hydromorphone (oral)

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Pronunciation: HYE droe MOR fone

Brand: Dilaudid, Dilaudid-5, Exalgo

Dilaudid 2 mg ABB

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Dilaudid 2 mg

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Dilaudid 4 mg

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Dilaudid 8 mg

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Hydromorphone 2 mg-ETH

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Hydromorphone 2 mg-MAL

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Hydromorphone 2 mg-ROX

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Hydromorphone 4 mg-ETH

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Hydromorphone 4 mg-MAL

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Hydromorphone 4 mg-ROX

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round, white, imprinted with 4, 54 609

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Hydromorphone 8 mg-ETH

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Hydromorphone 8 mg-ROX

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

Hydromorphone can slow or stop your breathing. Never use this medicine in larger amounts, or for longer than prescribed. Do not crush, break, or open an extended-release pill. Swallow it whole to avoid exposure to a potentially fatal dose. Hydromorphone may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Tell your doctor if you are pregnant. Hydromorphone may cause life-threatening withdrawal symptoms in a newborn.

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with hydromorphone.

What is hydromorphone?

Hydromorphone is an opioid pain medication. An opioid is sometimes called a narcotic.

Hydromorphone is used to treat moderate to severe pain.

The extended-release form of this medicine is for around-the-clock treatment of moderate to severe pain. This form of hydromorphone is not for use on an as-needed basis for pain.

Hydromorphone may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using hydromorphone?

You should not take this medicine if you have ever had an allergic reaction to hydromorphone or other narcotic medicines, or if you have:

  • severe asthma or breathing problems;
  • a blockage in your stomach or intestines; or
  • a bowel obstruction called paralytic ileus.

Do not use hydromorphone if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Some medicines can interact with hydromorphone and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

You may not be able to take hydromorphone if you are NOT already being treated with a similar opioid (narcotic) pain medicine and are tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.

To make sure hydromorphone is safe for you, tell your doctor if you have:

  • any type of breathing problem or lung disease;
  • a history of head injury, brain tumor, or seizures;
  • a history of drug abuse, alcohol addiction, or mental illness;
  • urination problems;
  • liver or kidney disease;
  • sulfite allergy;
  • Addison's disease or other adrenal gland disorders; or
  • problems with your gallbladder, pancreas, or thyroid.

It is not known whether this medicine will harm an unborn baby. If you use hydromorphone while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Hydromorphone can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using hydromorphone.

How should I use hydromorphone?

Follow all directions on your prescription label. Hydromorphone can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never use hydromorphone in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Hydromorphone may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away hydromorphone is against the law.

Do not crush, break, or open an extended-release pill. Swallow it whole to avoid exposure to a potentially fatal dose.

Stop taking all other around-the-clock narcotic pain medications when you start taking hydromorphone.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not stop using hydromorphone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using hydromorphone.

Never crush or break a hydromorphone pill to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death with the misuse of hydromorphone and similar prescription drugs.

Store at room temperature away from moisture, heat, and light. Throw away any unused liquid after 90 days.

Keep track of the amount of medicine used from each new bottle. Hydromorphone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Do not keep leftover hydromorphone pills or liquid. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush any unused pills or liquid medicine down the toilet.

What happens if I miss a dose?

Since hydromorphone is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A hydromorphone overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting.

What should I avoid while using hydromorphone?

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with hydromorphone. Check your food and medicine labels to be sure these products do not contain alcohol.

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how hydromorphone will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

What are the possible side effects of hydromorphone?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • weak or shallow breathing;
  • confusion, feelings of extreme happiness or sadness;
  • severe weakness or drowsiness;
  • a light-headed feeling, like you might pass out;
  • infertility, missed menstrual periods;
  • impotence, sexual problems, loss of interest in sex; or
  • low cortisol levels -- nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Hydromorphone is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.

Common side effects may include:

  • constipation, nausea, vomiting, stomach pain;
  • dizziness, drowsiness;
  • headache, tired feeling;
  • feelings of extreme happiness or sadness;
  • sweating, mild itching;
  • dry mouth; or
  • flushing (warmth, redness, or tingly feeling).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect hydromorphone?

Some medicines can cause unwanted or dangerous effects when used with hydromorphone. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.

Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking hydromorphone with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with hydromorphone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your pharmacist can provide more information about hydromorphone.


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.

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