hydromorphone

If you are prescribed this medication on a regular schedule and miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Depending on your specific product, this medication is given by injection under the skin, into a muscle, or slowly into a vein. When given into a vein, this medication may be given as a continuous injection using an infusion pump. Use exactly as directed by your doctor. Learn the proper way to give injections. If you have any questions about using this medication properly, consult your doctor or pharmacist. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Before injecting each dose, clean the injection site with rubbing alcohol. If this medication is given into a muscle or under the skin, it is important to change the location of the injection site with each dose to avoid problem areas under the skin. Use needles and syringes only once. Learn how to discard needles and medical supplies safely. Some brands of this medication contain more than 1 dose. Some brands contain only 1 dose. Review the use of the product you have been prescribed with your pharmacist. If your doctor has directed you to use a single-dose brand, use it for only 1 dose. Do not save any medication remaining in the package. Consult your pharmacist for more information. The dosage is based on your medical condition and response to treatment. Pain medications work best if they are used when the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well. Do not increase your dose, use the medication more frequently, or use it for a longer time than prescribed. Properly stop the medication when so directed. If nausea occurs, consult your doctor or pharmacist for ways to decrease it (such as taking antihistamines, lying down for 1 to 2 hours with as little head movement as possible). If you are taking long-acting narcotic medications or use narcotic patches for ongoing pain, this medication might be used for sudden (breakthrough) pain only as needed. Also follow your doctor's or pharmacist's instructions for safely using non-narcotic pain relievers (such as naproxen, ibuprofen). If you have any questions, ask your doctor or pharmacist. This medication may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses. In such cases, withdrawal symptoms (such as mental/mood changes, fast breathing, yawning, sweating, watering eyes, goosebumps, muscle twitching) may occur if you suddenly stop using this medication. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately. Along with its benefits, this medication may rarely cause abnormal drug-seeking behavior (addiction). This risk may be increased if you have abused alcohol or drugs in the past. Use this medication exactly as prescribed to lessen the risk of addiction. When this medication is used for a long time, it may not work as well. Your doctor may need to increase your dose or change your medication. Talk with your doctor if this medication stops working well. Tell your doctor if your pain persists or worsens.

The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring. To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval. Some products that may interact with this drug include: cimetidine, drugs that slow down the movement of the gut (such as benztropine, belladonna alkaloids, oxybutynin), certain pain medications (mixed narcotic agonists/antagonists such as pentazocine, nalbuphine, butorphanol), narcotic antagonists (such as naltrexone, naloxone). The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if you use this medication with other products that may also affect breathing or cause drowsiness. Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, psychiatric medicines (such as MAO inhibitors, chlorpromazine, risperidone, amitriptyline, trazodone). Your dose of hydromorphone or your other medications may need to be changed. Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely. This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.

Do not share this medication with others. It is against the law. This medication has been prescribed for your current condition only. Do not use it later for another condition unless told to do so by your doctor. A different medication may be necessary in that case.

If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, inability to wake up, slow/shallow breathing, slow heartbeat, cold/clammy skin, bluish skin/lips/nails, seizures.

Before using hydromorphone, tell your doctor or pharmacist if you are allergic to it; or to other narcotic pain medications; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: abdominal problems (such as chronic constipation, ileus), brain disorders (such as brain injury, tumor, increased intracranial pressure, seizures), diarrhea due to infection (such as Clostridium difficile), breathing problems (such as emphysema, chronic bronchitis, asthma, sleep apnea), heart problems (such as irregular heartbeat, heart failure, low blood pressure), disease of the pancreas (such as pancreatitis), mental/mood disorders (such as depression, psychosis), a certain spinal problem (kyphoscoliosis), gallbladder disease, personal or family history of regular use/abuse of drugs/alcohol, kidney disease, liver disease, adrenal gland problem (such as Addison's disease), difficulty urinating (such as due to enlarged prostate or urethral stricture), underactive thyroid (hypothyroidism), intoxication with medications that depress the nervous system or your breathing (CNS/respiratory depressants such as alcohol or tranquilizers/sedatives). This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid the use of alcohol and certain other medications that cause drowsiness (see also Drug Interactions section). Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Caution is advised when using this drug in older adults because they may be more sensitive to its effects, especially slow/shallow breathing, urination problems, and drowsiness. During pregnancy, this medication should be used only when clearly needed. Using it for long periods or in high doses near the expected delivery date is not recommended because of possible harm to the unborn baby. Discuss the risks and benefits with your doctor. Infants born to mothers who have used this medication for an extended time may have breathing problems or withdrawal symptoms such as irritability, abnormal/persistent crying, vomiting, or diarrhea. Tell your doctor immediately if you notice any of these symptoms in your newborn. This medication may pass into breast milk. Discuss the risks and benefits with your doctor before breast-feeding.

Store at room temperature. Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Nausea, vomiting, constipation, lightheadedness, dizziness, or drowsiness may occur. Pain, redness, or swelling at the injection site may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. To prevent constipation, eat a diet adequate in fiber, drink plenty of water, and exercise. Consult your pharmacist for help in selecting a laxative (such as a stimulant type with stool softener). To lower your risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur: severe stomach/abdominal pain, fainting, mental/mood changes (such as agitation, hallucinations, confusion), seizures, change in amount of urine/difficulty urinating. Seek immediate medical attention if any of these rare but serious side effects occur: severe drowsiness/difficulty waking up, slow/shallow/irregular breathing, fast/slow/irregular heartbeat. A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

This medication comes in several strengths. Be sure you are using the correct strength. The higher strength product should only be used if you have been using narcotic pain medications for a long time. Use of the higher strength medication by someone who is not regularly using narcotic pain relievers can cause very serious (possibly fatal) breathing problems. Hydromorphone has a high risk for abuse and severe, possibly fatal, breathing problems. The risk for harm is higher if you use the wrong dose/strength, or if you use it along with alcohol or other drugs that might affect breathing. Be sure you know how to use hydromorphone and what other drugs you should avoid taking with it. (See also Drug Interactions section.) Get immediate medical help if you notice unusual slow/shallow breathing. Keep this medicine in a safe place to prevent theft, misuse, or abuse. If a child accidentally swallows this drug, get emergency help right away.