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Dilaudid Injection Generic Name & Formulations
Legal Class
CII
General Description
Hydromorphone HCl 0.5mg/0.5mL, 1mg/mL, 2mg/mL; soln for IV, IM or SC inj; preservative-free; contains sulfites.
Pharmacological Class
Opioid agonist.
See Also
How Supplied
Prefilled syringes—10, 24; HPF Injection—contact supplier
Manufacturer
Dilaudid Injection Indications
Indications
Management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.
Limitations of Use
Reserve for use in patients for whom alternative treatment options have not been tolerated or not provided adequate analgesia.
Dilaudid Injection Dosage and Administration
Adult
Use lowest effective dose for shortest duration. Individualize. Initially 1–2mg SC or IM, or 0.2–1mg by slow IV (at least 2–3mins) every 2–3 hours as needed. Elderly, debilitated: initially 0.2mg IV. Renal or hepatic impairment: initially ¼ to ½ the usual dose. Conversion from other opioids: see full labeling. Withdraw gradually by 25–50% every 2–4 days.
Children
Not established.
Dilaudid Injection Contraindications
Contraindications
Significant respiratory depression. Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment. Known or suspected GI obstruction, including paralytic ileus. Hydromorphone-HPF: opioid non-tolerant.
Dilaudid Injection Boxed Warnings
Boxed Warning
Addiction, abuse, and misuse. Life-threatening respiratory depression. Neonatal opioid withdrawal syndrome. Risks from concomitant use with benzodiazepines and other CNS depressants.
Dilaudid Injection Warnings/Precautions
Warnings/Precautions
Abuse potential (monitor). Life-threatening respiratory depression; monitor within first 24–72hrs of initiating therapy and following dose increases. Sleep-related breathing disorders (including central sleep apnea (CSA), sleep-related hypoxemia); consider dose reduction if CSA develops. COPD, cor pulmonale, decreased respiratory reserve, hypoxia, hypercapnia, or pre-existing respiratory depression; monitor and consider non-opioid analgesics. Adrenal insufficiency. Head injury. Increased intracranial pressure, brain tumors; monitor. Seizure disorders. CNS depression. Impaired consciousness, coma, shock; avoid. Biliary tract disease. Acute pancreatitis. Drug abusers. Renal or hepatic impairment. Reevaluate periodically. Avoid abrupt cessation. Elderly. Cachectic. Debilitated. Pregnancy; potential neonatal opioid withdrawal syndrome during prolonged use. Labor & delivery: not recommended. Nursing mothers: monitor infants.
Dilaudid Injection Pharmacokinetics
See Literature
Dilaudid Injection Interactions
Interactions
Increased risk of hypotension, respiratory depression, sedation with benzodiazepines or other CNS depressants (eg, non-benzodiazepine sedatives/hypnotics, anxiolytics, general anesthetics, phenothiazines, tranquilizers, muscle relaxants, antipsychotics, alcohol, other opioids); reserve concomitant use in those for whom alternative options are inadequate; limit dosages/durations to minimum required; monitor. During or within 14 days of MAOIs: not recommended. Risk of serotonin syndrome with serotonergic drugs (eg, SSRIs, SNRIs, TCAs, triptans, 5-HT3 antagonists, mirtazapine, trazodone, tramadol, cyclobenzaprine, metaxalone, MAOIs, linezolid, IV methylene blue); monitor and discontinue if suspected. Avoid concomitant mixed agonist/antagonist opioids (eg, butorphanol, nalbuphine, pentazocine) or partial agonist (eg, buprenorphine); may reduce effects and/or precipitate withdrawal symptoms. May antagonize diuretics; monitor. Paralytic ileus may occur with anticholinergics.
Dilaudid Injection Adverse Reactions
Adverse Reactions
Lightheadedness, dizziness, sedation, nausea, vomiting, sweating, flushing, dysphoria, euphoria, dry mouth, pruritus; respiratory depression, severe hypotension, syncope.
Dilaudid Injection Clinical Trials
See Literature
Dilaudid Injection Note
Not Applicable
Dilaudid Injection Patient Counseling
See Literature
