Generic Name: hydromorphone (hye-dro-MOR-fone)
Brand Names: Dilaudid®
Classification: Opioid Analgesic
Issue Date: 1988

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. Never use more Dilaudid than is prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Do not take Dilaudid rectal by mouth. It is for use only in your rectum.

This medication comes with patient instructions for using the rectal suppository. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Remove the outer wrapper from the suppository before inserting it. Avoid handling the suppository too long or it will melt in your hands.

For best results from the suppository, lie down after inserting it and hold in the suppository for a few minutes. The suppository will melt quickly once inserted and you should feel little or no discomfort while holding it in. Avoid using the bathroom just after you have inserted the suppository.

Drink 6 to 8 full glasses of water daily to help prevent constipation while you are using Dilaudid. Ask your doctor about ways to increase the fiber in your diet. Do not use a stool softener (laxative) without first asking your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using Dilaudid. You may need to stop using the medicine for a short time.

You may have withdrawal symptoms when you stop using this medication after using it over a long period of time. Withdrawal symptoms include:

• feeling restless or irritable
• blurred vision
• runny nose
• watery eyes
• yawning
• sweating
• tingly feeling under your skin
• sleep problems
• weakness
• muscle spasms
• severe back or stomach pain
• muscle cramps
• hot and cold flashes
• nausea, vomiting, diarrhea
• weight loss
• fast heart rate

Do not stop using Dilaudid suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

Store the suppositories in the refrigerator and do not allow them to freeze.

Do not use this medication if you are allergic to Dilaudid, or if you have breathing problems such as an asthma attack. Before using Dilaudid, tell your doctor if you are allergic to any drugs, or if you have:

• Asthma, COPD, Sleep Apnea, or Other Breathing Disorders
• Kidney disease
• Liver disease
• Curvature of the Spine
• History of Head Injury or Brain Tumor
• Low Blood Pressure
• Underactive Hypothyroid
• Seizures or epilepsy
• Gallbladder disease
• Addison's disease
• Enlarged Prostate, Urination Problems
• Mental Illness
• History of Drug or Alcohol Addiction

If you have any of these conditions, you may not be able to use Dilaudid, or you may need a dosage adjustment or special tests during treatment.

Dilaudid may be habit-forming and should be used only by the person it was prescribed for. Dilaudid should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

This medication may be harmful to an unborn baby, and could cause addiction or withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Dilaudid can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medicine to anyone younger than 18 years old. Older adults may be more sensitive to the effects of this medicine.

Since Dilaudid is sometimes used as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Try to use the medicine at a time when you can lie down afterward and hold the medicine in. Do not use extra medicine to make up the missed dose.

Seek emergency medical attention if an overdose is suspected. An overdose of Dilaudid can be fatal.

Symptoms of a Dilaudid overdose may include:

• extreme drowsiness
• muscle weakness
• confusion
• cold and clammy skin
• pinpoint pupils
• shallow breathing
• slow heart rate
• fainting
• coma

Do not drink alcohol while you are using Dilaudid. Dangerous side effects or death can occur when alcohol is combined with Dilaudid. Check the label of any other medicines you take to be sure they do not contain alcohol. Avoid using other medicines that make you sleepy such as:

• cold medicine
• pain medication
• muscle relaxers
• medicine for seizures, depression or anxiety

They can add to sleepiness caused by Dilaudid, which could result in extreme drowsiness or coma. Do not use Dilaudid if you have used an MAO inhibitor such as:

• Isocarboxazid (Marplan®)
• Phenelzine (Nardil®)
• Rasagiline (Azilect®)
• Selegiline (Eldepryl®, Emsam®)
• Tranylcypromine (Parnate®)

within the past 14 days. Serious, life-threatening side effects can occur if you use Dilaudid before the MAO inhibitor has cleared from your body.

Dilaudid can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction:

• hives
• difficulty breathing
• swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these SERIOUS side effects:

• Shallow breathing, slow heartbeat
• Seizures
• Cold, clammy skin
• Severe weakness or dizziness
• Confusion

Less serious side effects are more likely to occur, such as:

• Constipation
• Warmth, tingling, or redness under your skin
• Dry mouth, nausea, vomiting, or decreased appetite
• Dizziness, tiredness, or lightheadedness
• Sleep problems, insomnia
• Sweating
• Itching

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

Do not use Dilaudid with alcohol, other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result. Before using Dilaudid, tell your doctor if you are using:

• Pentazocine (Talwin®)
• Nalbuphine (Nubain®)
• Butorphanol (Stadol®)
• Buprenorphine (Buprenex®, Subutex®)

If you are using any of these drugs, you may not be able to use Dilaudid, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect Dilaudid. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.