Hydromorphone use has the potential to develop into a habit, especially over time. Follow the hydromorphone directions exactly. Do not take it in larger amounts, more frequently, or otherwise differently than prescribed by your doctor. Discuss your pain management objectives, course of treatment, and additional pain management options with your healthcare provider while you are taking hydromorphone. Inform your doctor if you or any family members regularly use significant amounts of alcohol, take street drugs, abuse prescription drugs excessively, experience overdosing, or currently suffer from depression or another mental disorder. If you currently have or have ever had any of these conditions, there is a higher chance that you may misuse hydromorphone. 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.

When taking hydromorphone for the first 24 to 72 hours of treatment or if the dose is increased, breathing issues that are serious or life-threatening can occur. The course of your treatment will be closely monitored by your doctor. If you have asthma or have previously had asthma, let your doctor know. You shouldn’t take hydromorphone, according to your doctor. Moreover, let your doctor know if you have ever experienced lung disease such as chronic obstructive pulmonary disease (a set of conditions that affect the lungs and airways), a head injury, a brain tumour, any condition that raises the pressure inside of your skull, or kyphoscoliosis (curving of the spine that may cause breathing problems). Being an older adult or being weak or undernourished as a result of a sickness may increase your risk of developing respiratory issues. Call your doctor right away or seek emergency medical attention if you have any of the following symptoms: breathing slowly, holding their breath for a lengthy time, or having trouble breathing.

The chance of developing severe or life-threatening respiratory issues, sedation, or coma while receiving hydromorphone treatment may rise if you take certain drugs. Benzodiazepines, such as 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 tranquillizers are all things you should discuss with your doctor if you are currently taking them or intend to start taking them. Your prescription doses may need to be adjusted, and your doctor will closely watch you. If you take hydromorphone along with any of these drugs and experience any of the following symptoms, call your doctor right away or go to the hospital for emergency care. These symptoms include unusual lightheadedness, extreme drowsiness, breathing that is sluggish or difficult, or unresponsiveness. Make sure your carer or family members are aware of any symptoms that could be significant so they can contact an emergency room or a doctor if you are unable to do so on your own.

The likelihood that you will encounter severe, potentially fatal adverse effects while receiving hydromorphone treatment rises if you consume alcohol, take prescription or over-the-counter treatments that include alcohol, or use illicit substances. During your therapy, refrain from drinking alcohol, using illicit substances, or taking any prescription or over-the-counter medications that include alcohol.

The extended-release tablets should be taken whole. Never chew, split, dissolve, or crush them. You risk ingesting an excessive amount of hydromorphone at once if you swallow chewed, crushed, chewed, or dissolved pills as opposed to taking the drug gradually over time. Serious respiratory issues or even death could result from this.

Do not share your medication with anybody else. Some people who take your drug, especially children, may suffer injury or even pass away from hydromorphone. Store hydromorphone in a secure location to prevent accidental or intentional consumption by others. Take extra care to keep hydromorphone out of children’s reach. Count the remaining pills or liquid so you’ll know if any prescriptions are missing. Extensive-release tablets, fluids, and unwanted or no longer required tablets should all be flushed down the toilet. (See DISPOSAL and STORAGE.)

If you are pregnant or want to become pregnant, let your doctor know. Regular hydromorphone use during pregnancy increases the risk of your unborn child developing potentially fatal withdrawal symptoms. If your infant exhibits any of the following symptoms, contact your doctor straight away: irritability, hyperactivity, disturbed sleep, high-pitched crying, excessive shaking of a body part, vomiting, diarrhoea, or failure to gain weight.

As you start your hydromorphone medication and each time you fill your prescription, your doctor or pharmacist will give you the manufacturer’s patient information leaflet (Medication Guide). If you have any questions, thoroughly read the material, then consult your physician or pharmacist. The Medication Guide is also available on the Food and Drug Administration (FDA) website or the manufacturer’s website.

The dangers of using hydromorphone should be discussed with your doctor.

Utilized to treat pain is hydromorphone. When alternative treatments are ineffective and a person is predicted to require pain medicine 24 hours a day for a lengthy period of time, hydromorphone extended-release tablets are used to relieve severe pain. It is not recommended to use hydromorphone extended-release tablets to treat mild to moderate pain, short-term pain, pain following an operation or other medical or dental procedure, or pain that can be managed with medication taken only as needed. Instead, these tablets should only be used to treat people who have taken opioid medications for at least one week and are tolerant to their effects. Opiate (narcotic) analgesics, which include hydromorphone, are a group of drugs used to treat pain. It functions by altering how the nerve system and brain react to pain.

Extended-release (long-acting) tablets of hydromorphone are also available in liquid and tablet form for oral administration. Every 3 to 6 hours, the liquid is often taken, and every 4 to 6 hours, the pills. Taken once daily, either with or without food, are the extended-release tablets. Use the same time(s) every day to take hydromorphone. If there is anything you do not understand about the instructions on your prescription label, contact your doctor or pharmacist to clarify it. Just as prescribed, take hydromorphone.

Do not let your skin or clothing come in contact with the hydromorphone liquid. If such contact occurs, take off any clothing that was in contact with the oral liquid and thoroughly wash your skin with lukewarm water.

Your doctor might prescribe you a low dose of hydromorphone to start, and then gradually increase it, no more frequently than once every three to four days. If you encounter side effects, your doctor might reduce your dose. If you believe that your pain is not being controlled or if you suffer any negative effects while receiving hydromorphone medication, let your doctor know. Without first consulting your doctor, never alter the dosage of your prescription.

Without consulting your doctor, do not discontinue taking hydromorphone. Your dose will likely be gradually reduced by your doctor. Restlessness, teary eyes, runny noses, yawning, sweating, chills, hair standing on end, muscle or 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 may be withdrawal symptoms if you abruptly stop taking hydromorphone. Your dose will likely be gradually reduced by your doctor. Talk to your doctor before starting the drug again if you stop taking hydromorphone extended-release tablets for more than three days for any reason.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

Before taking hydromorphone,

• If you have an allergy to any of the substances in hydromorphone tablets, solution, or extended-release tablets, including sulfites, let your doctor and pharmacist know right away. For a list of the ingredients, consult the Medication Guide or speak with your pharmacist.
• Inform your doctor and pharmacist about any vitamins, nutritional supplements, herbal items, and prescription and over-the-counter medicines you are now taking or intend to take. Mention any of the following as well as the medications specified in the IMPORTANT WARNING section. drugs for glaucoma, irritable bowel syndrome, Parkinson’s disease, ulcers, and urinary difficulties; lithium (Lithobid); buprenorphine (Buprenex, Butrans, in Suboxone, in Zubsolv, among others); butorphanol; cyclobenzaprine (Amrix); dextromethorphan (found in several cough medications; in Nuedexta); such as sumatriptan (Alsuma, Imitrex, in Treximet), zolmitriptan (Zomig), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), and eletriptan (Relpax); mirtazapine (Remeron); nalbuphine; fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Prozac, Pexeva), and sertraline (Zoloft); pentazocine (Talwin); 5HT3 serotonin blockers such as alosetron (Lotronex), dolasetron (Anzemet), granisetron (Kytril), ondansetron (Zofran, Zuplenz); trazodone (Oleptro); serotonin and norepinephrine reuptake inhibitors such milnacipran (Savella), desvenlafaxine (Effexor), duloxetine (Cymbalta), and venlafaxine (Khedezla); amitriptyline, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine are examples of tricyclic antidepressants (sometimes known as “mood elevators”) (Surmontil). Additionally, let your doctor or pharmacist know if you’re taking any of the monoamine oxidase (MAO) inhibitors listed below or have stopped taking them within the previous two weeks: tranylcypromine (Eldepryl, Emsam, Zelapar), isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), or selegiline (Eldepryl, Em (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.
• Please let your doctor know if you are taking any herbal supplements, especially St. John’s wort and tryptophan.
• If you have any of the ailments detailed in the IMPORTANT WARNING section, paralytic ileus (a condition in which food does not pass through the intestines), a blockage in the stomach, or any other medical issue, let your doctor know right once. You might be advised by your doctor not to take hydromorphone.
• Tell your doctor if you will be taking the extended-release pills and if you have ever undergone surgery that altered how food passes through your stomach or intestines, or if you have any conditions that can narrow the oesophagus (the tube that carries food from the mouth to the stomach), stomach, or intestines, such as cystic fibrosis (a condition that causes the body to produce thick, sticky mucus that may clog the pancreas, lungs (a bulge in the lining of the small intestine that is present at birth), Inflammatory bowel disease (IBD), a collection of disorders that involve inflammation of the gut lining, or chronic intestinal pseudo-obstruction (condition in which the muscles in the colon do not pass food through the intestine smoothly). You could be advised by your doctor not to take extended-release pills of hydromorphone.
• If you have or have ever had low blood pressure, Addison’s disease (a condition in which the adrenal gland produces less hormone than normal), seizures, any condition that makes it difficult to urinate, such as an enlarged prostate (a male reproductive gland) or urethral stricture (a blockage of the tube that allows urine to leave the body), or gallbladder, pancreas, liver, thyroid, or kidney disease, be sure to let your doctor know.
• If you are breastfeeding, let your doctor know.
• You should be aware that this medicine may lower both male and female fertility. Discuss the dangers of using hydromorphone with your doctor.
• Inform the surgeon, including the dentist, if you are undergoing surgery, that you are taking hydromorphone.
• 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. Get out of bed gradually, resting your feet on the floor for a few minutes before standing up, to avoid this issue.
• You ought to be aware that hydromorphone might result in constipation. While using hydromorphone, discuss with your doctor whether you should alter your diet or take additional medications to avoid or cure constipation.

Keep eating normally unless your doctor instructs you otherwise.

Take the missed dose of any tablets or solution as soon as you remember it, if you are taking them. 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.

Skip the missed dosage if you are using extended-release pills and carry on with your normal dosing regimen. The extended-release pills should not be taken more than once per 24 hours.

Side effects from hydromorphone could exist. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Headache
• Having trouble falling or staying asleep
• Mouth ache
• Lightheadedness
• Drowsiness
• Heavy perspiration
• Back, joint, or muscular pain
• Abdominal pain
• Anxiety
• Flushing
• Itching
• Depression

Some adverse effects may be severe. Get emergency medical care or call your doctor right away if you develop any of the following symptoms or any of those in the IMPORTANT WARNING section:

• Rash
• Hives
• Edoema of the lower legs, lower arms, hands, feet, ankles, tongue, lips, mouth, or throat
• Breathing or swallowing challenges
• Hoarseness
• Agitation, hallucinations (hearing voices or seeing things that are not there), disorientation, fever, sweating, shivering, extremely stiff or twitching muscles, loss of coordination, nausea, vomiting, or diarrhoea
• Nausea, vomiting, weight loss, anorexia, or lightheadedness
• Failure to achieve or maintain erection
• Irregular periods of time
• Less sexual arousal
• Seizures
• Chest ache
• Extreme somnolence
• Fainting
• Feeling dizzy when shifting positions

Further negative consequences of hydromorphone could exist. If you have any strange side effects while taking this medicine, contact your doctor right once.

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).

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from excessive heat and moisture at room temperature (not in the bathroom). Any medication that has expired or is no longer needed must be disposed of right away via a medicine take-back programme. If there is no take-back programme close by or that you can quickly reach, flush any hydromorphone liquid or tablets that are no longer effective or necessary down the toilet. See your pharmacist for advice on how to properly dispose of your medications.

Although 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

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, 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 while taking hydromorphone (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:

• Weak or sluggish breathing
• Having trouble breathing
• Sleepiness
• Not able to speak or awaken
• Muscular tremor
• Clammy, frigid skin
• Pupil dilation or dilation of the pupils (dark circles in the middle of the eyes)
• Slow or irregular heartbeat
• Dizziness
• Fainting

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 taking hydromorphone prior to any laboratory test (particularly one that uses methylene blue).

Tell the x-ray technician that you are taking the extended-release pill if you have any upcoming x-ray procedures.

This medication cannot be renewed. Call your doctor if the discomfort persists after you’ve finished the hydromorphone.

You might find the tablet shell in your stool if you’re using extended release tablets. This is typical and does not imply that you didn’t take the entire drug dose.

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.