Hydromorphone

Hydromorphone is an opioid medication that helps relieve moderate to severe pain.

The extended-release version of hydromorphone is meant for continuous treatment of moderate to severe pain and should not be used for pain on an as-needed basis.

Hydromorphone may also be used for reasons that are not mentioned in this medication guide.

MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it.

Using opioid medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects may occur if you also drink alcohol or use other drugs that cause drowsiness or slow breathing.

You should not take hydromorphone 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, and tranylcypromine. Wait at least 14 days after stopping an MAO inhibitor before you take hydromorphone.

Tell your doctor if you have ever had:

• a head injury, brain tumor, or seizures;
• breathing problems, sleep apnea;
• alcoholism, drug addiction, or mental illness;
• urination problems;
• problems with your gallbladder, pancreas, or thyroid;
• a sulfite allergy; or
• liver or kidney disease.

May harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. If you use hydromorphone for a long time during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

Ask a doctor if it is safe to breastfeed while using this medicine. Hydromorphone in breast milk can cause life-threatening side effects in a nursing baby.

Hydromorphone may affect fertility in men or women if you use this medicine for a long time. Pregnancy could be harder to achieve while either parent is using this medicine.

Get emergency medical help if you have signs of an allergic reaction: hives, difficulty breathing, swelling of your face, lips, tongue, or throat.

Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue-colored lips, or if you are hard to wake up.

Hydromorphone may cause serious side effects. Call your doctor at once if you have:

• breathing that stops during sleep;
• slow heart rate, weak pulse, fainting, slow breathing (breathing may stop);
• confusion, feelings of extreme happiness or sadness;
• severe weakness or drowsiness;
• worsening pain, more sensitivity towards pain;
• a light-headed feeling, like you might pass out; or
• 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.

Common side effects of hydromorphone may include:

• drowsiness, tiredness;
• dizziness;
• dry mouth; itching;
• flushing (sudden warmth, redness, or tingly feeling), sweating;
• headache; or
• constipation, nausea, vomiting, stomach pain.

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

Follow the directions on your prescription label and read all medication guides or instruction sheets. Never use hydromorphone in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more of this medicine.

Never share opioid medicine with another person, especially someone with a history of drug addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medicine where others cannot get to it. Selling or giving away this medicine is against the law.

Swallow the capsule or tablet whole to avoid exposure to a potentially fatal overdose. Do not crush, chew, break, open, or dissolve.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Do not stop using hydromorphone suddenly, or you could have unpleasant symptoms (such as agitation, confusion, tingling or electric shock feelings). Ask your doctor before stopping the medicine.

Never crush a pill to inhale the powder or inject it into your vein. This could result in death.

Store at room temperature away from moisture, heat, and light.

Keep your medicine in a place where no one can use it improperly.

Do not keep leftover medicine. Just one dose can cause death in someone using it accidentally or improperly. Ask your pharmacist about a drug take-back program, or flush the unused medicine down the toilet.

Since hydromorphone is used for pain, you are unlikely to miss a dose. If you do miss a dose and it is almost time for your next dose, skip the missed dose. Do not take two doses at the same time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal, especially in a child or someone using opioid medicine without a prescription. Overdose symptoms may include severe drowsiness, pinpoint pupils, slow breathing, or no breathing.

Your doctor may recommend that you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or do not wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.

Anyone can buy naloxone from a pharmacy or local health department. Make sure that anyone caring for you knows where you keep naloxone and how to use it.

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or doing hazardous activities until you know how hydromorphone will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Many other drugs can be dangerous when used with opioid medicine. Tell your doctor if you also use:

• medicine for allergies, asthma, blood pressure, motion sickness, irritable bowel, or overactive bladder;
• other opioid medicines;
• a benzodiazepine sedative like Valium, Klonopin, or Xanax;
• sleep medicine, muscle relaxers, or other drugs that make you drowsy; or
• drugs that affect serotonin, such as antidepressants, stimulants, or medicine for migraines or Parkinson's disease.

This list is not complete. Many drugs may affect hydromorphone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

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