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This medication is available in various strengths, and it's crucial to ensure you're using the appropriate one. The higher strength is intended for individuals who have been on opioid pain medications for an extended period. If someone who is not accustomed to opioid pain relievers uses the higher strength, it can result in severe, potentially fatal breathing issues. Consult your doctor or pharmacist about having naloxone on hand for treating opioid overdose, and educate your family or household members on recognizing and responding to an opioid overdose.

Hydromorphone carries a risk of abuse and addiction, which can lead to overdose and death. Additionally, it may cause severe and possibly fatal breathing problems. To minimize risks, your doctor should prescribe the lowest effective dose for the shortest duration. The risk of breathing issues is heightened when starting this medication, after a dose increase, or if taking an incorrect dose or strength. Combining this medication with alcohol or other substances that cause drowsiness or breathing problems can lead to serious side effects, including death. Ensure you understand how to properly use hydromorphone and are aware of substances to avoid. Seek immediate medical assistance if you experience symptoms like slow or shallow breathing, unusual lightheadedness, severe drowsiness or dizziness, or trouble waking up.

Store this medication securely to prevent theft, misuse, or abuse. If someone accidentally ingests it, seek emergency help immediately. Women of childbearing age should discuss the risks and benefits of this medication with their doctor before use. Inform your healthcare provider if you are pregnant or planning to become pregnant. During pregnancy, this medication should only be used when absolutely necessary as it may slightly increase the risk of birth defects in the first two months. Prolonged or high-dose use near delivery can harm the unborn baby. Babies born to mothers using this drug long-term may develop severe withdrawal symptoms. Report any symptoms in your newborn, such as persistent crying, slow or shallow breathing, irritability, shaking, vomiting, diarrhea, poor feeding, or difficulty gaining weight, to a doctor immediately.

Additional Precautions:

• Accidental overdose is possible, even at recommended doses, and can be life-threatening if not addressed promptly.
• There is a potential for addiction and misuse; addiction can develop even when used as prescribed.
• The medication can cause severe respiratory depression, especially when starting or after a dose increase.
• Using this drug during pregnancy can lead to neonatal opioid withdrawal syndrome (NOWS) in newborns.
• Long-term use may result in low hormone levels, causing symptoms like nausea, vomiting, and dizziness.
• The medication can cause low blood pressure, including a drop when standing, which may lead to dizziness.
• There is an increased risk of seizures for those with a history of seizure disorders.
• Physical dependence can develop, leading to withdrawal symptoms if the medication is suddenly stopped.
• The drug can cause extreme drowsiness, affecting concentration and reaction times.
• Contains sulfites, which may cause allergic reactions in sensitive individuals.

Contraindications:

• Severe respiratory depression
• Severe asthma
• Conditions leading to stomach blockage
• Allergy to sulfite-containing products
• First-time opioid users for extended-release tablets

It is crucial to discuss your medical history and any concerns with your healthcare provider before starting this medication.

When using this medication, you may experience some common side effects, which are generally mild. These include lightheadedness, dizziness, drowsiness, nausea, vomiting, constipation, sweating, flushing, dry mouth, and itchy skin. It's essential to manage constipation by consuming dietary fiber, staying hydrated, and exercising. Rising slowly from sitting or lying positions can help reduce dizziness. If these effects persist or worsen, consult your healthcare provider for advice.

There are other side effects that some individuals might experience, such as slowed breathing, weakness, headache, fainting, stomach pain, low appetite, mood changes, anxiety, depression, nervousness, and unusual dreams. Changes in heartbeat and blood pressure may also occur. If you notice any of these symptoms, especially if they are severe, contact your healthcare provider.

In rare cases, more serious side effects can occur, requiring immediate medical attention. These include severe drowsiness or difficulty waking up, slow or irregular breathing, and changes in heartbeat. An overdose may result in extreme sleepiness, slowed breathing, and pale or cold skin; this situation demands urgent care. Additionally, signs of opioid withdrawal, such as restlessness, runny nose, sweating, and anxiety, should be addressed promptly.

While a severe allergic reaction is uncommon, seek medical help immediately if you experience symptoms like rash, severe dizziness, itching or swelling (particularly of the face, tongue, or throat), and trouble breathing. Always notify your healthcare provider about any side effects you encounter, as this is not a comprehensive list of potential reactions.

Certain medications can interact with this drug. These include some pain relievers, specifically mixed opioid agonists/antagonists like Butorphanol, Nalbuphine, and pentazocine, as well as Cimetidine. Medications that slow gut movement, such as belladonna alkaloids and oxybutynin, also interact, as do Naltrexone and samidorphan.

Using this drug with other substances that cause drowsiness or breathing issues can increase the risk of serious side effects, like slow or shallow breathing and severe drowsiness or dizziness. Inform your doctor or pharmacist if you're using other opioid painkillers or cough suppressants, such as codeine or hydrocodone, or if you consume alcohol, marijuana, sleep or anxiety medications like Alprazolam, Lorazepam, or Zolpidem. Muscle relaxants like Carisoprodol and Cyclobenzaprine, as well as antihistamines such as Cetirizine and diphenhydramine, should also be mentioned.

Check all medication labels, including those for allergy or cough and cold remedies, because they may contain ingredients that cause drowsiness. Consult your pharmacist to ensure the safe use of these products.

Additionally, this drug may affect certain lab tests, such as those measuring amylase or lipase levels, potentially leading to incorrect results. Be sure to inform lab personnel and all your healthcare providers that you are taking this medication.