What is the most important information I should know about hydromorphone?

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Do not stop taking hydromorphone suddenly if you have been taking it continuously for more than 5 to 7 days. Stopping suddenly could cause withdrawal symptoms and make you very uncomfortable. Your doctor may want to gradually reduce your dose.

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Hydromorphone will cause drowsiness and fatigue. Avoid alcohol, sleeping pills, antihistamines, sedatives and tranquilizers except under the supervision of your doctor. These may also make you drowsy.

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Hydromorphone will also cause constipation. Drink plenty of water (six to eight full glasses a day) to lessen this side effect. Increasing the amount of fiber in your diet can also help to alleviate constipation.

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Never take more hydromorphone than is prescribed for you. If your pain is not being adequately treated, talk to your doctor.

What is hydromorphone?

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Hydromorphone is in a class of drugs called narcotic analgesics. It relieves pain.

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Hydromorphone is used to treat moderate-to-severe pain. Hydromorphone is also a cough suppressant.

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Hydromorphone may also be used for purposes other than those listed in this medication guide.

Who should not take hydromorphone?

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Hydromorphone is habit forming and should only be used under close supervision if you have an alcohol or drug addiction.

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Before taking this medication, tell your doctor if you have

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kidney disease;

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liver disease;

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asthma;

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urinary retention;

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an enlarged prostate;

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hypothyroidism;

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seizures or epilepsy;

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gallbladder disease;

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a head injury; or

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Addison's disease.

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You may not be able to take hydromorphone, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

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Hydromorphone may cause addiction and withdrawal symptoms as well as other harmful effects in an unborn baby. Do not take hydromorphone without first talking to your doctor if you are pregnant.

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Hydromorphone may also cause addiction and withdrawal symptoms in a nursing baby. Do not take hydromorphone without first talking to your doctor if you are breast-feeding a baby.

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If you are younger than 18 years of age or older than 60 years of age, you may be more likely to experience side effects from hydromorphone therapy. Use extra caution.

How should I take hydromorphone?

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Take hydromorphone exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

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Take each dose with a full glass of water.

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Take hydromorphone with food or milk if it upsets your stomach.

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Never take more of this medication than is prescribed for you. Too much hydromorphone could be very harmful.

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To ensure that you get a correct dose, measure the liquid form of hydromorphone with a special dose-measuring spoon or cup, not with a regular tablespoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

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Do not stop taking hydromorphone suddenly if you have been taking it continuously for more than 5 to 7 days. Stopping suddenly could cause withdrawal symptoms and make you feel uncomfortable. Your doctor may want to gradually reduce your dose.

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Avoid getting hydromorphone liquid on your skin. It can be absorbed through your skin, and you may get too large a dose.

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Use the suppositories rectally as directed by your doctor. If you do not know how to use them, ask you doctor, nurse, or pharmacist for instructions.

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Hydromorphone will cause constipation. Increase the amount of fiber and water (at least six to eight full glasses daily) in your diet to prevent constipation.

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Do not share this medication with anyone else.

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Store hydromorphone at room temperature away from moisture and heat.

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Discard any opened bottle of hydromorphone solution after 90 days.

What happens if I miss a dose?

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Take the missed dose as soon as you remember. Do not take a double dose of this medication. Wait the prescribed amount of time before taking your next dose.

What happens if I overdose?

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Seek emergency medical attention.

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Symptoms of a hydromorphone overdose include slow breathing, seizures, dizziness, weakness, loss of consciousness, coma, confusion, tiredness, cold and clammy skin, and small pupils.

What should I avoid while taking hydromorphone?

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Avoid alcohol while taking hydromorphone. Alcohol will greatly increase the drowsiness and dizziness caused by hydromorphone and could be dangerous.

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Also avoid sleeping pills, tranquilizers, sedatives, and antihistamines except under the supervision of your doctor. These medications also may cause dangerous sedation.

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Use caution when driving, operating machinery, or performing other hazardous activities. Hydromorphone may cause drowsiness. If you experience drowsiness, avoid these activities.

What are the possible side effects of hydromorphone?

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If you experience any of the following serious side effects, stop taking hydromorphone and seek emergency medical attention:

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an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

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slow, weak breathing;

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seizures;

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cold, clammy skin;

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severe weakness or dizziness; or

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unconsciousness.

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Other, less serious side effects may be more likely to occur. Continue to take hydromorphone and talk to your doctor if you experience

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constipation;

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dry mouth, nausea, vomiting, or decreased appetite;

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dizziness, tiredness, or lightheadedness;

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muscle twitches;

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sweating;

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itching;

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decreased urination; or

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decreased sex drive.

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Hydromorphone is habit forming. Do not stop taking it suddenly.

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Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect hydromorphone?

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Do not take hydromorphone if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. Dangerous side effects could result.

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The most serious interactions affecting hydromorphone are with those drugs that also cause sedation. The following drugs may lead to dangerous sedation if taken with hydromorphone:

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antihistamines such as brompheniramine (Dimetane, Bromfed, others), diphenhydramine (Benadryl, Nytol, Compoz, others), chlorpheniramine (Chlor-Trimeton, Teldrin, others), and others;

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tricyclic antidepressants, such as amitriptyline (Elavil) and doxepin (Sinequan), and serotonin reuptake inhibitors such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil);

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other commonly used antidepressants, including amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor), and protriptyline (Vivactil);

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anticholinergics such as belladonna (Donnatal), clidinium (Quarzan), dicyclomine (Bentyl, Antispas), hyoscyamine (Levsin, Anaspaz), ipratropium (Atrovent), propantheline (Pro-Banthine), and scopolamine (Transderm-Scop);

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phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Prolixin), thioridazine (Mellaril), and prochlorperazine (Compazine); and

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tranquilizers and sedatives such as phenobarbital (Solfoton, Luminal), amobarbital (Amytal), secobarbital (Seconal), alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan), flurazepam (Prosom), and temazepam (Restoril).

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Do not take any of the drugs listed above without the approval of your doctor.

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Drugs other than those listed here may also interact with hydromorphone. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

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Your pharmacist has additional information about hydromorphone written for health professionals that you may read.

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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.