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Depending on the clinical situation, the initial starting dose may be lowered in patients who are opioid naïve. Titrate the dose based upon the individual patient’s response to their initial dose of Hydromorphone Hydrochloride Injection. While the general side effects are similar, Dilaudid has a higher potential for sedation, a shorter half-life, and a higher potential https://sober-house.org/post-acute-withdrawal-syndrome-symptoms-treatment/ for abuse. 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. Ask your doctor or pharmacist if you should have naloxone available to treat opioid overdose.
Symptoms such as fainting, a slow heart rate, or a weak pulse also indicate you should stop using the medication. Both hydromorphone and morphine are very strong pain medications. Using hydromorphone or morphine with one of these drugs raises your risk for severe constipation and not being able to urinate.
When writing prescriptions, include both the total dose in mg and the total dose in volume. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. It is very important that you understand the rules of the Opioid Analgesic REMS program to prevent addiction, abuse, and misuse of hydromorphone. Read it again each time you refill your prescription in case there is new information.
An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed. Dilaudid may cause life-threatening addiction and withdrawal symptoms in a newborn if the mother has taken this medicine during pregnancy. Initiate treatment with DILAUDID Tablets in a dosing range of 2 mg to 4 mg, crack cocaine symptoms and warning signs orally, every 4 to 6 hours as needed for pain, and at the lowest dose necessary to achieve adequate analgesia. Titrate the dose based upon the individual patient’s response to their initial dose of DILAUDID Tablets. Ensure accuracy when prescribing, dispensing, and administering DILAUDID Oral Solution to avoid dosing errors due to confusion between mg and mL, which could result in accidental overdose and death.
Make sure you store the medicine in a safe and secure place to prevent others from getting it. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary.
The hydromorphone in DILAUDID INJECTION may cause spasm of the sphincter of Oddi. Monitor patients with biliary tract disease, including acute pancreatitis, for worsening symptoms. Life-threatening respiratory depression is more likely to occur in elderly, cachectic, or debilitated patients because they may have altered pharmacokinetics or altered clearance compared to younger, healthier patients [see WARNINGS AND PRECAUTIONS]. Infants born to mothers physically dependent on opioids will also be physically dependent and may exhibit respiratory difficulties and withdrawal signs [see Use In Specific Populations]. Physical dependence is a state that develops as a result of a physiological adaptation in response to repeated drug use, manifested by withdrawal signs and symptoms after abrupt discontinuation or a significant dose reduction of a drug.
Hydromorphone is a full opioid agonist and is relatively selective for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses. The principal therapeutic action of hydromorphone is analgesia. Like all full opioid agonists, there is no ceiling effect for analgesia with morphine. Clinically, dosage is titrated to provide adequate analgesia and may be limited by adverse reactions, including respiratory and CNS depression. The pharmacokinetics of hydromorphone are affected by hepatic impairment.
However, this effect is not consistent and may be offset by an increased rate of cervical dilation, which tends to shorten labor. Monitor such patients for signs of sedation and respiratory depression, particularly when initiating therapy with DILAUDID INJECTION. Monitor such patients closely, particularly when initiating and titrating DILAUDID INJECTION and when DILAUDID INJECTION is given concomitantly with other drugs that depress respiration [see WARNINGS AND PRECAUTIONS, DRUG INTERACTIONS]. Alternatively, consider the use of non-opioid analgesics in these patients. Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality compared to use of opioid analgesics alone.
Frequent communication is important among the prescriber, other members of the healthcare team, the patient, and the caregiver/family during periods of changing analgesic requirements, including initial titration. Individually titrate DILAUDID Oral Solution or DILAUDID Tablets to a dose that provides adequate analgesia and minimizes adverse reactions. Use of opioid analgesics for an extended period of time during pregnancy for medical or nonmedical purposes can result in physical dependence in the neonate and neonatal opioid withdrawal syndrome shortly after birth. All patients treated with opioids require careful and frequent reevaluation for signs of misuse, abuse, and addiction, because use of opioid analgesic products carries the risk of addiction even under appropriate medical use. Inform patients that opioids could cause a rare but potentially life-threatening condition called serotonin syndrome resulting from concomitant administration of serotonergic drugs. Warn patients of the symptoms of serotonin syndrome and to seek medical attention right away if symptoms develop after discharge from hospital.
Ask your pharmacist or doctor if you are not sure how to check or measure the dose. If your liquid is a suspension, shake the bottle well before each dose. If you have nausea, it may how much does the average american spend on alcohol help to take this drug with food. Ask your doctor or pharmacist about other ways to decrease nausea (such as lying down for 1 to 2 hours with as little head movement as possible).
Avoid driving or hazardous activity until you know how hydromorphone will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). Long-term use of opioid medication may affect fertility (ability to have children) in men or women.
If DILAUDID INJECTION is abruptly discontinued in a physically-dependent patient, a withdrawal syndrome may occur, typically characterized by restlessness, lacrimation, rhinorrhea, perspiration, chills, myalgia, and mydriasis. “Drug-seeking” behavior is very common in persons with substance use disorders. “Doctor shopping” (visiting multiple prescribers to obtain additional prescriptions) is common among people who abuse drugs and people with substance use disorder.
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