Treats moderate to severe chronic pain. This medicine is a narcotic analgesic.
There may be other brand names for this medicine.
When This Medicine Should Not Be Used
Do not use this medicine if you have had an allergic reaction to hydromorphone or sulfites. Do not use this medicine if you have severe breathing or lung problems (such as severe asthma), paralytic ileus, or stomach or bowel blockage or narrowing.
How to Use This Medicine
Liquid, Tablet, Long Acting Tablet
- Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
- This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.
- Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
- Swallow the extended-release tablet whole. Do not crush, break, or chew it.
- Take the extended-release tablet at the same time each day.
- While taking the extended-release form of this medicine, part of the tablet may pass into your stools. This is normal and is nothing to worry about.
- Drink plenty of fluids to help avoid constipation.
- If the medicine comes in contact with your skin, rinse it with cool water right away.
- Exalgo® tablets works differently than hydromorphone tablets, even at the same dose (number of milligrams). Do not switch from the extended-release tablets to the immediate-release tablets unless your doctor tells you to.
If a dose is missed:
- If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
- If you are using the extended-release tablets, do not take another dose of this medicine within 24 hours.
How to Store and Dispose of This Medicine
- Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
- This medicine can cause serious side effects if used by adults or children who are not used to strong narcotic pain medicines. Make sure you store the medicine in a safe and secure place to prevent others from getting it. Keep the medicine away from pets.
- Do not throw any unused or expired medicine in the trash. Take it to a community take-back program or flush it down the toilet.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- There are many medicines that can interact with hydromorphone. Make sure your doctor knows about all other medicines you are using.
- Make sure your doctor knows if you use a buprenorphine (Buprenex®), butorphanol (Stadol®), nalbuphine (Nubain®), pentazocine (Talwin®), muscle relaxants (such as cyclobenzaprine, pancuronium, tubocurarine, Flexeril®, Pavulon®), or a phenothiazine medicine (such as promethazine, Phenergan®, Thorazine®). Tell your doctor if you use atropine, dicyclomine (Bentyl®), or glycopyrrolate (Robinul®).
- Tell your doctor if you are using or have used an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days.
- Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
- Do not drink alcohol while you are using this medicine.
Warnings While Using This Medicine
- Make sure your doctor knows if you are pregnant or breastfeeding or if you have kidney disease, liver disease, heart disease, heart rhythm problems, lung disease or breathing problems (such as chronic obstructive pulmonary disease [COPD], cor pulmonale, hypercapnia), low blood pressure, an underactive thyroid, Addison disease, pancreas problems, prostate problems, problems with urination, cystic fibrosis, or stomach or bowel problems. Tell your doctor if you have a history of head injury, brain tumor, seizures, depression, mental problems, or severe scoliosis. Tell your doctor if you have a history of alcohol or drug abuse.
- Do not use more of this medicine or take it more often than your doctor tells you to. This can be life-threatening. Symptoms of an overdose include extreme dizziness or weakness, slow heartbeat or breathing, seizures, trouble breathing, and cold, clammy skin. Call your doctor right away if you notice these symptoms.
- This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.
- Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
- This medicine may make you dizzy, drowsy, or lightheaded. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you feel lightheaded or dizzy.
- This medicine may cause constipation. This is more common if you use it for a long time. Ask your doctor if you should also use a laxative to prevent and treat constipation.
- If your symptoms do not improve or if they get worse, call your doctor.It may take a day or longer for the medicine to reach its full effect.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
- Blue lips, fingernails, or skin
- Change in how much or how often you urinate
- Confusion, trouble breathing, slow or shallow breathing, weakness, sweating, cold or clammy skin
- Fast, slow, or uneven heartbeat
- Lightheadedness, dizziness, fainting
If you notice these less serious side effects, talk with your doctor:
- Constipation, diarrhea, nausea, vomiting, loss of appetite, stomach pain
- Headache, trouble sleeping
- Sleepiness or unusual drowsiness