Uses
This medication is used to relieve moderate to severe pain. Hydromorphone is an opioid pain reliever. It acts on certain centers in the brain to give you pain relief.
How To Use
Depending on your specific product, this medication is given by injection under the skin, into a muscle, or slowly into a vein. 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 often, or use it for a longer time than prescribed. Properly stop the medication when so directed.
If nausea occurs, ask your doctor or pharmacist for ways to decrease it (such as lying down for 1 to 2 hours with as little head movement as possible).
If you have ongoing pain (such as due to cancer), your doctor may direct you to also take long-acting opioid medications. In that case, this medication might be used for sudden (breakthrough) pain only as needed. Other pain relievers (such as acetaminophen, ibuprofen) may also be prescribed. Ask your doctor or pharmacist about using hydromorphone safely with other drugs.
Suddenly stopping this medication may cause withdrawal, especially if you have used it for a long time or in high doses. To prevent withdrawal, your doctor may lower your dose slowly. Tell your doctor or pharmacist right away if you have any withdrawal symptoms such as restlessness, mental/mood changes (including anxiety, trouble sleeping, thoughts of suicide), watering eyes, runny nose, nausea, diarrhea, sweating, muscle aches, or sudden changes in behavior.
Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Use this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details.
When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well.
Tell your doctor if your pain does not get better or if it gets worse.
Side Effects
See also Warning section.
Nausea, vomiting, constipation, flushing, dry mouth, lightheadedness, dizziness, drowsiness, or sweating may occur. Pain, redness, or swelling at the injection site may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.
To prevent constipation, eat dietary fiber, drink enough water, and exercise. Consult your pharmacist for help in selecting a laxative (such as a stimulant type with stool softener).
To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
Remember that this medication has been prescribed because your doctor 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 right away if you have any serious side effects, including:
- interrupted breathing during sleep (sleep apnea)
- severe stomach/abdominal pain
- fainting
- mental/mood changes (such as agitation, hallucinations, confusion)
- seizures
- difficulty urinating
- signs of your adrenal glands not working well (such as loss of appetite, unusual tiredness, weight loss)
Get medical help right away if you have any very serious side effects, including:
- severe drowsiness/difficulty waking up
- slow/shallow/irregular breathing
- fast/slow/irregular heartbeat
A very serious allergic reaction to this drug is rare. However, get medical help right away 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 or at www.fda.gov/medwatch.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Precautions
Before using hydromorphone, tell your doctor or pharmacist if you are allergic to it; or to other opioid pain medications (such as hydrocodone, morphine); or if you have any other allergies. This product may contain inactive ingredients (such as sulfites, latex), 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:
- stomach/intestinal problems (such as blockage, constipation, diarrhea due to infection, paralytic ileus)
- brain disorders (such as brain injury, tumor, increased intracranial pressure, seizures)
- 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 a substance use disorder (such as overuse of or addiction to 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)
This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Older adults may be more sensitive to the side effects of this drug, especially confusion, dizziness, drowsiness, and slow/shallow breathing.
During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor. (See also Warning section.)
This drug passes into breast milk and may have undesirable effects on a nursing infant. Tell the doctor right away if your baby develops unusual sleepiness, difficulty feeding, or trouble breathing. Consult your doctor before breast-feeding.
Drug Interactions
See also Warning section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include:
- certain pain medications (mixed opioid agonists/antagonists such as butorphanol, nalbuphine, pentazocine)
- cimetidine
- drugs that slow down the movement of the gut (such as belladonna alkaloids, oxybutynin)
- naltrexone
- samidorphan
The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is used with other products that may also cause drowsiness or breathing problems. Tell your doctor or pharmacist if you are taking other products such as other opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).
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 medication may interfere with certain lab tests (such as amylase/lipase levels), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.
Overdose
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, give them naloxone if available, then call 911. If the person is awake and has no symptoms, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Alberta residents can call PADIS (Poison and Drug Information Service) 24 hours a day at 1-800-332-1414. 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, seizure, coma.
Notes
Do not share this medication with others. Sharing 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.
Missed Dose
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. Use your next dose at the regular time. Do not double the dose to catch up.
If you have questions about missing a dose or you don't have more medication, contact your healthcare provider or pharmacist.
Storage
Store at room temperature away from light and moisture. Do not store in the bathroom. 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. See also Warning section.
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.
