Guide to Dilaudid
Dilaudid is a commonly prescribed narcotic aimed at treating pain. If you’re experiencing moderate or severe pain, it may work for your symptoms.
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Approximately 20 percent of Americans suffer from chronic pain, with an estimated 8 percent suffering from high-impact chronic pain that severely inhibits their daily function.
This is where Dilaudid has proven to be helpful, because it changes the way your nervous system and your brain respond to pain, increasing your overall pain tolerance to the point where theoretically you no longer feel it.
What is Dilaudid?
Dilaudid is a pain reliever medication that belongs to the opioid analgesics class. It’s commonly used to treat short-term moderate to severe pain that arises from surgical procedures, cancer, broken bones and other medical conditions. However, some people take Dilaudid to manage long-term pain as well.
Doctors prescribe it in liquid, tablet and sometimes suppository forms, though it also comes as an injection. It is not meant to treat mild pain.
The tablets range in color and shape, depending on their dosages and the manufacturer. However, the manufacturers produce them similarly.
For example, 2mg, 3mg and 4mg strengths are all round in orange, pink and yellow, respectively with the corresponding number imprinted on the face of the pill. The 8mg tablet is white and triangular in shape with an 8 on it to distinguish it as the higher strength.
Other Names for Dilaudid include:
Dilaudid may be filled under its generic name: hydromorphone, which is also commonly known as dihydromorphone. If your doctor prescribes the extended-release tablets, they’ll be under the brand Exalgo.
There are a few different Dilaudid brands, including:
- Dilaudid-HP Injections
The brand name depends on the form that the prescription comes in. For example, the Dilaudid brand covers tablets, injections, suppositories and liquid medication. Exalgo is the brand name for the extended-release tablet.
What Does Dilaudid Treat and Who Is It For?
Dilaudid is approved for treatment in adults for pain treatment as a result of surgery, broken bones or even cancer. It’s also regularly prescribed for adults who have been suffering from chronic back, stomach, chest or nerve pain.
It’s not uncommon for doctors to administer it as a treatment for pancreatitis or to keep patients in end-of-life care comfortable as part of compassionate treatment.
The main category of patients that receive Dilaudid prescriptions are adults who either use it short-term as pain care for surgery, broken bones or as part of cancer treatment. Some adults also take it for extended periods of time to treat chronic pain.
What Are the Ingredients of Dilaudid?
The active ingredient in Dilaudid is hydromorphone, which is a semisynthetic form of morphine. There are other, inactive ingredients as well.
The liquid form of Dilaudid contains:
- Purified water
- Sodium metabisulfite
The tablets contain the following inactive ingredients, depending on the manufacturer:
- D&C red #30 Lake dye
- D&C yellow #10 Lake dye
- Lactose or lactose anhydrous
- Magnesium stearate
- Sodium metabisulfite
Be sure to ask your physician for a full list of ingredients if you think that you may be allergic to one or more of them.
Common Dilaudid Side Effects
There are a variety of common side effects that you may experience while taking Dilaudid. However, it’s important to note that everyone’s body responds differently so you may experience several symptoms or you may experience none at all.
If the adverse reactions concern you, contact your physician to discuss any potential interaction.
Common side effects include, but are not limited to:
- Joint pain
- Sore or stiff muscles
- Difficulty moving
- Nausea, sometimes with vomiting
- Lightheadedness or dizziness
- Dry mouth
It’s possible that users may experience adverse reactions that are not on this list. If this is the case, it’s important to seek medical care or speak with your doctor.
Other rare side effects may occur while you’re taking Dilaudid as well. They include, but are not limited to:
- Respiratory distress such as bronchospasm or laryngospasm
- Muscle weakness or tremors
- Mood alterations
- Blurred vision
- Hypertension or hypotension
- Heart palpitations
If you experience any of these, let your doctor know immediately and head to the emergency room if you’re unable to reach your physician.
The Dilaudid dose that you’re prescribed will depend on your physician’s evaluation. They will typically start you off on the lowest dosage possible.
For liquid solutions, the Dilaudid dose ranges between 2.5mL (2.5 mg) and 2 teaspoons (10 mg), every 3 to 6 hours. Those taking tablets will have a dosage that ranges between 2 and 4 mg.
Injections start at 2 mg while suppositories, when prescribed, are taken one at a time as needed.
Dilaudid tablets come in different dosage amounts, including 2, 3, 4 and 8 mg. The extended-release tablets come in even higher strengths as they’re meant to be taken once a day.
You can find these in 8, 12, 16 or 32 mg strengths.
Over time, your doctor may choose to increase your dosage, particularly if you’re starting to build up a tolerance. Once you’ve reached the maximum, however, your doctor may decide to explore other solutions.
Warnings: Before You Take Dilaudid, Talk to Your Healthcare Provider if:
As with any medication, there are a few things that you should be aware of when it comes to Dilaudid. You should not take this prescription if you have or have had blockages in your intestines or stomach.
Because it can slow down your breathing or in some cases, even stop it, those with breathing problems that are severe in nature should avoid Dilaudid.
If you’re currently taking MAOIs or have taken them in the last two weeks (14 days), do not take Dilaudid. If you have reduced kidney or liver function, your doctor will likely not prescribe this.
Those with head injuries or CNS depression should not take Dilaudid, nor should pregnant or breastfeeding women.
How Should You Take Dilaudid?
Dilaudid comes in three forms: injection, liquid and tablet. Liquid doses are taken between 3 and 6 hours apart.
The tablets come in two different versions including a regular tablet that you take every 4 to 6 hours, and an extended-release tablet that you take once per day.
Tablets should be swallowed whole and not altered in any way, this includes crushing, breaking or chewing. It’s important to take the medication at the same time every day and most doctors recommend taking it with food to avoid nausea that may arise when Dilaudid is taken on an empty stomach.
How Much Dilaudid Can You Take in One Day?
The amount of Dilaudid that you can take in one day depends on the form you’re taking. Since tablets are taken every 4 to 6 hours, you’ll take a maximum of six pills per day.
Oral doses may be taken up to eight times a day if taken every three hours. Of course, your prescription will tell you what the maximum amount you can safely take per day, so follow the instructions outlined when you pick up your script.
Dilaudid Addiction Risks
Dilaudid is classified as an opioid analgesic, which makes it a schedule II controlled substance. This increases the likelihood that a patient can become addicted with regular use and it doesn’t take long for addiction to set in, especially with those who develop high tolerances for the drug.
Dilaudid abuse is not uncommon, and the drug is even sold on the streets under slang names like Dust, Juice and Smack among others.
Dilaudid Interactions: What Should You Avoid Taking With Dilaudid?
There are specific medications that you should avoid when you’re taking Dilaudid because they can interact badly.
When you’re taking the Dilaudid narcotic, it’s important to avoid other opioids as this can compound the effect and lead to an overdose. Additionally, it’s best to avoid:
These medications, when they interact, could cause opioid-induced respiratory depression, which is a life-threatening condition. Other medications and supplements to avoid include:
- St. John’s Wort
In addition to avoiding the aforementioned medications and supplements, users are strongly cautioned to completely avoid alcohol while taking Dilaudid. The combination can prove to be deadly as alcohol intensifies the effects of the drug as they are both CNS depressants.
Taking both can lead to an overdose where the patient falls into a coma or simply stops breathing.
Dilaudid Withdrawal Symptoms
Because of its addictive nature, it’s not recommended that you stop Dilaudid cold turkey. Your doctor will wean you off the medication by slowing decreasing your dose to avoid withdrawal as much as possible.
If you quit Dilaudid without weaning, you’ll likely experience symptoms that range from uncomfortable to serious.
Withdrawal from the Dilaudid narcotic can cause the following symptoms:
- Severe cravings for the drug
- Nausea or vomiting
- Rapid heartbeat
- High blood pressure
- Muscle spasms and tremors
- Drastic mood swings including suicidal thoughts
- Restlessness or agitation
- Difficulty sleeping
- Decreased appetite
- Fever or chills
If you’re experiencing withdrawal symptoms that are too much to bear, you can speak with your physician to determine the best course of action.
Dilaudid Efficacy: What Does Dilaudid Do for Your Symptoms?
Because it’s stronger than Morphine, Dilaudid treatments are often prescribed when pain reaches intolerable levels. Since it changes the way your brain responds to pain, it’s considered very effective when taken before the pain gets to be too bad.
Dilaudid and Pregnancy
It is strongly recommended that you avoid Dilaudid while pregnant because it’s known to cross the placenta, exposing the fetus to the drug. Let your doctor know if you are currently pregnant or become pregnant while on this medication.
Newborns whose mothers have taken this drug during pregnancy are at risk for a potentially life-threatening addiction or withdrawal after birth. There may be other options for expectant women, which is why it’s important to notify your physician as soon as you know you’re pregnant.
Several double-blind controlled studies have been carried out to test the results of Dilaudid, both with a placebo and compared to other pain relievers such as morphine.
The placebo test was done with two different doses of Dilaudid liquid: 5mg and 10mg. When compared with a placebo, the results were strongly in favor of Dilaudid.
When compared with morphine, some participants received 5mg or 10mg of Dilaudid liquid, while others received 30mg or 60mg of morphine sulfate oral liquid. The results found the two to be comparable in terms of pain relief.
Dilaudid is manufactured by two main companies: Purdue Pharma LP and Fresenius Kabi USA, LLC.
FDA Approval Status of Dilaudid
The FDA approved Dilaudid in both its liquid and tablet form in January of 1984. Since then there have been updates as recently as 2016 to the packaging materials that come with the drug, including warnings, precautions and dosage information.
Related Drugs or Medications
Dilaudid falls into the category of opioid analgesics. Other medications that fall into the classification include:
- Roxanol (morphine)
- Roxicodone (oxycodone)
These medications, like Dilaudid, help boost brain endorphins to help control the amount of pain a patient feels. None of them contain hydromorphone, but they all serve the same purpose and may be prescribed in place of Dilaudid if your physician deems the risk too great or if it has lost its efficacy.