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This medication, Dilaudid (hydromorphone), is available in various strengths, and it's crucial to use the correct one. The higher strength is intended only for individuals who have been using opioid pain medications for an extended period. Misuse of the higher strength by those not accustomed to opioid pain relievers can result in severe, potentially fatal respiratory issues. Here are important safety considerations and warnings:

• Risk of Overdose: Accidental overdose can be life-threatening, even at recommended doses. This risk increases if taken improperly, by children, or by individuals unfamiliar with the correct dosage forms (e.g., pills, liquid, suppositories). Ensure you understand the differences in dosage measurements to prevent dangerous errors.

• Addiction Potential: Dilaudid carries a risk of abuse and addiction, which can lead to overdose and death. Addiction may occur even at prescribed doses or if used for purposes other than intended. Physicians should prescribe the lowest effective dose for the shortest duration possible to minimize this risk.

• Respiratory Depression: This medication can cause severe, life-threatening breathing problems, particularly at the start of treatment or following a dose increase. The risk is heightened if combined with alcohol or other drugs that depress the central nervous system, such as benzodiazepines or muscle relaxants.

• Pregnancy Considerations: For women of childbearing age, it's important to discuss the risks and benefits of using Dilaudid during pregnancy with a healthcare provider. Long-term use during pregnancy may lead to neonatal opioid withdrawal syndrome (NOWS) in newborns, presenting symptoms such as persistent crying, feeding difficulties, and irritability. Use the smallest effective dose for the shortest period to mitigate these risks.

• Hormonal and Blood Pressure Effects: Long-term use may lead to low hormone levels, causing symptoms like nausea and fatigue, or low blood pressure, which can result in dizziness or fainting. Stand up slowly to prevent falls if experiencing dizziness.

• Seizure Risk: Opioids like Dilaudid may increase seizure frequency in individuals with a history of seizures. Notify your healthcare provider if seizures become more frequent.

• Physical Dependence and Withdrawal: Prolonged use can lead to physical dependence, with withdrawal symptoms occurring if the medication is suddenly stopped. Tapering off under medical supervision is crucial to avoid withdrawal.

• Drowsiness and Concentration Impairment: Dilaudid can cause significant drowsiness and affect mental alertness. Avoid alcohol and other sedatives, and be cautious when driving or performing tasks that require focus.

• Sulfite Allergy: The medication contains sulfites, which can trigger allergic reactions in sensitive individuals. Inform your provider if you have a sulfite allergy.

In case of overdose or accidental ingestion, seek emergency medical assistance immediately. Consult your healthcare provider if any of these warnings apply to your health conditions or if you have concerns about taking Dilaudid.

Common side effects:

• lightheadedness
• dizziness
• drowsiness
• nausea
• vomiting
• constipation
• sweating
• flushing
• dry mouth
• euphoria
• itchy skin

Less common but important to monitor:

• headache
• weakness
• fainting
• stomach pain
• low appetite
• mood changes
• unusual dreams
• changes in heartbeat or blood pressure

Serious side effects:

• slowed or irregular breathing
• severe drowsiness
• difficulty waking up
• changes in heartbeat
• allergic reaction
• overdose symptoms
• opioid withdrawal symptoms

Interactions with high risk of serious adverse effects and should be avoided:

• Other opioid pain or cough relievers (such as codeine, hydrocodone)
• Alcohol
• Marijuana (cannabis)
• Drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem)
• Muscle relaxants (such as carisoprodol, cyclobenzaprine)
• Antihistamines (such as cetirizine, diphenhydramine)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Mixed opioid agonists/antagonists (such as butorphanol, nalbuphine, pentazocine)
• Cimetidine
• Drugs that reduce gut movement (such as belladonna alkaloids, oxybutynin)
• Naltrexone
• Samidorphan