$Unique_ID{BRK01986}
$Pretitle{}
$Title{HYDROMORPHONE}
$Subject{Dilaudid (Knoll)
hydromorphone hydrochloride (Roxane)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


HYDROMORPHONE
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BRAND NAMES (Manufacturers):
     Dilaudid (Knoll)
     hydromorphone hydrochloride (Roxane)
TYPE OF DRUG:
     Analgesic
INGREDIENT:
     hydromorphone
DOSAGE FORMS:
     Tablets (1 mg, 2 mg, 3 mg, and 4 mg)
     Suppositories (3 mg)
STORAGE:
     Hydromorphone tablets should be stored at room temperature in a tightly
       closed, light-resistant container.  The suppositories should be stored
       in the refrigerator.

USES

     Hydromorphone is a narcotic analgesic that acts directly on the central
nervous system (brain and spinal cord).  It is used to relieve moderate to
severe pain.

TREATMENT

     In order to avoid stomach upset, you can take hydromorphone tablets with
food or milk.
     To use the suppository, remove the foil wrapper and moisten the
suppository with water (if the suppository is too soft to insert, refrigerate
it for half an hour or run cold water over it before removing the wrapper).
Lie on your left side with your right knee bent.  Push the suppository into
the rectum, pointed end first.  Lie still for a few minutes.  Try to avoid
having a bowel movement for at least an hour.
     Hydromorphone works most effectively if you take it at the onset of pain,
rather than waiting until the pain becomes intense.
     If you are taking this medication on a regular schedule and you miss a
dose, take the missed dose as soon as possible, unless it is almost time for
your next dose.  In that case, do not take the missed dose at all; just return
to your regular dosing schedule.  Do not double the next dose.

SIDE EFFECTS

     Minor.

     Constipation, dizziness, drowsiness, dry mouth, false sense of
well-being, flushing, light-headedness, loss of appetite, nausea, or sweating.
These side effects should disappear as your body adjusts to the medication.
     If you are constipated, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads), exercise, and
drink more water (unless your doctor directs you to do otherwise).
     Chew sugarless gum or suck on ice chips or a piece of hard candy to
reduce mouth dryness.
     If you feel dizzy or light-headed, sit or lie down for a while; get up
from a sitting or lying position slowly, and be careful on stairs.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
anxiety, confusion, continued constipation, difficult or painful urination,
difficulty in breathing, excitation, fatigue, rash, restlessness, sore throat
and fever, tremors, or weakness.

INTERACTIONS

     Hydromorphone interacts with several other types of drugs:
     1. Concurrent use of it with other central nervous system depressants
(such as alcohol, antihistamines, barbiturates, benzodiazepine tranquilizers,
muscle relaxants, and phenothiazine tranquilizers) or with tricyclic
antidepressants can cause extreme drowsiness.
     2. A monoamine oxidase (MAO) inhibitor taken within 14 days of this
medication can lead to unpredictable and severe side effects.
     Before starting to take hydromorphone, BE SURE TO TELL YOUR DOCTOR about
any medications you are currently taking, especially any of those listed
above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to hydromorphone or to any other narcotic
analgesics (such as codeine, hydrocodone, meperidine, methadone, morphine,
oxycodone, and propoxyphene).
     * Tell your doctor if you now have or if you have ever had acute
abdominal conditions, asthma, brain disease, colitis, epilepsy, gallstones or
gallbladder disease, head injuries, heart disease, kidney disease, liver
disease, lung disease, mental illness, emotional disorders, prostate disease,
thyroid disease, or urethral stricture.
     * If this drug makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous machinery.
     * Before having surgery or any other medical or dental treatment, be sure
to tell your doctor or dentist that you are taking this medication.
     * Hydromorphone has the potential for abuse and must be used with
caution.  Usually, you should not take it on a regular schedule for longer
than ten days (unless your doctor directs you to do so).  Tolerance develops
quickly; do not increase the dosage or stop taking the drug abruptly, unless
you first consult your doctor.  If you have been taking large amounts of this
medication for long periods, you may experience a withdrawal reaction (muscle
aches, diarrhea, gooseflesh, runny nose, nausea, vomiting, shivering,
trembling, stomach cramps, sleep disorders, irritability, weakness, excessive
yawning, or sweating).  Your doctor may, therefore, want to reduce the dosage
gradually.
     * Some of these products contain the color additive FD&C Yellow No. 5
(tartrazine), which can cause allergic-type reactions (rash, fainting,
difficulty in breathing) in certain susceptible individuals.
     * The elderly may be more sensitive to side effects, especially
constipation, mental effects, or breathing problems.  Report any such effects
to your doctor.
     * Be sure to tell your doctor if you are pregnant.  The effects of this
medication during the early stages of pregnancy have not been thoroughly
studied in humans.  However, hydromorphone used regularly in large doses
during the later stages of pregnancy can result in addiction of the fetus,
leading to withdrawal symptoms (irritability, excessive crying, tremors,
fever, vomiting, diarrhea, sneezing, or excessive yawning) at birth.  Also,
tell your doctor if you are breast-feeding an infant.  Small amounts of this
medication may pass into breast milk and cause excessive drowsiness in the
nursing infant.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
