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Dilaudid, the brand name for hydromorphone, is a drug used to treat severe pain. It belongs to the drug class opioid analgesics. Dilaudid is typically used only when other alternative pain medications have failed, such as non-opioid pain relievers and opioid combination drugs.
Dilaudid is available as a liquid oral solution or as tablets. The drug concentration of the liquid solution is 5 milligrams/milliliter (mg/ml). The tablet is available in 2, 4 or 8 mg doses. It should always be stored at room temperature.
Use Dilaudid only as prescribed by a health care professional. Dosing for each form is as follows:
- Oral Liquid solution — for adults, usual dosing is 2.5 mL to 10 mL every three to six hours. This amount is equivalent to 2.5 mg to 10 mg of the drug
- Tablet — for adults, usual dosing is between 2 and 4 mg, and must be taken every four to six hours
A study from 2018 found that about 10 million people (12 and older) have misused opioids in the past year. This is nearly 4 percent of the U.S. population.National Survey on Drug Use and Health (NSDUH)
Side Effects of Dilaudid
The most commonly reported adverse side effects of Dilaudid include:
- Pain relief
- Nausea and vomiting
- Dizziness or lightheadedness
- Dry mouth
- Sedation or sleepiness
- Heavy sweating
- Loss of appetite
Additionally, more serious side effects can include:
- Hearing impairment or permanent loss
- Skin rashes
- Impairment of mental and physical performance
- Anxiety or fear
- Low blood pressure
- Serotonin syndrome
- Mood changes
Dilaudid passes through breast milk. If you are pregnant or plan on becoming pregnant, seek medical advice from your healthcare provider before breastfeeding.
Risks of Dilaudid
Dilaudid is classified as a Schedule II drug by the Drug Enforcement Administration. These are drugs that are defined as, “drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence.”
It is important to pay attention to the dosing of the liquid form of Dilaudid to ensure you are taking the correct amount. Do not confuse mg and mL with each other, as this can result in accidental overdose and death. Additionally, make sure to use proper measuring equipment to avoid inaccuracies in dosing.
Furthermore, Dilaudid may cause life-threatening respiratory depression in patients with preexisting pulmonary issues. It is not advised to use the drug without proper monitoring if you have acute or severe asthma. Patients with chronic pulmonary disease are at an increased risk of decreased respiratory function and apnea (temporarily stopping breathing).
If you are allergic to sodium metabisulfite, do not take the drug as it may cause a severe allergic reaction. Signs of an allergic reaction include:
- Rash and hives
- Swelling of the lips, face, or throat
- Difficulty breathing or swallowing
If any of these occur, stop using Dilaudid and contact emergency medical services right away.
If you have a head injury, do not take Dilaudid, as it can elevate the pressure of cerebrospinal fluid. This elevation may become exaggerated with a head injury and can become dangerous.
Dilaudid Drug Interactions
Dilaudid has several adverse drug interactions including:
- Other opioid analgesics/opioid antagonists
- Benzodiazepines such as clonazepam, lorazepam, and diazepam
- Muscle relaxants
- Sleep drugs/tranquilizers
- Antipsychotics such as phenothiazine
- Sodium oxybate
- MAO inhibitors
Dilaudid has similar properties to other opioid medications, such as oxycodone, fentanyl, and hydrocodone. These drugs are all addictive, and may eventually lead to physical and psychological dependence, and abuse. The active ingredient hydromorphone binds to the opioid receptors in the brain and blocks the sensation of pain. This interaction induces feelings of euphoria (a high), and calm, which can become addictive very quickly.
Addiction is characterized by a set of behaviors surrounding drug use. Someone who is addicted to Dilaudid might have cravings when not taking it, may be unable to stop using it, and may continue to do so despite knowing it is harmful.
Signs of opioid addiction and abuse include:
- Lack of hygiene
- Changes in sleep patterns
- Frequent flu-like symptoms
- Isolation from family or friends
- Changes in exercise habits
- Taking their next dose of hydromorphone before the prescribed time
- Weight loss
- Decreased libido
- Money problems
- Associating with people who encourage addiction
- Stealing from family, friends, or businesses
Hydromorphone Overdose and Withdrawal
Overdoses from opioids can happen for many reasons, including:
- Using more of an opioid than is prescribed (intentionally or accidentally)
- Mixing opioids with other CNS depressant medication, alcohol, or illicit drugs
- Taking an opioid with the intention of getting high
- Taking an opioid that was not prescribed for you
Respiratory depression (slow and ineffective breathing), is an extremely dangerous condition that can develop with opioid use. High doses of the drug act on the brain stem, where breathing rate and rhythm are controlled. Using alcohol, benzodiazepines, and other drugs that affect your central nervous system can exacerbate respiratory depression.
Most often, breathing problems are seen in opioid overdose, or when too much drug is taken in a single dose. Signs of Dilaudid overdose to look out for include:
- Trouble breathing
- Severe drowsiness
- Inability to speak
- Limp body
- Pale and clammy skin
- Purple/blue lips and fingernails
If any of these symptoms are observed, call 911 for medical attention immediately and administer naloxone if available.
Someone who uses Dilaudid for an extended period of time can become physically and psychologically dependent on it. In short, this means they need to take the drug in order to feel normal and function daily. If drug use is stopped suddenly during dependence, withdrawal syndrome can occur. Symptoms of withdrawal from Dilaudid, include:
- Increased pain
- Irritability or agitation
- Anxiety or restlessness
- Difficulty sleeping
- Muscle cramps/aches
- Watery eyes, runny nose
- Chills, sweating or goosebumps
- Stomach cramps
- Changes in blood pressure
- Suicidal thoughts
- Rapid heart rate
Do not attempt to withdraw from Dilaudid on your own, as this can be extremely dangerous.
A sudden change in opioid use can induce seizures, and in some severe cases, death. Talk with your doctor about quitting opioid use, and how to safely do so.
One supervised method of stopping Dilaudid use is tapering off the drug. This process reduces the dose of the drug slowly over a period of time to prevent shock to the body’s systems. With this, withdrawal symptoms will be much less severe and can be managed with other medications. In order to ensure safety, tapering should only be done under the direction of a medical professional.
The safest way to stop using a drug is under the care of trained medical professionals. There, it is important to find a treatment option that works best for you or a loved one.
One treatment option for treating opioid addiction is medication-assisted treatment, or MAT. This approach combines drugs such as buprenorphine, methadone, and naltrexone with therapy to provide a “whole patient” approach.
Other programs and counseling options help facilitate lifestyle changes and thoughts around drug use. Options include:
- Individual counseling— one-on-one sessions focused on goal setting and discussions on recovery and progress. It can include specific types of therapy, including:
- Family counseling— includes partners, spouses, and other family members that help improve and repair family relationships.
- Group counseling— classes that encourage conversation and allow you to learn from one another. Often other group members share the same experiences, which can help you feel that you are not alone.
Overcoming addiction to Dilaudid is difficult to do alone. Find medical help today.