WARNING
Rectal hydromorphone use has the potential to develop into a habit, especially over time. Utilize hydromorphone rectal as prescribed. Use the medication only as directed by your doctor, and never in excess of the recommended dosage, frequency, length of time, or manner of use. As you use hydromorphone rectal, talk to your doctor about your pain management options, treatment duration, and pain management goals. Inform your doctor if you or any family members regularly consume significant amounts of alcohol, use illicit substances, have ever experienced an overdose, have abused prescription medications, or currently suffer from depression or another mental disorder. If you currently have or have ever had any of these conditions, you are more likely to misuse hydromorphone rectal. If you suspect that you may have an opioid addiction, speak with your doctor right away and ask for advice, or call the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP.
While receiving hydromorphone rectal treatment, taking specific drugs may raise your chance of experiencing significant or life-threatening respiratory issues, drowsiness, or coma. Benzodiazepines, such as estazolam, flurazepam, lorazepam (Ativan), oxazepam, temazepam (Restoril), and triazolam (Halcion), medications for mental illness or nausea, muscle relaxants, other painkillers, sedatives, sleeping pills, or tranquillizers are all things you should discuss with your doctor if you are currently taking them or intend to start taking them. Your doctor will closely monitor you and may need to adjust the dosage of your drugs. Call your doctor right away if you experience any of the following symptoms after using hydromorphone rectal in combination with any of these drugs: extraordinary dizziness, lightheadedness, extreme drowsiness, slowed or laboured breathing, or inability to respond. If you are unable to seek treatment on your own, make sure your caregiver or family members are aware of any symptoms that may be dangerous so they can contact the doctor or emergency services.
You run a higher chance of developing these severe, perhaps fatal adverse effects while receiving therapy with hydromorphone rectal if you consume alcohol, use prescription or over-the-counter products that do, or use illicit substances. During your treatment, refrain from drinking alcohol, taking alcohol-containing prescription or over-the-counter medications, or using illegal substances.
Discuss the dangers of using hydromorphone rectal with your doctor.
Why is this medication prescribed?
Suppositories containing hydromorphone are used to treat moderate to severe pain. The class of drugs known as opiate (narcotic) analgesics includes hydromorphone. It functions by altering how the nerve system and brain react to pain.
How should this medicine be used?
Hydromorphone is available as a rectally administered suppository. Typically, it is inserted once every six to eight hours. Place hydromorphone at roughly the same intervals each day. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Follow the directions on the hydromorphone suppository exactly.
Without consulting your doctor, do not stop using hydromorphone suppositories. You might experience withdrawal symptoms if you abruptly stop using hydromorphone suppositories, such as agitation, teary eyes, runny noses, yawning, sweating, chills, hair standing on end, muscle and joint pain, widening of the pupils (black circles in the middle of the eyes), irritability, anxiety, backache, weakness, stomach cramps, trouble falling or staying asleep, nausea, loss of appetite, vomiting, diarrhoea, fast breathing, or rapid heartbeat Your dose will likely be gradually reduced by your doctor.
Follow these steps to utilise the suppositories:
- Take the wrapping off.
- Water should be applied to the suppository’s tip.
- Raise your right knee toward your chest while lying on your left side (a left-handed person should lie on the right side and raise the left knee).
- Put the suppository about 1 inch (2.5 centimetres) into the rectum with your finger.
- For a short while, hold it in place with your finger.
- After about fifteen minutes, get up. After a thorough hand wash, get back to your regular routine.
Other uses for this medicine
Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.
What special precautions should I follow?
Before using hydromorphone suppositories,
- Tell your doctor and pharmacist if you are allergic to hydromorphone, any other medications, or any of the ingredients in hydromorphone suppositories. Ask your pharmacist for a list of the ingredients.
- Inform your doctor and pharmacist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products that you are now taking or intend to use. Incorporate any of the following: narcotic painkillers other than hydromorphone; 5HT3 serotonin blockers like alose; the anticonvulsant drug cyclobenzaprine (Amrix); dextromethorphan (found in many cough medicines; in Nuedexta); lithium (Lithobid, in Librax); medications for seizures; medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax),Selective serotonin-reuptake inhibitors like citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Prozac, Pexeva), and sertraline (Zoloft); serotonin and norepinephrine reuptake inhibitors (Surmontil). Additionally, let your doctor or pharmacist know if you’re receiving any of the following monoamine oxidase (MAO) inhibitors or if you’ve recently stopped taking them: methylene blue, isocarboxazid (Marplan), linezolid (Zyvox), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate). Tell your doctor about all of the medications you are taking, even those not on this list, as many other drugs may also interact with hydromorphone. Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
- Tell your doctor if you’re taking any herbal supplements, especially St. John’s wort or tryptophan.
- Inform your doctor if you have ever experienced a head injury, a condition that damaged your brain, a condition that increased your brain’s pressure, slowed breathing, or a condition that affects your ability to breathe, such as asthma, chronic obstructive pulmonary disease (COPD), a group of illnesses that affect your lungs and airways and includes chronic bronchitis and emphysema, or kyphoscoliosis (curving of the spine that may cause breathing problems). Your physician could advise against using hydromorphone suppositories.
- If you are an older adult or if an illness has left you weak or malnourished, let your doctor know. Tell your doctor if you have or have ever had liver or kidney disease, an enlarged prostate (a male reproductive gland), Addison’s disease (a condition in which the adrenal gland produces less hormone than normal), any condition that makes it difficult to urinate, such as a urethral stricture (a blockage of the tube that allows urine to leave the body), or hypothyroidism (a condition in which the thyroid gland produces less hormone than normal).
- If you are breastfeeding a child or intend to become pregnant, let your doctor know. Call your doctor if you become pregnant while using hydromorphone suppositories.
- You should be aware that this medicine may lower both male and female fertility. Discuss the dangers of using hydromorphone suppositories with your doctor.
- Inform the surgeon or dentist that you are using hydromorphone suppositories if you are having surgery, including dental surgery.
- You ought to be aware that hydromorphone might make you sleepy. Prior to understanding how this drug affects you, avoid using machinery or driving a car.
- You should be aware that if you stand up too rapidly from a supine position while taking hydromorphone, you could have dizziness, lightheadedness, and fainting. When you first start using hydromorphone suppositories, this happens more frequently. Get out of bed gradually, resting your feet on the floor for a few minutes before standing up, to avoid this issue.
What special dietary instructions should I follow?
Keep eating normally unless your doctor instructs you otherwise.
What should I do if I forget a dose?
The missed dose should be taken as soon as you remember. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.
What side effects can this medication cause?
Suppositories containing hydromorphone may have adverse effects. If any of these symptoms are severe or do not go away, let your doctor know right once:
- Constipation
- Drowsiness
- Mood shifts
- Confusion
- Having trouble urinating
- Reduction in pupil size (dark circles in the centre of the eyes)
Some adverse effects can be very harmful. Call your doctor right away if you encounter any of these symptoms, or seek emergency care:
- Slowed or stopped breathing
- Breathing that is irregular or that stops and starts
- Agitation, hallucinations (seeing things or hearing voices that do not exist), fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
- Nausea, vomiting, loss of appetite, weakness, or dizziness
- Inability to get or keep an erection
- Irregular menstruation
- Decreased sexual desire
Other negative effects from hydromorphone suppositories could also occur. If you experience any strange issues while taking this medicine, contact your doctor right away.
You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).
What should I know about storage and disposal of this medication?
Keep this medication tightly closed in the original container and out of the reach of children. It should be kept in the fridge. Medication that has expired or is no longer required should be thrown away. Consult your pharmacist for advice on how to properly dispose of your medications.
As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org
So that no one else takes the medication intentionally or accidently, keep hydromorphone suppositories in a refrigerator. Count the remaining suppositories so you can detect any missing ones.
In case of emergency/overdose
Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.
You should speak with your doctor about keeping naloxone, a life-saving drug, on hand when using hydromorphone rectal (e.g., home, office). Naloxone is used to undo an overdose’s potentially fatal consequences. To treat harmful symptoms brought on by excessive levels of opiates in the blood, it functions by inhibiting the effects of opiates. If you live with young children or someone who has abused prescription or illicit drugs, your doctor could also advise you to get naloxone. Make sure you, your family, your caretakers, and anyone else who spends time with you are aware of the signs of an overdose, how to administer naloxone, and what to do until emergency assistance arrives. You and your family members will be shown how to use the medication by your doctor or pharmacist. For the directions, speak to your pharmacist or go to the manufacturer’s website. If you start to experience overdose symptoms, a friend or family member should administer the first dose of naloxone, contact 911 right away, and stay by your side while keeping a careful eye on you until emergency medical assistance comes. After receiving naloxone, your symptoms can come back a short while later. The person should administer you another dose of naloxone if your symptoms come back. If symptoms reappear before receiving medical attention, more doses may be given every 2 to 3 minutes.
Overdose signs could include the following:
- Shallow or sluggish breathing
- Having trouble breathing
- Sleepiness
- Unable to wake up or speak
- Muscle tremor
- Clammy, frigid skin
- Pupils that are either smaller or larger (dark circle in the middle of the eye)
- Sluggish or irregular pulse
- Dizziness
- Fainting
- What additional details should I be aware of?
Keep all of your appointments with your physician and the lab. To monitor your body’s reaction to hydromorphone, your doctor may request specific lab tests.
Inform your doctor and the lab staff that you are using hydromorphone prior to any laboratory test (particularly those involving methylene blue).
This medication cannot be renewed. Call your doctor if your discomfort persists after you’ve finished the hydromorphone suppositories.
You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.
Brand names
- available generically