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Dilaudid (Hydromorphone Hydrochloride)

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Manufacturers: Rhodes Pharmaceuticals.

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Description

DILAUDID (hydromorphone hydrochloride), a hydrogenated ketone of morphine, is an opioid agonist.

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This medication is used to help relieve moderate to severe pain. Hydromorphone belongs to a class of drugs known as opioid (narcotic) analgesics. It works in the brain to change how your body feels and responds to pain. DILAUDID is used to relieve pain. Dilaudid (hydromorphone) is a schedule II-controlled substance prescribed for moderate to severe pain. The drug attaches to receptors in the brain and central nervous system to dull pain. Dilaudid also triggers the release of excessive amounts of dopamine in the brain, causing pleasurable feelings. This activates the reward center of the brain, which interprets the event as something that is important and should be repeated. The more this happens, the less the brain will naturally produce dopamine, and the more reliant the body becomes on Dilaudid. Hydromorphone extended-release tablets are used to relieve severe pain in people who are expected to need pain medication around the clock for a long time and who cannot be treated with other medications. DILAUDID extended-release tablets should only be used to treat people who are tolerant to opioid medications because they have taken this type of medication for at least one week and should not be used to treat mild or moderate pain, short-term pain, pain after an operation or medical or dental procedure, or pain that can be controlled by medication that is taken as needed.  Hydromorphone is an opioid agonist that binds to several opioid receptors. Its analgesic characteristics are through its effect on the mu-opioid receptors. It also acts centrally at the level medulla, depressing the respiratory drive and suppressing cough. Hydromorphone is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain. Currently approved hydromorphone products include tablets of 2, 4, and 8 mg, extended release tablets of 8, 12, 16, 32 mg, oral solution of 5 mg/5 ml viscous liquid, and ampules of 1, 2, 4, and 10 mg/ml sterile solution for parenteral administration. 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. Dilaudid is one of the more powerful synthetic narcotics in the opioid class of drugs and an addiction to Dilaudid can rapidly develop through continued use. Hydromorphone, also known as dihydromorphinone, and sold under the brand name Dilaudid among others, is an opioid used to treat moderate to severe pain. Typically, long-term use is only recommended for cancer pain. It may be used by mouth or by injection into a vein, muscle, or under the skin. Effects generally begin within half an hour and last for up to five hours. Hydromorphone is a potent schedule II opioid analgesic drug. It is marketed as injectable ampules, multiple dose vials, tablets and suppositories. Hydromorphone is indicated for relief of moderate-to-severe pain. Hydromorphone is marketed under brand names, Dilaudid and Exalgo. It is also marketed in generic forms. DILAUDID Tablets are supplied in 2 mg, 4 mg, and 8 mg tablets for oral administration. The tablet strengths describe the amount of hydromorphone hydrochloride in each tablet. DILAUDID Oral Solution is supplied as 5mg/5 mL (1 mg/mL) viscous liquid. Dilaudid (hydromorphone) is an opioid pain medication. An opioid is sometimes called a narcotic. Dilaudid is used to treat moderate to severe pain. Dilaudid may also be used for purposes not listed here.

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INDICATIONS AND USAGE

Hydromorphone hydrochloride extended-release tablets are an opioid

agonist indicated in opioid-tolerant patients for the management of pain

severe enough to require daily, around-the-clock, long-term opioid

treatment and for which alternative treatment options are inadequate.

Patients considered opioid tolerant are those who are taking, for one

week or longer, at least 60 mg oral morphine per day, 25 mcg

transdermal fentanyl/hour, 30 mg oral oxycodone/day, 8 mg oral

hydromorphone/day, 25 mg oral oxymorphone/day or an equianalgesic

dose of another opioid.

DOSAGE AND ADMINISTRATION

Dilaudid exist as Dilaudid oral Solution and Dilaudid Tablets

tablet: immediate-release 2mg, 4mg, 8mg

tablet, extended-release: 8mg, 12mg, 16mg, 32mg

injection solution: 1mg/mL, 2mg/m, L4mg/mL

injection solution, preservative free: 10mg/mL

oral liquid: 5 mg/5 mL (1 mg/mL)

suppository: 3mg

Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.

Hydromorphone administration can be administered through intramuscular, intravenous, subcutaneous, or oral routes at a concentration up to 10 mg/ml.

 

Usual adult dosage of Dilaudid Oral Solution is one-half (2.5 mL) to two teaspoonful (10 mL) (2.5 mg – 10 mg) every 3 to 6 hours. The usual adult starting dose for Dilaudid Tablets is 2 mg to 4 mg, orally, every 4 to 6 hours.

Hepatic Impairment: Initiate treatment with one-fourth to one-half the usual starting dose, depending on degree of hepatic impairment. Renal Impairment: Initiate treatment with one-fourth to one-half the usual starting dose, depending on degree of renal impairment.

Orals: Patients can take it orally with or without food in the immediate or extended-release form. It cannot be crushed, chewed, or dissolved, because it will void immediate release of the formulation. Immediate-release oral formulations have an onset of action at 15 to 30 minutes, peak at 30 to 60 minutes, and last 3 to 4 hours. Extended-release formulations have an onset of action at 6 hours, peak at 9 hours, and lasts 13 hours.

Recommended dosage usually starts out at 2-4 mg every 4-6 hours but can be adjusted based on the patient’s needs.

-For once daily administration.

-Instruct patients to swallow hydromorphone hydrochloride extended-release tablets intact.

-Do not abruptly discontinue hydromorphone hydrochloride extended-release tablets.

Dose may be increased using increments of 4 to 8 mg every 3 to 4 days as needed to achieve adequate analgesia.

Dilaudid Injection: The usual starting dose is 1 mg to 2 mg subcutaneously or intramuscularly every 2 to 3 hours as necessary.

Dilaudid-HP Injection should be used only if the amount of hydromorphone required can be delivered accurately with this formulation.

The dose should be adjusted according to the severity of pain, as well as the patient’s underlying disease state and age.

Should intravenous administration be necessary, the injection should be given slowly, over at least 2 to 3 minutes and the usual starting dose is 0.2 to 1 mg.

Dilaudid Side Effects

Drowsiness, tiredness, Agitation, decreased urination, blurred vision, rapid breathing, headache, constipation, changes in behavior, nausea, severe stomach pain, cramping, or burning, vomiting, stomach pain, bloating or swelling of the face, arms, hands, lower legs, or feet, Slowed breathing, fast, pounding, slow, or irregular heartbeat, Loss of appetite and Itching. Contact your doctor for more side effects.

Flushing (warmth, redness, or tingling of skin), itching, sweating, nausea, vomiting, constipation, diarrhea, stomach pain, dizziness, Seizures, Confusion, drowsiness, blurred vision, double vision, headache, sleep problems (insomnia), strange dreams, and dry mouth. Just like with any other drug, not everybody experiences these side effects. If any symptoms persist, contact your doctor. Buy Pain Pills Online

CONTRAINDICATIONS

Dilaudid Oral Solution or Dilaudid tablets are contraindicated in patients with known or suspected gastrointestinal obstruction, including paralytic ileus. The hydromorphone in Dilaudid Oral Solution or Dilaudid tablets may cause spasm of the sphincter of Oddi. Opioids may cause increases in serum amylase. Hypersensitivity to hydromorphone, hydromorphone salts, any other components of the product, or sulfite containing medications. Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment. Dilaudid-HP injection is contraindicated in patients who are not opioid tolerant.

Do not take DILAUDID tablets or oral liquid if you:

suffer from shallow or difficult breathing or have any breathing problems such as acute asthma, have severe abdominal pain with bloating, cramps or vomiting, have a condition where your small bowel does not work properly, take medicine for depression called a ‘monoamine oxidase inhibitor’ or have taken any in the last two weeks.
Do not take DILAUDID tablets or oral liquid if you are allergic to hydromorphone, opioid painkillers. The tablets contain lactose so consider this if you are lactose intolerant
Do not take this medicine during labour for the delivery of premature infants.
Hydromorphone given to the mother can cause breathing problems in the newborn, especially premature babies.
Do not take this medicine if you are pregnant or intend to become pregnant whilst taking this medicine.

-Opioid non-tolerant patients.

-Significant respiratory depression.

-Acute or severe bronchial asthma.

-Known or suspected paralytic ileus.

-Narrowed or obstructed gastrointestinal tract.

-Known hypersensitivity to any components including hydromorphone hydrochloride and sulfites.

WARNINGS AND PRECAUTIONS

Before taking hydromorphone, tell your doctor or pharmacist if you are allergic to it; or to hydrocodone; or if you have any other allergies. This product may contain inactive ingredients (such as sulfites), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Adrenal insufficiency may present with non-specific symptoms and signs such as nausea, vomiting, anorexia, fatigue, weakness, dizziness, and low blood pressure. Advise patients to seek medical attention if they experience a constellation of these symptoms while taking Dilaudid. Opioid analgesics may only be partially effective in relieving dysesthetic pain, postherpetic neuralgia, stabbing pains, activity-related pain and some forms of headache. That is not to say that patients with advanced cancer suffering from some of these forms of pain should not be given an adequate trial of opioid analgesics, but it may be necessary to refer such patients at an early time to other forms of pain therapy.

Drinking alcohol, taking prescription or nonprescription medications that contain alcohol, or using street drugs during your treatment with hydromorphone increases the risk that you will experience serious, life-threatening side effects. Do not drink alcohol, take prescription or nonprescription medications that contain alcohol, or use street drugs during your treatment.

-Interactions with CNS depressants: Concomitant use may cause profound sedation, respiratory depression, and death. If coadministration is required, consider dose reduction of one or both drugs because of additive pharmacological effects.

Taking certain medications during your treatment with hydromorphone may increase the risk that you will develop serious or life-threatening breathing problems, sedation, or coma. Tell your doctor if you are taking or plan to take any of the following medications: benzodiazepines such as alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), diazepam (Diastat, Valium), estazolam, flurazepam, lorazepam (Ativan), oxazepam, temazepam (Restoril), and triazolam (Halcion); medications for mental illness or nausea; muscle relaxants; other narcotic pain medications; sedatives; sleeping pills; or tranquilizers

-Elderly, cachectic, debilitated patients and those with chronic pulmonary disease: Monitor closely because of increased risk for life-threatening respiratory depression.

-Hypotensive effect: Monitor during dose initiation and titration.

-Patients with head injury or increased intracranial pressure: Monitor for sedation and respiratory depression. Avoid use of hydromorphone hydrochloride extended-release tablets in patients with impaired consciousness or coma susceptible to intracranial effects of CO2 retention. visit Wiki for more info

Hydromorphone may be habit forming, especially with prolonged use. Take hydromorphone exactly as directed. Do not take more of it, take it more often, or take it in a different way than directed by your doctor.

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