician or laboratory technician to any problems you have with side effects or with hydromorphone hydrochloride.

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Warnings

The FDA has categorized hydromorphone hydrochloride as a Pregnancy Category C, which means scientists cannot determine if this drug can affect your unborn baby. Talk with your physician if you are pregnant or plan to become pregnant to find out if taking hydromorphone hydrochloride is worth the risk to your unborn child. Do not take hydromorphone hydrochloride while breastfeeding, as this drug may pass into breast milk.

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Drug Interactions

Hydromorphone hydrochloride may increase or decrease the effectiveness of other medications or interact in an unfavorable or even dangerous way with other prescriptions, over-the-counter medications and herbal remedies. Give your doctor and pharmacist a complete list of medicines. Be sure to tell your doctor if you take any of the following drugs:

  • Antiemetics (drugs that prevent or lessen nausea and vomiting such as Compazine and Phenergan)
  • Antihistamines
  • General Anesthetics
  • Narcotic Pain Relievers.
  • Antipsychotics.
  • Sedatives.
  • Tranquilizers.
  • Antidepressants.

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Side effects

You may experience side effects while taking hydromorphone hydrochloride. If side effects become acute or don't go away on their own, talk with your doctor. Common side effects include dizziness, drowsiness, blurred vision, dry mouth, lightheadedness, sweating, nausea and vomiting.

Some side effects can be severe or life-threatening. Seek medical assistance immediately if you experience severe side effects such as:

  • Allergic Reaction.
  • Fainting.
  • Hallucinations.
  • Irregular Heartbeat.
  • Mood Changes.
  • Seizure.
  • Trouble Breathing.
  • Tremors.
  • Vision Changes.
  • Severe or Persistent Dizziness and Drowsiness.

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Overdose

Taking too much hydromorphone hydrochloride can lead to overdose, a serious and life-threatening medical condition. If you think that you have taken too much hydromorphone hydrochloride, or suspect someone you know has overdosed, seek emergency assistance immediately by going to the emergency room or calling an ambulance. You may also contact your local poison control center at 1-800-222-1222. Overdose symptoms include:

  • Extreme Drowsiness.
  • Pinpoint Pupils.
  • Confusion
  • Cold and Clammy Skin.
  • Weak Pulse.
  • Shallow Breathing.
  • Fainting.
  • Breathing that Stops.

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Abuse

Hydromorphone hydrochloride is a Schedule II drug, which means researchers consider this drug to carry significant risk for physical as well as psychological dependence if abused. The pleasant, narcotic effects of this drug make it a target for abuse. Recreational users obtain hydromorphone hydrochloride by "doctor shopping", presenting forged prescriptions or by stealing from pharmacies and friends. Read More About Hydromorphone Hydrochloride Abuse

Withdrawal

Withdrawal is not necessarily a sign of criminal substance abuse. Withdrawal symptoms are normal, predictable signs of physical and mental dependency. You may experience unpleasant withdrawal symptoms may appear after you stop taking hydromorphone hydrochloride, especially if you have been taking this opioid for a long time or have been on very high doses. Everyone experiences withdrawal differently. Some may have withdrawal symptoms so severe that they cannot stop taking hydromorphone hydrochloride without help. Speak with your physician, or seek out in-patient or out-patient rehabilitative services, if withdrawal symptoms prevent you from quitting hydromorphone hydrochloride. Withdrawal symptoms include:

  • Insomnia.
  • Delusions.
  • Tremors.
  • Rapid Heartbeat.
  • Rigid Muscles.
  • Anxiety.
  • Flu-like Symptoms.
  • Sweating.

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Detox

You may need the help of qualified professionals to help you detoxify your body from hydromorphone hydrochloride. Strong withdrawal symptoms may make dependency and addiction to hydromorphone hydrochloride difficult to overcome on your own. Quitting may be more difficult if you have been taking large doses or using opioids for a long time. Talk with your doctor or seek in-patient and out-patient treatment facilities where trained professionals can minimize withdrawal symptoms, detoxify your body and give you the tools you need to live drug-free. Detoxification, rehabilitation and counseling are effective therapies to treat addiction to hydromorphone hydrochloride and other opiates.

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Storage

Store tablets and injectable hydromorphone hydrochloride at 59 degrees to 86 degrees Fahrenheit, away from direct light, moisture and heat. Suppositories should be stored in the refrigerator, temperatures maintained between 36 degrees and 46 degrees Fahrenheit. Keep this and all medicines out of reach of children and pets.

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