Hydromorph Contin

Brand Name:Dilaudid, Dilaudid-HP, Dilaudid-HP-Plus, Dilaudid-XP, Dilaudid Sterile Powder, Hydromorph-IR, Hydromorphone HCl Injection USP, Hydromorphone HP 10, Hydromorphone HP 20, Hydromorphone HP 50, Hydromorphone HP Forte, PMS-Hydromorphone

Prescription needed: Yes

What is this drug used for?

Hydromorphone is primarily used to relieve moderate to severe pain that can be caused by many illnesses, such as cancer, acute and chronic pain conditions, a severe injury or pain after surgery. Hydromorpohone is similar to morphine and is a strong pain killer that is used when milder pain relievers are not working.

Is there any reason not to take this drug?

You should not take this drug if you are allergic to hydromorphone, morphine, oxycodone, hydrocodone or codeine. Before taking this medication, tell your doctor if you have or have ever had:

  • a problem with alcohol and/or drug abuse
  • feelings of being depressed or suicidal
  • constipation
  • problems with your lungs or breathing (e.g. severe emphysema or severe asthma)
  • problems with your kidney or liver
  • under-active thyroid (hypothyroidism) or Addison’s disease
  • enlarged prostate or problems with urinating
  • brain disease or head injury
  • seizures
  • problems with your gallbladder
  • low blood pressure
  • heart rhythm problems

What about possible side effects?

The most common side effects are:

  • feeling tired and drowsy
  • dizziness, lightheadedness
  • nausea and vomiting
  • constipation
  • feeling unsteady, loss of balance
  • rash and itching

These side effects are usually related to dose, the use of other medications and other factors (e.g. older age, other medical conditions). As well, some of these side effects may go away with time. Talk to your doctor or pharmacist about whether you have any risk factors that may make you more sensitive to these side effects. Contact your doctor if these symptoms continue or become worse.

Other less common side effects include:

  • difficulty breathing
  • mood changes, confusion
  • becoming dependent on the drug
  • difficulty urinating
  • dry mouth
  • wheezing
  • vivid dreams

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs since he/she may need to make changes or monitor you more closely:

  • drugs that can cause tiredness, sedation, dizziness - talk to your doctor or pharmacist if you are taking any of the following drugs:
  • antihistamines (e.g. diphenhydramine, hydroxyzine)
  • other opioid pain medications (e.g. codeine, oxycodone, morphine)
  • antidepressants (e.g. amitriptyline, trazodone) and antipsychotics (e.g. risperidone, haloperidol)
  • muscle relaxants (e.g. cyclobenzaprine)
  • drugs for epilepsy (gabapentin, phenytoin, phenobarbital, carbamazepine, valproic acid)
  • medicine for insomnia or anxiety (e.g. alprazolam, diazepam, lorazepam, temazepam)
  • amantadine, amitriptyline and other similar antidepressants, MAO-I inhibitors, amoxapine, diphenydramine, chlorpheniramine, thioridizine, hyoscine, scopolamine, oxybutynin and other anti-cholinergic drugs - may increase your chances of side effects with urinating, constipation or dry mouth
  • phenelzine, tranylcypromine, moclobemide, selegeline, pargyline, and other MAO-I inhibitors - may increase the chance for side effects; generally suggested to wait at least two weeks after stopping one before you can start the other

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information:

This drug may not work as well after a period of time at the same dose because the body can develop a tolerance to the medication. Talk to your doctor if you find your pain is not being relieved or if it is getting worse as he/she may need to make some changes. Long-term use may also cause physical and psychological dependence, loss of sexual desire and/or impotence.

If you are having any kind of surgery, including dental surgery, tell your doctor prior to undergoing this surgery.

Special Instructions:

How to take: In order to get the most from this medication, it is important to take it at the start of pain. Do not wait for the pain to get too bad because it will be harder for the medication to work. Be sure to follow the suggested schedule if you are instructed to take it on a scheduled basis (for example, every 4 hours or every 12 hours). If you have pain in between these times, try to write down how often this occurs and how bad the pain feels. Share this information with your doctor as he/she can make changes to your medicine to help it work better and make you feel better.

Although this drug can be habit forming, which can lead to abuse and addiction, this usually doesn’t happen when it is taken properly for pain. The important thing is that you do not make any changes to your medication without talking to your doctor or other healthcare provider.

Managing side effects: Most people who take this medication will have some type of side effect, especially stomach side effects. Some of these will go away with time; others can be prevented or treated with other medications, like laxatives. It is important to talk to your healthcare provider early so that you don’t feel like you have to stop the medication and miss the opportunity of getting your pain relieved because you can’t tolerate the side effects.

Try to increase your fluid intake, activity level (if possible with the pain) and natural fibre in your diet to help prevent constipation.

Children: If used, the dose of the medication is usually dependent on the weight of the child. Talk to your doctor.

Seniors: Are more sensitive to side effects and lower doses are usually necessary, especially at the start of therapy.

Pregnant women: Can be used although the risks and benefits must be discussed with your doctor. Talk to your doctor.

Women who are nursing: Generally can be used. Talk to your doctor and/or pharmacist.

People who drive or operate machinery: Should not do so until they know the impact this medicine has on them personally. This drug may cause drowsiness and dizziness.

Alcohol: Do not consume alcohol while taking this medicine as it will increase side effects such as dizziness or drowsiness.

Overdose: A large overdose of this medicine could cause slow or irregular breathing, extreme drowsiness and possible loss of consciousness. If you experience any unusual reactions, or if you seriously exceed the recommended dosage, call your doctor or 911 or have someone do it for you.

Stopping the drug: Talk to your doctor before stopping if you have been regularly taking this medicine for several weeks. Your dose should be decreased gradually to avoid withdrawal symptoms. Some withdrawal symptoms can be severe.

If you miss a dose: Take it as soon as you remember. However, if your next dose is almost due do not take the missed dose. Instead, wait and take the next scheduled dose. Do not take a double dose.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom) and light; always out of reach of children. Some forms of this medication (injectable) are stored at the hospital.

Dietary precautions: Increase your intake of fluids and high fiber foods to help prevent constipation.