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What is Dilaudid?

Dilaudid is the brand name for the generic drug hydromorphone hydrochloride, which is an opioid pain medication. It comes in formulations for both immediate release and delayed release, and it is used to treat moderate to severe pain.

The immediate-release tablets or liquid are used for treating acute, short-term pain. The extended-release tablets are used for managing chronic, long-lasting pain that requires around-the-clock treatment.

Function of Dilaudid

Dilaudid contains the active ingredient hydromorphone hydrochloride, which is an opioid pain medication. Opioid receptors in the brain, spinal cord, and other parts of the body are bound to and activated by hydromorphone. This blocks pain signals from being sent and perceived in the brain.

Specifically, Hydromorphone binds to mu-opioid receptors, causing analgesia and euphoria by blocking pain signal transmission. This results in pain relief and decreased pain perception.

In the brain and spinal cord, Hydromorphone reduces pain signals in the brain and spinal cord, leading to decreased pain sensation and altering emotional pain responses.

Dosage considerations

The dosage of Dilaudid is individualized based on the patient’s pain severity, opioid tolerance, age, and other factors. Lower starting doses are recommended for opioid-naïve patients, the elderly, and those with certain medical conditions. The dose is titrated up as needed and tolerated to provide adequate pain relief. Around-the-clock dosing works better than as-needed dosing for chronic pain. The lowest effective dose should be used.

Serious Side Effects  

More serious side effects are possible with Dilaudid use, including:

• Slowed or difficult breathing – This can lead to hypoxia, a dangerous lack of oxygen reaching the brain.
• Severe allergic reaction – Symptoms include swelling, hives, and tightness in the chest. This requires immediate medical care.
• Slow heartbeat and fainting – Dilaudid can cause bradycardia and hypotension. The risk increases if other medications that slow heart rate are also taken.
• Seizures – Dilaudid can trigger seizures in some people, especially at higher doses.  

Adrenal gland problems – Long-term use of Dilaudid may impact hormone production and blood pressure regulation.

Contraindications

Dilaudid is contraindicated in patients with:

• Known hypersensitivity to hydromorphone or any components of the product
• Significant respiratory depression
• Acute or severe bronchial asthma
• Paralytic ileus
• GI obstruction

The drug should also not be used in infants under 6 months of age due to increased risk of death from respiratory depression.

Interactions

Dilaudid has a number of interactions with other drugs that can increase side effects or cause dangerous medical problems. It’s important to tell your doctor and pharmacist about all medications you are taking before starting Dilaudid. 

Drug Interactions

• Antidepressants like fluoxetine and paroxetine can lead to serotonin syndrome when combined with Dilaudid. Symptoms include agitation, hallucinations, rapid heartbeat, and seizures.
• Antihistamines, sedatives, and medications for mental illness can enhance the drowsiness and breathing problems caused by Dilaudid.
• Dilaudid combined with barbiturates, benzodiazepines, or alcohol significantly raises the risk of life-threatening respiratory depression.
•  Medications that block the CYP3A4 enzyme like ketoconazole may increase Dilaudid levels in the body, enhancing its effects.
• Other opioid painkillers like codeine can increase side effects when taken with Dilaudid. 

Food Interactions 

Dilaudid can be taken with or without food. However, drinking grapefruit juice regularly while on Dilaudid may increase the drug’s levels and effects due to grapefruit inhibiting CYP3A4 enzymes. Patients should avoid or limit grapefruit juice intake when using Dilaudid.

How to Take ?

Take Dilaudid exactly as prescribed by your doctor. Never take more than the prescribed dose. 

When to Take ?

Dilaudid is available in immediate and extended release formulations.

• Immediate release Dilaudid is typically taken every 3-6 hours as needed for pain. Do not take more than 1 dose every 3 hours.
• Extended release Dilaudid is taken once or twice daily. Take at the same time(s) each day. 

Dilaudid can be taken with or without food. Taking with food may help reduce side effects like nausea.

How to Take Properly ?

• Swallow the tablets whole. Do not crush, break, or chew extended release tablets. This can lead to a dangerous overdose.
• Open the capsules and sprinkle contents into applesauce or pudding if you cannot swallow pills. Swallow immediately without chewing. 
• Use the oral syringe provided to measure liquid medicine. Shake the bottle well before each dose.

Overdose

An overdose of Dilaudid can be fatal. The most serious symptoms of Dilaudid overdose include:

• Extreme drowsiness
• Slow, shallow breathing
• Pinpoint pupils
• Cold, clammy skin  
• Loss of consciousness 

Non-Drug Treatments

Beyond medication, there are many non-pharmacological therapies that can provide pain relief, either alone or in conjunction with medicine:

• Physical therapy can help strengthen muscles, improve mobility, and reduce pain from injuries or conditions like arthritis. 
• Massage therapy may relieve muscle and joint pain by increasing circulation and relaxing tight tissues.
• Acupuncture uses thin needles placed in the skin to stimulate certain points and nerves to reduce pain.
• Cognitive behavioral therapy can help patients change unhelpful thought patterns and develop better coping skills for managing chronic pain.