Side effects of Hydromorphone that cannot be ignored

Narcotic or opioid medications always come with a lot of side effects that range from mild to severe. You cannot ignore even mild side effects that continue to exist for a long time. You should immediately call your health care provider if you notice any unusual side effects that bother you. This article will illustrate side effects of Hydromorphone that cannot be ignored and need immediate medical attention

Major – Less Common side effects

In case you notice the below given side effects,, call your medical help immediately.

  • Blurred vision
  • Dry mouth
  • behavioral changes
  • chest discomfort or pain
  • mental or mood changes
  • fainting, dizziness or lightheadedness
  • convulsions
  • decreased urination
  • irregular, pounding, fast pulse or heartbeat
  • stiff neck
  • breathing problems
  • irregular or slow heartbeat
  • rapid breathing
  • severe stomach burning, cramping or pain
  • sunken eyes
  • suicidal thoughts
  • unusual tiredness
  • wrinkled skin
  • severe and continuous vomiting

Occurrence not known

  • confusion
  • dizziness
  • headache
  • cough
  • clammy or cold skin
  • bluish skin or lips
  • change in vision to see colors like yellow and blue the most
  • heart stops
  • decreased urination
  • weak or fast pulse
  • noisy breathing
  • painful urination
  • not breathing
  • appetite loss
  • sweating
  • unconscious
  • sleeping problems
  • chest tightness
  • no pulse or no BP
  • shallow, slow, fast or irregular breathing

Get emergency medical help in case you notice any of these symptoms of overdose

Overdose symptoms

  • no muscle movement or muscle tone
  • increased eyes sensitivity to light
  • unusual drowsiness or sleepiness
  • decreased responsiveness or awareness


Minor side effects

Some of the Hydromorphone side effects that need no medical attention are some minor side effects which go away with time as your body gets used to the medicine.  You can speak to your physician to know how to prevent or reduce these minor side effects. If you notice any of the minor side effects continue to exist for a long time, then call your doctor immediately.

More Common

  • nausea
  • problems with moving
  • joint pain
  • muscle stiffness or pain
  • troublesome bowel movement

Less Common

  • belching
  • diarrhea
  • sour or acid stomach
  • discouragement
  • back pain
  • muscles spasms
  • irritability
  • pain in legs and arms
  • trouble concentrating
  • unusual weight loss or weight gain
  • tingling of feet and hands
  • stomach pain, upset or discomfort
  • indigestion
  • heartburn
  • loss of pleasure or interest
  • feeling empty or sad
  • bloating feet, legs, arms or face
  • irritability

Some rare side effects are

  • double vision
  • being forgetful
  • clumsiness
  • crying
  • full feeling
  • extra heartbeats
  • hearing loss
  • increased appetite
  • muscles aches
  • passing gas
  • shivering
  • week pulse

In case you notice any symptoms that are unusual, it is always better to speak to your doctor and your doctor can advice you how to prevent or treat the side effects safely.

Hydromorphone drug interactions elaborated

While taking Hydromorphone, you should speak to your doctor about drug interactions related to Hydromorphone. Knowing about various drug interactions can help you to be alert for any unusual side effects that you may experience because of drug interactions. This article will help you know the Hydromorphone drug interactions.

Hydromorphone with CNS depressants

Using CNS depressants like general anesthetics, tranquilizers, phenothiazines and alcohol parallel with opioids can lead to added depressant effects. Hypertension, respiratory depression, coma or profound sedation can occur. When the combination of medications is observed, the dose of one or other medication needs to be reduced. Hydromorphone tablets should not be taken with alcohol. Hydromorphone can increase the neuromuscular blocking action and create high level of respiratory depression.

Hydromorphone with Mixed Antagonist/Agonist opioid analgesics

Antagonist analegesic/Agonist like butorphanol, nalbuphine, buprenophine, pentazocine should be examined with caution to the patient who is receiving or has received a session of therapy using pure opioid agonist anlegesic like hydromorphone. In such instances mixed antagonist analgesic/agonist can decrease the hydromorphone effect or lead to withdrawal symptoms.

Hydromorphone oral – artemether-lumefantrine (oral)

Hydromorphone oral can enhance the effect of artemether-lumefantrine(oral) by changing drug metabolism

Hydromorphone oral- selegiline hcl (oral)

Hydromorphone oral can enhance the toxicity of selegiline hcl (oral) through unknown mechanism. There should be a gap of 14 days between halting the use of MAO inhibiting medication and beginning Hydromorphone.

Hydromorphone- Tramadol

Check with your doctor before you use the combination of Hydromorphone and tramadol. Taking these medications together can enhance the risk of breathing problems, seizures and other serious side effects. If your health care provider prescribes the combination of these two medicines, you might need dose adjustments or certain special tests in order to use both medications safely. Speak to your doctor, if you have tremors, seizures, shallow breathing, speech problems, problems with walking or balance. Avoid driving till the time you know how the medication works for you. Also let your doctor know about any other medication you use including herbs and vitamins.

Hydromorphone- Lorazepam

Using Hydromorphone and lorazepam together can enhance the side effects such as drowsiness, dizziness, confusion and difficulty in concentrating. Some elderly people also experience impairment in judgment, thinking and motor coordination. Try to avoid consuming alcohol or limit the use of alcohol when you are on these medications. Do not engage yourself in activities that  need extra alertness such as driving.  In case you have any questions, speak to your doctor  and also let him know about all other medications you are using currently.

Taking two medications together does not necessarily or always mean that you should discontinue taking either of them. Speak to your  health care provider so that the drug interactions are managed well by him. Apart from drugs some other things that can interact with the drug are caffeine, nicotine (through cigarettes), street drugs or supplements that you use for various purposes. Let your physician know about these medications as they can also affect how Hydromorphone works for you. You need to follow doctor’s instructions in order to use the drugs safely.

Hydromorphone dosage information and treating overdose

Use Hydromorphone as prescribed by the doctor. Do not use in large doses or for a longer period than recommended by the doctor. This is important for old patients, who are often very sensitive to pain medication effects. Taking the medication in large amounts can lead to habit-forming or drug dependency.

Dosing Information

For extended-release tablets or capsules

Extended-release tablets or capsule forms of Hydromorphone are recommended for patients who are opioid tolerant only. If you are not sure whether you are tolerant to opioids or not, discuss with your doctor before you start using this medication.

There is a medication guide that comes with the medicine. Read the instructions carefully and follow them. In case you have any queries speak to your doctor.

Take the medicine the same time every day, with food or without food. Swallow the tablet as whole and do not chew, break or crush it. When using this tablet some portion of tablet can pass into stools, which is normal and you need to worry about that.

Do not shift from extended release to immediate release tablets unless your physician asks you to do so.

The dose of this medication will vary from person to person. Follow the instructions of your doctor and read the label carefully. The information given below includes average doses of Hydromorphone. If doctor has prescribed you a different dose, do not try to change the dose without doctor’s consultation.

Oral dosage – extended release form- capsules – for moderate- severe pain

For patients shifting from other narcotic drugs


The capsule is recommended once in a day. The first dose entirely depends on the amount of narcotic medication you are taking on a daily basis. Your doctor will suggest you the right dose and can increase the dose if required. For patients who shift from fentanyl transdermal, this medication should be taken at least after 18 hours of fentanyl patch removal.


For right use and the right dose you should consult your doctor.

Oral dosage – extended release form- tablets – for moderate- severe pain

For patients shifting from regular forms of Hydromorphone


The tablet is recommended once in a day. The total quantity of mg (milligrams) each day is exactly same as quantity of Hydromorphone that is used per day.


For right use and the right dose you should consult your doctor.


For patients shifting from regular forms of Hydromorphone


The capsule is recommended once in a day. The first dose entirely depends on the amount of narcotic medication you are taking on a daily basis. Your doctor will suggest you the right dose and can increase the dose if required. For patients who shift from fentanyl transdermal, this medication should be taken at least after 18 hours of fentanyl patch removal.


For right use and the right dose you should consult your doctor.

Oral dosage- Liquid form

For pain


At first – 2.5-10ML or 1-1/2 – 2 teaspoonful after every 3-6 hours as required.


For right use and the right dose you should consult your doctor.

Hydromorphone overdose treatment

Overdose of Hydromorphone can be fatal and if you notice any unusual symptoms call poison centre for help.

How effective is Hydromorphone in treating pain?

Hydromorphone is an opioid medication used to treat mild to severe pain. It is also known as a narcotic. The generic name is Hydromorphone and brand name is Exalgo, Dilaudid-5 and Dilaudid.

This medication in its extended form is used as 24 hours treatment medicine to treat mild to severe pain.

Some important information

Hydromorphone can stop or slow your breathing.  do not use this  medication in excess amounts or for a longer period than prescribed. do not break, crush or open the pill available in extended release form. swallow the pill as whole to avoid life threatening complications. Hydromorphone can cause drug dependency even through regular doses. Do not share the medicine with others who have a history of drug addicition or drug abuse and store the medicine in a place where others cannot have access to the medicine.

Misuse of any narcotic drug can lead to overdose, death or addiction, especially in people who use the medication without doctor’s prescription or in children. If you are pregnant you should tell your doctor as Hydromorphone can lead to withdrawal symptoms in unborn baby, which can be fatal too.

Do not combine alcohol with Hydromorphone as it can even lead to death.

What should I ask my doctor before using Hydromorphone?

You should avoid taking this medicine if you are allergic to Hydromorphone or any other  narctotic medicine or if you have

  1. blockage in intestines or stomach
  2. severe breathing problems or asthma
  3. paralytic ileus or bowel problems

Avoid using Hydromorphone if you had used MAO inhibitor in last 14 days. There are chances of harmful drug interactions. Some medicines interact with Hydromorphone and lead to a serious medical condition known as serotonin syndrome. Make sure you inform your doctor if you are taking medicines for migraine, depression, Parkinson’s disease, infections, medicines for preventing vomiting or nausea, headaches or mental illness. Ask your doctor before making changes in dose and frequency of medciations you are taking.

Your doctor may not advice you to use Hydromorphone if you are not tolerant to the medication or never being treated with any other narcotic medicine for pain. Speak to your doctor if you are not tolerant to opioid medication.

To ensure that Hydromorphone is safe for you tell your physician if you have

  • lung disease or breathing problem
  • seizures, brain tumor, head injury in the past.
  • history of mental illness, addiction or drug abuse
  • kidney or liver disease
  • sulfite allergy
  • urination problems
  • disorders related to adrenal gland or Addison’s disease
  • problem with pancreas, gallbladder or thyroid

Is Hydromorphone addictive?

Hydromorphone is a common drug associated with drug abuse. Since it acts quite fast to treat pain, many people get addicited to the medicine easily. Many people who face addicition problem often visit rehabs meant for treating opiates addicition. This helps them get rid of the urge to use the medicine and eliminate addiction completely.

Taking the medicine in excess to get desired effect can cause drug addiction. Avoid taking medication in large amounts.

Effects of Hydromorphone on pregnancy and breastfeeding

Pregnancy and breastfeeding is a completely different phase wherein a woman not only takes good care of her, but also cares for her baby. During this phase, apart from healthy and nutritional diet, she should take care of medications that she is using and how the drugs going to affect her baby.

In this article we will discuss about the effects of hydromorphone on pregnancy and breastfeeding.

Hydromorphone and pregnancy

Hydromorphone intersect the placenta causing fetal exposure. If you are pregnant and using Hydromorphone, you should tell your doctor to know how this drug is going to affect your pregnancy. Hydromorphone should be used during pregnancy only if the possible benefits are higher than the risks. If you are using Hydromorphone regularly during your pregnancy, there are chances that your baby may experience harmful withdrawal symptoms post birth.

The expecting mothers who take Hydromorphone regularly before their delivery can become dependent on the drug and the withdrawal signs may include

  • Tremors
  • Hyperactive reflexes
  • Excessive crying
  • Sneezing
  • Yawning
  • Fever
  • Vomiting
  • Irritability
  • Increased stools

There are still no best methods discovered to manage withdrawal. To support treatment supportive care is given along with certain medications.

Hydromorphone and breastfeeding

Low levels of Hydromorphone are found in breast milk, which can lead to respiratory problems in new born babies. Hydromorphone should not be taken while breastfeeding as it is secreted in breast milk and can harm the baby. There is limited data available indicating that low doses of Hydromorphone are secreted in breast milk. Mothers using narcotic drugs during breastfeeding often results in infant death, drowsiness and depression of central nervous system. New born are sensitive to even low doses of narcotic drugs.

While breastfeeding it is better to manage pain using non narcotic medications and restrict the use of Hydromorphone for a couple of days to low doses and monitor the health of your baby closely.

If your baby shows some unusual signs like increased sleepiness, breathing problems, difficulty in breastfeeding or limpness, immediately contact your physician.

Sometimes nursing mothers have to undergo surgery after birth of their baby and they need narcotic analgesics during their surgery. They can arrange for nursing their new born prior to their surgery so that they can take some time to recover. They can consult their lactating consultant to help them suggest supplementary feedings or helping her arrange for a breast pump for temporary use. She can also opt to freeze supply of breast milk before undergoing a surgery.

Once the nursing mother recovers from surgery she can take care of her baby and be alert. She can also consult her doctor to prescribe her low doses of pain medications.

It is always better to be safe and not use narcotic medications during breastfeeding or pregnancy. You can also look for other alternative non narcotic drugs to treat pain. If you want to use narcotic drugs safely, consult your doctor for the right dosage. It will help you avoid complications that can be harmful for you and your baby.

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