Hydromorphone or Dilaudid belongs to a group of medications called narcotic analgesics, which are pain-relieving medications. Dilaudid is used to relieve pain in patients who require a narcotic. Dilaudid-HP is used to relieve moderate to severe pain in patients who are opioid-tolerant and who require a higher dose of opioids.
Hydromorphone acts on the central nervous system (CNS) to relieve pain. Some of the side effects are also caused by actions in the CNS. When this medication is used for an extended period of time, it can become habit-forming, causing mental or physical dependence.
However, people who have chronic pain should not let the fear of dependence deter them from using narcotics to relieve their pain. Mental dependence is not likely to occur when narcotics are used for the correct reasons (relieving pain).
Physical dependence may occur if the medication is stopped abruptly. However, a gradual reduction of dosage can help prevent severe withdrawal effects.
This medication is only available with your doctor’s prescription. This medication is available in the following forms:
Solution
Powder for solution
2 What to Know Before Using
Before using Dilaudid, you must know all about the risks and complications associated with it. This is a decision that you and your doctor will make together.
For this medication, there are many things that need to be considered:
Allergies: Inform your doctor if you have ever had an allergic reaction to any other medications. It is also important to inform your doctor of any non-medicine allergies such as foods, dyes, preservatives or animals.
Pediatric: No appropriate studies have been performed on the relationship of age to the effects of this medication in children. Safety and efficacy have not been established.
Geriatric: Up-to-date studies have not shown any problems specific to the elderly that would limit the use of this medication in the elderly population. However, elderly patients are more likely to have age-related liver, kidney or heart problems, which may require an adjustment in dose.
Pregnancy: This medication is listed as Pregnancy Category C. This means that animal studies have shown an adverse effect and no studies have been performed on pregnant women OR there are no adequate studies on pregnant animals and pregnant women.
Breastfeeding: Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the baby for side effects and adequate milk intake.
Drug Interactions: Certain medications should not be used together. However, in certain cases, two medications may be used together, even if an interaction might occur. In these cases, your doctor may want to change your dose or take other precautions.
When taking this medication, it is important that you inform your doctor if you are taking any of the medications listed below. The following interactions were selected on the basis of potential significance and are not all-inclusive. Using this medication with any of the following is not recommended.
Your doctor may decide not to treat you with this medication, or change some of the other medications you take:
Naltrexone
Using this medication with any of the following medication is not recommended, but may be unavoidable in some cases.
Your doctor may make the decision not to treat you with this medication or change some of the other medications you take:
Other Interactions: Certain medications should not be used while eating, or while eating certain foods in the case of negative interactions. Using alcohol or tobacco with certain medications may also cause negative interactions. Talk with your doctor about the use of your medication with food, alcohol or tobacco.
Using this medication with any of the following is not normally recommended, but may be unavoidable.
If used together, your doctor may change the dose or how often you take your medication or give you special instructions about the use of food, alcohol or tobacco:
Ethanol
Other Medical Problems: Pre-existing medical problems may affect the use of this medication.
Be sure to tell your doctor if you have any other medical problems, especially:
Seizures - Use with caution. May make these conditions worse.
Kidney disease
Liver disease - Use with caution. The effects may be increased because of slower removal of the medicine from the body.
3 Proper Usage
To use Dilaudid properly, you must follow all instructions given by your doctor. Dilaudid-HP should only be used by patients who have already taken opioids. These patients are called opioid-tolerant. If you are unsure whether or not you are opioid-tolerant, ask your doctor.
A nurse or other trained health professional will give you this medication in a hospital. This medication may be given as a shot placed under the skin (subcutaneous), into one of your muscles (intramuscular) or in one of your veins (intravenous).
This medication may sometimes be given at home to patients who do not need to be in the hospital. If you are using this medication at home, your doctor will teach you how to prepare and inject the medication.
You will be shown the body areas where this shot can be given. Keep track of where you give each shot and be sure to use a different body area each time you use this medication. Use a new needle and syringe each time.
If the medication in the vial or ampule has changed colour, or if you see particles in it, do not use it. Use only the brand of this medication your doctor has prescribed. Different brands may not work the same way.
Dosing: Different patients will be given a different dose of this medication based on the strength of the medication. The number of doses you take each day, the time between doses and the length of time you take this medication depends on the reason you are taking this medication.
The following information only includes the average dose of this medication. If your dose is different, do not change it without first speaking to your doctor.
Dilaudid:
Adults - Start with 1-2mg injected under your skin (subcutaneous) or into your muscle (intramuscular) every 2-3 hours as needed. Your doctor may adjust your dose as needed and tolerated.
Children - Use and dose must be determined by your doctor.
Dilaudid-HP:
Adults - Your dose is the same as your dose of Dilaudid or your doctor will determine your dose based on the dose you already take.
Children - Use and dose must be determined by your doctor.
Missed dose: Call your doctor or pharmacist for instructions.
Storage: Store this medication in a closed container at room temperature. Keep it away from heat, moisture, and direct light. Do not freeze. Keep our of the reach of children.
Do not keep expired medication or medication you no longer need. Flush all expired and leftover medication down the toilet after you have finished your treatment. This medication is one of only a few medications that can be disposed of this way.
4 Precautions to Take
Before using Dilaudid, there are some precautions you must take. It is very important that your doctor checks in with you often while you are receiving this medication to make sure that it is working properly.
Do not take other prescription or over-the-counter medications without asking your doctor. This medication may add to the effects of alcohol and other CNS depressants (medications that make your drowsy or less alert).
Some examples of CNS depressants are antihistamines or allergy medications, sedatives or sleeping medications, prescription pain medications or narcotics, medications for seizures or barbiturates, muscle relaxants or anaesthetics. Inform your doctor if you are using any of the above while on this medication.
This medication may be habit-forming. If you feel the medication is not working well, do not use more than your prescribed dose. Call your doctor for instructions.
Dizziness, lightheadedness or fainting may occur after you take this medication, especially when getting up suddenly from a laying or sitting position. Getting up slowly may lessen this problem. If you feel dizzy, lie back down so you do not faint. Sit for a few moments before standing to prevent the dizziness or lightheadedness from returning.
Using narcotics for a long time may lead to severe constipation. Your doctor may direct you to use laxatives, drink a lot of fluid or increase the amount of fibre in your diet. Be sure to follow the directions carefully, as chronic constipation may lead to more serious problems.
This medication may cause a serious type of allergic reaction called anaphylaxis, which is life-threatening and requires immediate emergency medical help. Inform your doctor immediately if you have a rash, itching, hoarseness, difficulty breathing, difficulty swallowing or any swelling of the hands, face or mouth while using this medication.
If you use this medication regularly for several weeks or longer, do not suddenly stop taking it without asking your doctor. Your doctor may want you to gradually reduce the amount you use before stopping completely.
This may help prevent making your condition worse and reduce the possibility of severe withdrawal symptoms such as abdominal or stomach cramps, anxiety, fever, nausea, runny nose, sweating, tremors or difficulty sleeping (insomnia).
Some babies born to mothers physically dependent on this medication will also be physically dependent and may have breathing problems and withdrawal symptoms. This could be life-threatening and requires immediate medical attention. Inform your doctor immediately if your child has difficulty breathing, shortness of breath, excessive crying, irritability, fever, vomiting or tremors.
5 Potential Side Effects
Make sure you meet with your doctor in using Dilaudid to avoid unwanted potential side effects.
Get emergency medical help if the following symptoms of overdose occur:
Bigger, dilated or enlarged pupils (black part of the eye)
Decreased awareness or responsiveness
Increased sensitivity of the eyes to light
No muscle tone or movement
Sleepiness or unusual drowsiness
Some side effects that may occur do not normally need medical attention. These may leave as your body becomes accustomed to treatment.
Ask your doctor about ways to prevent or reduce some of these side effects. Ask your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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