$200.00 – $1,200.00
Product name: Dilaudid
Active substance: Hydromorphone hydrochloride (Extended Release)
Brand names: Dilaudid
Dosage Strength(s): 2 MG, 4 MG, 8 MG
Quantity: 170 – 750 Capsules
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This medication is used to help relieve moderate to severe pain. Dilaudid (Hydromorphone) belongs to a class of drugs known as opioid (narcotic) analgesics. It works in the brain to change how your body feels and responds to pain.
Hydromorphone is an opioid pain medication, sometimes called a narcotic.
Hydromorphone is used to treat moderate to severe pain.
The extended-release form of this medicine is for around-the-clock treatment of moderate to severe pain. This form of hydromorphone is not for use on an as-needed basis for pain.
Hydromorphone may also be used for purposes not listed in this medication guide.
You should not take this medicine if you have ever had an allergic reaction to hydromorphone or other narcotic medicines, or if you have:
severe asthma or breathing problems;
a blockage in your stomach or intestines; or
a bowel obstruction called paralytic ileus.
Do not use hydromorphone if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
Some medicines can interact with hydromorphone and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, herbal products, or medicine for depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.
To make sure Dilaudid is safe for you, tell your doctor if you have ever had:
any type of breathing problem or lung disease;
a injury, brain tumor, or seizures;
drug or alcohol addiction, or mental illness;
liver or kidney disease;
problems with your gallbladder, pancreas, or thyroid; or
Addison’s disease or other adrenal gland disorder.
If you use hydromorphone while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.
Do not breast-feed. Hydromorphone can pass into breast milk and may cause drowsiness or breathing problems in a nursing baby.
Dilaudid is available as immediate-release and extended-release tablets, an injection, a rectal suppository, and an oral liquid. Your dose will depend on your condition, pain level, and other factors.
Injectable Dilaudid is typically administered once every two to three hours as needed.
Oral: 2 to 4 mg every four hours
Opioid Analgesic Equivalents with Approximately Equianalgesic Potency
morphine sulfate IM/SC 10 mg OR ORAL 30 mg
hydromorphone HCl (DILAUDID® preparations) IM/SC1.3-2.0 mg OR ORAL 6.5-7.5 mg
pethidine HCl IM/SC 75-100 mg OR ORAL 300-400 mg
methadone HCl IM/SC 10 mg OR ORAL 10-20 mg
*Dosages and ranges of dosages represented in the above table are a compilation of estimated equipotent dosages from published references comparing opioid analgesics in cancer and severe pain.
Follow all directions on your prescription label. Hydromorphone can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never use hydromorphone in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Hydromorphone may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away hydromorphone is against the law.
Do not crush, break, or open an extended-release pill. Swallow it whole to avoid exposure to a potentially fatal dose.
Stop taking all other around-the-clock narcotic pain medications when you start taking hydromorphone. Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. Do not stop using hydromorphone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using hydromorphone.
Never crush or break a hydromorphone pill to inhale the powder or mix it into a liquid to inject the drug into your vein. This can cause in death.
Store at room temperature away from moisture, heat, and light. Throw away any unused liquid after 90 days.
Keep track of your medicine. Hydromorphone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.
Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush the unused medicine down the toilet.
Since Dilaudid is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A hydromorphone overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, very slow breathing, or coma.
What to avoid
Do not drink alcohol. Dangerous side effects or death could occur.
Avoid driving or operating machinery until you know how hydromorphone will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
Narcotic (opioid) medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:
other narcotic medications –opioid pain medicine or prescription cough medicine;
a sedative like Valium —diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others; or
drugs that make you sleepy or slow your breathing –a sleeping pill, muscle relaxer, tranquilizer, antidepressant, or antipsychotic medicine.
This list is not complete. Other drugs may interact with hydromorphone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
DILAUDID SIDE EFFECTS
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Like other narcotic medicines, hydromorphone can slow your breathing. Death may occur if breathing becomes too weak. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, pinpoint pupils, or if you are hard to wake up.
Call your doctor at once if you have:
Noisy breathing, sighing, shallow breathing;
a slow heart rate or weak pulse;
confusion, feelings of extreme happiness or sadness;
severe weakness or drowsiness;
a light-headed feeling, like you might pass out;
low cortisol levels –nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Serious side effects may be more likely in older adults and those who are malnourished or debilitated.
Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.
Common side effects may include:
constipation, nausea, vomiting, stomach pain;
headache, tired feeling;
feelings of extreme happiness or sadness;
sweating, mild itching;
dry mouth; or flushing (warmth, redness, or tingly feeling).
PRECAUTIONS AND WARNINGS
Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.
Alcohol use: Alcohol increases the risk of severe side effects of hydromorphone, such as decreased blood pressure, seizures, breathing problems, and severe drowsiness. Consuming alcohol while you are taking Dilaudid is not recommended.
Abdominal (stomach) conditions: Like other narcotic medications, hydromorphone may make the diagnosis of abdominal conditions more difficult or it may worsen these conditions. If you have a history of abdominal problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Accidental use: Accidental ingestion or use of as little as one dose of Dilaudid by someone for whom it has not been prescribed can lead to a fatal overdose. Children are especially at risk. Keep this medication out of sight and reach of children.
Constipation: Constipation happens frequently while taking opioid (narcotic) pain relievers on a regular basis. Ask your doctor or pharmacist for advice on how to manage constipation.
Dependence and withdrawal: As with other opioid medications (narcotics), this medication may become habit-forming if taken for long periods of time. Misuse of hydromorphone usually is not a problem when it is used appropriately for pain relief. Withdrawal symptoms (e.g., body aches, diarrhea, nausea, nervousness, restlessness, runny nose, sneezing, goose bumps, shaking, shivering, nausea, stomach cramps, fast heart rate, fever, sweating) may occur if hydromorphone is stopped suddenly. Reducing the dose gradually under medical supervision can help prevent or decrease these withdrawal symptoms when this medication is no longer required for pain control.
Difficulty breathing: Dilaudid can cause serious breathing problems. If you experience slowed breathing or difficulty breathing, seek immediate medical attention. People are more at risk for experiencing this if they have lung problems or a head injury or are taking other medications that can slow breathing. Make sure you follow the instructions on how to properly use this medication. If you have any questions, contact your doctor or pharmacist. If you have a chronic lung condition (e.g., bronchitis, emphysema, asthma), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Drowsiness/reduced alertness: Dilaudid may reduce the mental or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery. Do not drive or operate dangerous machinery while using this medication unless you have determined that the medication does not affect your ability to do so.
Head injury: Hydromorphone can cause increased pressure inside the head. If you have experienced a head injury or other condition which increases the pressure inside your head, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Kidney function: Decreased kidney function or kidney disease may cause this medication to build up in the body, causing side effects. If you have reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have reduced liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Low blood pressure: Hydromorphone can make low blood pressure worse or cause low blood pressure, which may be severe. If you experience severe dizziness, especially when standing from a lying or sitting position, contact your doctor.
Other medical conditions: Hydromorphone may cause increased symptoms or reduce the symptoms of worsening illness for people with the following conditions:
enlarged prostate (BPH)
irregular heart rhythms
narrowing of the urethra
If you have any of these conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Seizures: Hydromorphone may worsen pre-existing seizure disorders. If tolerance to the medication develops and the dosage is increased substantially above recommended levels, seizures may occur in people without a history of seizure disorders. If you have a history of seizure disorders, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. Infants born to mothers who have been taking hydromorphone for long periods of time or who are physically dependent on hydromorphone will also be physically dependent on the medication and may experience breathing difficulties as well as withdrawal symptoms.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking hydromorphone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using hydromorphone have not been established for children.
Seniors: Seniors may be more sensitive to the effects of hydromorphone and may require lower doses to reduce the risk of side effects.
Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient.
Inspire Health Pharmacy does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.
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