HYDROMORPHONE (ORAL)

(HYE droe MOR fone) Brand: Dilaudid, Dilaudid-5, Exalgo

What is the most significant information I must know about hydromorphone?

• Hydromorphone may be habit-forming and should be used only by the face for whom it was prescribed. Hold the medicine in a secure seat where others can't get to it.

• Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with a narcotic pain medication. Check your food and medication labels to be certain these commodity do not contain alcohol.

• Never take hydromorphone in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Speak your doctor if the medication seems to stop working as well in relieving your pain.

• This medicine may impair your thinking or reactions. Avoid driving or operating machinery before you know how hydromorphone will affect you.

• Do not stop using hydromorphone suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using hydromorphone.

What is hydromorphone?

• Hydromorphone is an opioid pain medicine. An opioid is sometimes called a narcotic.

• Hydromorphone is used to treat temperate to severe pain. The extended-release form of this medicine is for around-the-clock treatment of pain.

• Hydromorphone may also be used for purposes not listed in this medicine guide.

What must I discuss with my healthcare provider till using hydromorphone?

• Do not use this medicine if you have ever had an allergic reaction to a narcotic medication (examples include codeine, methadone, morphine, Lortab, OxyContin, Percocet, Vicodin, and much others).

• You must also not take hydromorphone if you have:

· a bowel obstruction called paralytic ileus; or

· if you are having an asthma onslaught.

• Do not take hydromorphone if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the recent 14 days. A dangerous drug interaction could occur, leading to serious side effects.

• To create certain you can safely take hydromorphone, speak your doctor if you have any of these another conditions:

· asthma, COPD, sleep apnea, or another breathing disorders;

· sulfite allergy;

· liver or kidney disease;

· underactive thyroid;

· curvature of the spine;

· a history of head injury or brain tumor;

· epilepsy or another seizure disorder;

· low blood pressure;

· gallbladder malady or pancreatitis;

· Addison's malady or another adrenal gland disorders;

· enlarged prostate, urination problems;

· mental diseases;

· a history of alcoholism or drug addiction; or

· if you have recently used alcohol, sedatives, tranquilizers, or another narcotic medications.

• Hydromorphone may be habit forming and must be used only by the face for whom it was predesigned. Never share hydromorphone with other face, especially somebody with a history of drug abuse or addiction. Hold the medicine in a seat where others can't get to it.

• You may not be able to take hydromorphone unless you are already being treated with a similar opioid pain medication and your body is tolerant to it. Opioid medicines include fentanyl (Actiq, Duragesic), methadone (Methadose, Dolophine), morphine (Kadian, MS Contin, Oramorph), oxycodone (Oxycontin), oxymorphone (Opana), and much others. Conversation with your doctor if you are not certain you are opioid-tolerant.

• FDA pregnancy category C. It is not known whether hydromorphone will harm an unborn child. Hydromorphone may reason addiction or withdrawal symptoms in a newborn if the mother uses the medicine during pregnancy. Speak your doctor if you are pregnant or plan to become pregnant while using hydromorphone.

• Hydromorphone can pass into breast milk and may harm a nursing child. You must not breast-feed while you are using hydromorphone.

• Serious side effects may be more likely in older adults and those who are ill or debilitated.

How must I use hydromorphone?

• Take exactly as predesigned. Never take hydromorphone in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Speak your doctor if the medication seems to stop working as well in relieving your pain.

• Do not crush, chew, or interrupt an extended-release tablet. Swallow it intact. Breaking the pill may reason too many of the drug to be released at one time.

• Measure liquid medication with a particular dose-measuring spoon or medication cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

• Store at room temperature away from moisture, heat, and easy. Throw away any unused liquid after 90 days.

• Hold track of the amount of medication used from every new bottle. Hydromorphone is a drug of abuse and you must be aware if anyone is using your medication improperly or without a prescription.

• After you have stopped using this medicine, flush any unused pills or liquid down the toilet.

What happens if I miss a dose?

• Since hydromorphone is used on an as needed basis, you are not likely to miss a doze. Do not use extra medication to create up the missed dose.

• Extended-release hydromorphone is not for use on an as-needed basis for pain.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222. An overdose of hydromorphone can be fatal.

• Overdose symptoms may include extreme drowsiness, pinpoint pupils, confusion, cool and clammy skin, weak pulse, shallow breathing, fainting, or breathing that stops.

What must I avoid while using hydromorphone?

• This medicine may impair your thinking or reactions. Avoid driving or operating machinery before you know how hydromorphone will affect you.

What are the possible side effects of hydromorphone?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your person, lips, tongue, or throat.

• Call your doctor at once if you have a serious side effect such as:

· weak or shallow breathing;

· pounding heartbeats or fluttering in your chest;

· wheezing, chest tightness, trouble breathing;

· seizure (convulsions);

· confusion, severe weakness or drowsiness; or

· feeling like you might pass out.

• Smaller serious side effects are more likely to occur, such as:

· blurred vision, double vision;

· flushing (warmth, redness, or tingly feeling);

· nausea, vomiting, constipation, diarrhea, stomach pain;

· dizziness, drowsiness;

· dry mouth;

· sweating;

· itching; or

· sleep problems (insomnia), or strange dreams.

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect hydromorphone?

• Do not take hydromorphone with another narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or another medicines that can create you sleepy or slow your breathing. Dangerous side effects may result.

• Speak your doctor about all another medicines you use, especially:

· buprenorphine (Buprenex, Subutex);

· butorphanol (Stadol);

· nalbuphine (Nubain);

· pentazocine (Talwin);

· atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm Scop);

· bladder or urinary medicines such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);

· bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);

· irritable bowel medicines such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro Banthine); or

· ulcer medications such as glycopyrrolate (Robinul) or mepenzolate (Cantil).

• This list is not complete and another drugs may interact with hydromorphone. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about hydromorphone.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. 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 drugs you are taking, check with your doctor, nurse or pharmacist.

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