This abuse occurred most often by taking prescription medications that were prescribed for another person, taking larger doses than what was prescribed, taking more frequent doses and taking the medication with the sole purpose of getting high. Opioid antagonists, such as naloxone are specific antidotes to respiratory depression resulting from opioid overdose. For clinically significant respiratory or circulatory depression secondary to hydromorphone overdose, administer an opioid antagonist. Opioid antagonists should not be administered in the absence of clinically significant respiratory or circulatory depression secondary to hydromorphone overdose.
Hydromorphone, oral tablet Images
“Doctor shopping” (visiting multiple prescribers to obtain additional prescriptions) is common among people who abuse drugs and people with substance use disorder. Discuss with the patient and caregiver the availability of naloxone for the emergency treatment of opioid overdose, both when initiating and renewing treatment with DILAUDID Oral Solution or DILAUDID Tablets. Due to increased exposure of hydromorphone, 5 key differences between crack and cocaine patients with moderate hepatic impairment should be started at a lower dose and closely monitored during dose titration. Pharmacokinetics of hydromorphone in severe hepatic impairment patients has not been studied. Further increase in Cmax and AUC of hydromorphone in this group is expected. As such, starting dose should be even more conservative [see Use in Specific Populations (8.6)].
Drug Interactions
- This document does not contain all possible side effects and others may occur.
- Before using this medication, women of childbearing age should talk with their doctor(s) about the risks and benefits.
- If too much of this medicine is taken for a long time, it may become habit-forming (causing mental or physical dependence).
- Inform patients that anaphylaxis has been reported with ingredients contained in DILAUDID Oral Solution or DILAUDID Tablets.
The chart below further describes the features of both medications. Hydromorphone and morphine each come in several forms and strengths. All forms can be used at home, but injectable forms are more often used in the hospital.
1 Carcinogenesis, Mutagenesis, Impairment of Fertility
Titrate the dose based upon the individual patient’s response to their initial dose of DILAUDID INJECTION. Individually titrate DILAUDID INJECTION to a dose that provides adequate analgesia and minimizes adverse reactions. Frequent communication is important among the prescriber, other members of the healthcare team, the patient, and the caregiver/family during periods of changing analgesic requirements, including initial titration. Adverse effects of hydromorphone are similar to those of other potent opioid analgesics, such as morphine and heroin.
Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco. Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
After oral administration of DILAUDID, peak plasma hydromorphone concentrations are generally attained within ½ to 1 hour. The background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a the dangers of drinking and driving background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively.
The pharmacokinetics of hydromorphone are affected by hepatic impairment. Due to increased exposure of hydromorphone, patients with moderate hepatic impairment should be started at one-fourth to one-half the recommended starting dose depending on the degree of hepatic dysfunction and closely monitored during dose titration. A further what is ayahuasca increase in Cmax and AUC of hydromorphone in this group is expected and should be taken into consideration when selecting a starting dose [see CLINICAL PHARMACOLOGY]. DILAUDID INJECTION is not recommended for use in pregnant women during or immediately prior to labor, when other analgesic techniques are more appropriate.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Short-term use can result in slowed breathing, unconsciousness, nausea and coma. Overdose is also a concern for those who have detoxed from Dilaudid and have a relapse. Using the medication after the body has been clean from it can result in changed levels of tolerance. Repeat users may also experience altered vital functions, which can have fatal results.
This will help ensure optimal safety and maximize your therapy. Read on for an overview of the medications commonly prescribed for DI management. The following article covers the first-line diabetes insipidus medications used to treat specific types, side effects to be aware of, and other ways to manage this condition. Also, if you have an abnormal heart rhythm, talk to your healthcare provider before using morphine. The chart below lists examples of more common side effects of hydromorphone and morphine. The brand-name drug Dilaudid was more expensive than the generic forms of morphine.
IR tablets are available in 5 mg, 10 mg, 15 mg, 20 mg, and 30 mg. Treatment for acute pain typically involves taking 5–15 mg every 4–6 hours. The oral solution may be taken in 2.5–10 mL doses every 3–6 hours as directed. If you are prescribed this medication on a regular schedule and miss a dose, use it as soon as you remember.
Inform patients that accidental ingestion, especially by children, may result in respiratory depression or death [see Warnings and Precautions (5.3)]. In general, it is safest to start DILAUDID therapy by administering half of the usual starting dose every 3 to 6 hours for DILAUDID Oral Solution; and every 4 to 6 hours for DILAUDID Tablets. The dose of DILAUDID can be gradually adjusted until adequate pain relief and acceptable side effects have been achieved [see Dosage and Administration (2.5)]. Initiate treatment with DILAUDID Oral Solution in a dosing range of 2.5 mL to 10 mL, 2.5 mg to 10 mg, every 3 to 6 hours as needed for pain, and at the lowest dose necessary to achieve adequate analgesia.
“Drug-seeking” behavior is very common in persons with substance use disorders. “Doctor shopping” (visiting multiple prescribers to obtain additional prescriptions) is common among people who abuse drugs and people with substance use disorder. Preoccupation with achieving adequate pain relief can be appropriate behavior in a patient with inadequate pain control. Serious, life-threatening, or fatal respiratory depression has been reported with the use of opioids, even when used as recommended. Respiratory depression, if not immediately recognized and treated, may lead to respiratory arrest and death.
Opioid analgesics, including DILAUDID INJECTION, can prolong labor through actions which temporarily reduce the strength, duration, and frequency of uterine contractions. Inform patients of the risk of life-threatening respiratory depression, including information that the risk is greatest when starting DILAUDID INJECTION or when the dosage is increased, and that it can occur even at recommended dosages. To reduce the risk of respiratory depression, proper dosing and titration of DILAUDID INJECTION is essential [see DOSAGE AND ADMINISTRATION]. Overestimating the DILAUDID INJECTION dosage when converting patients from another opioid product can result in a fatal overdose with the first dose. If the level of pain increases after dosage stabilization, attempt to identify the source of increased pain before increasing the DILAUDID INJECTION dosage.
