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Hydromorphone (By mouth)

Hydromorphone (hye-droe-MOR-fone)

Treats moderate to severe chronic pain. This medicine is a narcotic analgesic.

Brand Name(s):

Dilaudid, Exalgo

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

Do not use this medicine if you have had an allergic reaction to hydromorphone or sulfites. Do not use this medicine if you have severe breathing or lung problems (such as severe asthma), paralytic ileus, or stomach or bowel blockage or narrowing.

How to Use This Medicine:

Liquid, Tablet, Long Acting Tablet

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
  • Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
  • Swallow the extended-release tablet whole. Do not crush, break, or chew it.
  • Take the extended-release tablet at the same time each day.
  • If you take the extended-release tablet, part of the tablet may pass into your stools. This is normal and is nothing to worry about.
  • Drink plenty of liquids to help avoid constipation.
  • If the medicine comes in contact with your skin, rinse it with cool water right away.
  • Exalgo® tablets works differently than hydromorphone tablets, even at the same dose (number of milligrams). Do not switch from the extended-release tablets to the immediate-release tablets unless your doctor tells you to.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
  • If you are using the extended-release tablets, do not take another dose of this medicine within 24 hours.

How to Store and Dispose of This Medicine:

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • This medicine can cause serious side effects if used by adults or children who are not used to strong narcotic pain medicines. Make sure you store the medicine in a safe and secure place to prevent others from getting it. Keep the medicine away from pets.
  • Do not throw any unused or expired medicine in the trash. Take it to a community take-back program or flush it down the toilet.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • There are many medicines that can interact with hydromorphone. Make sure your doctor knows about all other medicines you are using.
  • Make sure your doctor knows if you use a buprenorphine (Buprenex®), butorphanol (Stadol®), nalbuphine (Nubain®), pentazocine (Talwin®), muscle relaxants (such as cyclobenzaprine, pancuronium, tubocurarine, Flexeril®, Pavulon®), or a phenothiazine medicine (such as promethazine, Phenergan®, Thorazine®). Tell your doctor if you use atropine, dicyclomine (Bentyl®), or glycopyrrolate (Robinul®).
  • Tell your doctor if you are using or have used an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days.
  • Tell your doctor if you drink alcohol or if you are using any medicine that makes you sleepy, such as allergy medicine or narcotic pain medicine.
  • Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

  • Make sure your doctor knows if you are pregnant or breastfeeding or if you have kidney disease, liver disease, heart disease, heart rhythm problems, lung disease or breathing problems (such as chronic obstructive pulmonary disease [COPD], cor pulmonale, hypercapnia), low blood pressure, an underactive thyroid, Addison disease, pancreas problems, prostate problems, problems with urination, cystic fibrosis, or stomach or bowel problems. Tell your doctor if you have a history of head injury, brain tumor, seizures, depression, mental problems, or severe scoliosis. Tell your doctor if you have a history of alcohol or drug abuse.
  • Do not use more of this medicine or take it more often than your doctor tells you to. This can be life-threatening. Symptoms of an overdose include extreme dizziness or weakness, slow heartbeat or breathing, seizures, trouble breathing, and cold, clammy skin. Call your doctor right away if you notice these symptoms.
  • This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
  • Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
  • This medicine may make you dizzy, drowsy, or lightheaded. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you feel lightheaded or dizzy.
  • This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.
  • Call your doctor if your symptoms do not improve or if they get worse.It may take a day or longer for the medicine to reach its full effect.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Blue lips, fingernails, or skin
  • Change in how much or how often you urinate
  • Confusion, trouble breathing, slow or shallow breathing, weakness, sweating, cold or clammy skin
  • Fast, slow, or uneven heartbeat
  • Lightheadedness, dizziness, fainting
  • Seizures

If you notice these less serious side effects, talk with your doctor:

  • Constipation, diarrhea, nausea, vomiting, loss of appetite, stomach pain
  • Headache, trouble sleeping
  • Sleepiness or unusual drowsiness

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088


Last Updated: 4/4/2014

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