Why is this medication prescribed?

Hydromorphone is used to relieve moderate to severe pain. It also may be used to decrease coughing.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Hydromorphone comes as a tablet and liquid and as an extended release tablet and capsule to take by mouth. It also comes as a rectal suppository. The oral forms usually are taken every 4 to 6 hours as needed. The extended release forms are usually taken once daily. The suppository usually is used every 6 to 8 hours as needed. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Shake the liquid well before measuring a dose. Take hydromorphone exactly as directed. Hydromorphone can be habit-forming. Do not take a larger dose, take it more often, or for a longer period than your doctor tells you to.

To insert a hydromorphone suppository rectally, follow these steps:

1. Remove the wrapper.

2. Dip the tip of the suppository in water.

3. Lie down on your left side and raise your right knee to your chest. (A left-handed person should lie on the right side and raise the left knee.)

4. Using your finger, insert the suppository into the rectum, about 1/2 to 1 inch (1.25 to 2.5 centimeters) for infants and children and about 1 inch (2.5 centimeters) for an adult.

5. Hold it in place with your finger for a few moments.

6. Stand up after about 15 minutes. Wash your hands thoroughly and resume normal activities.

What special precautions should I follow?

Before taking hydromorphone,

• tell your doctor and pharmacist if you are allergic to hydromorphone, aspirin, sulfites, tartrazine (yellow dye), or any other drugs.

• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially other pain relievers; antidepressants; medications for cough, cold, or allergies; sedatives; sleeping pills; tranquilizers; and vitamins.

• tell your doctor if you have or have ever had liver or kidney disease, a history of alcoholism, lung or thyroid disease, heart disease, prostatic hypertrophy, or urinary problems.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using hydromorphone, call your doctor.

• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using hydromorphone.

• you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.

• remember that alcohol can add to the drowsiness caused by this drug.

What special dietary instructions should I follow?

Hydromorphone may cause nausea. Take hydromorphone with food or milk.

What should I do if I forget a dose?

Hydromorphone usually is used as needed. If your doctor has told you to use hydromorphone regularly, use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

What side effects can this medication cause?

Hydromorphone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness

• lightheadedness

• drowsiness

• nausea

• vomiting

• constipation

• stomach pain

• rash

• difficulty urinating

If you experience either of the following symptoms, call your doctor immediately:

• difficulty breathing

• fainting

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.