$Unique_ID{BRK03186} $Pretitle{} $Title{hydromorphone} $Subject{Dilaudid Knoll hydrochloride Analgesic hydromorphone narcotic analgesic central nervous system brain spinal cord pain} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. hydromorphone ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Dilaudid (Knoll) hydromorphone hydrochloride (various manufacturers) TYPE OF DRUG Analgesic INGREDIENT hydromorphone DOSAGE FORMS Tablets (1 mg, 2 mg, 3 mg, and 4 mg) Suppositories (3 mg) STORAGE Hydromorphone tablets should be stored at room temperature in a tightly closed, light-resistant container. The suppositories should be stored in the refrigerator. USES Hydromorphone is a narcotic analgesic that acts directly on the central nervous system (brain and spinal cord). It is used to relieve moderate to severe pain. TREATMENT In order to avoid stomach upset, you can take hydromorphone tablets with food or milk. To use the suppository, remove the foil wrapper and moisten the suppository with water (if the suppository is too soft to insert, refrigerate it for half an hour or run cold water over it before removing the wrapper). Lie on your left side with your right knee bent. Push the suppository into the rectum, pointed end first. Lie still for a few minutes. Try to avoid having a bowel movement for at least an hour. Hydromorphone works best if you take it at the onset of pain, rather than when the pain becomes intense. If you are taking this medication on a regular schedule and you miss a dose, take the missed dose as soon as possible, unless it is almost time for your next dose. In that case, do not take the missed dose at all; just return to your regular dosing schedule. Do not double the next dose. SIDE EFFECTS Minor. Constipation, dizziness, drowsiness, dry mouth, false sense of well-being, flushing, light-headedness, loss of appetite, nausea, or sweating. These side effects should disappear as your body adjusts to the medication. If you are constipated, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads), exercise, and drink more water (unless your doctor directs you to do otherwise). Chew sugarless gum or suck on ice chips or a piece of hard candy to reduce mouth dryness. If you feel dizzy or light-headed, sit or lie down for a while; get up from a sitting or lying position slowly, and be careful on stairs. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about anxiety, confusion, continued constipation, difficult or painful urination, difficulty in breathing, excitability, fatigue, rash, restlessness, sore throat and fever, tremors, or weakness. INTERACTIONS Hydromorphone interacts with several other types of drugs: 1. Concurrent use of it with other central nervous system depressants (such as alcohol, antihistamines, barbiturates, benzodiazepine tranquilizers, muscle relaxants, and phenothiazine tranquilizers) or with tricyclic antidepressants can cause extreme drowsiness. 2. A monoamine oxidase (MAO) inhibitor taken within 14 days of this medication can lead to unpredictable and severe side effects. BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially those listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to hydromorphone or to any other narcotic analgesics (such as codeine, hydrocodone, meperidine, methadone, morphine, oxycodone, and propoxyphene). * Tell your doctor if you now have or if you have ever had acute abdominal conditions, asthma, brain disease, colitis, epilepsy, gallstones or gallbladder disease, head injuries, heart disease, kidney disease, liver disease, lung disease, mental illness, emotional disorders, prostate disease, thyroid disease, or urethral stricture. * If this drug makes you dizzy or drowsy, do not take part in any activity that requires alertness, such as driving a car or operating potentially dangerous machinery. * Before having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking this medication. * Hydromorphone has the potential for abuse and must be used with caution. Usually, you should not take it on a regular schedule for longer than ten days (unless your doctor directs you to do so). Tolerance develops quickly; do not increase the dosage or stop taking the drug abruptly, unless you first consult your doctor. If you have been taking large amounts of this medication for long periods, you may experience a withdrawal reaction (muscle aches, diarrhea, gooseflesh, runny nose, nausea, vomiting, shivering, trembling, stomach cramps, sleep disorders, irritability, weakness, excessive yawning, or sweating). Your doctor may, therefore, want to reduce the dosage gradually. * The elderly may be more sensitive to side effects, especially constipation, mental effects, or breathing problems. Report any such effects to your doctor. * Be sure to tell your doctor if you are pregnant. The effects of this medication during the early stages of pregnancy have not been thoroughly studied in humans. However, hydromorphone used regularly in large doses during the later stages of pregnancy can result in addiction of the fetus, leading to withdrawal symptoms (irritability, excessive crying, tremors, fever, vomiting, diarrhea, sneezing, or excessive yawning) at birth. Also, be sure to tell your doctor if you are breast-feeding an infant. Small amounts of this medication may pass into breast milk and cause excessive drowsiness in the nursing infant. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.