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DILAUDID Oral Solution and DILAUDID Tablets are indicated for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.DILAUDID (hydromorphone hydrochloride), a hydrogenated ketone of morphine, is an opioid analgesic. DILAUDIDHP contains 10 mg of hydromorphone hydrochloride per mL, a smaller injection volume can be used than with other parenteral opioid formulations. Discomfort associated with the intramuscular or subcutaneous injection of an unusually large volume of solution can, therefore, be avoided.

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Dosage and Administration

Adult: IV/IM: 0.5 mg, slow IV push over 2-3 minutes, Q 10 minutes PRN for painto a maximum of 2 mg (Limit dosage to 2 mg in severe pain)
DILAUDID INJECTION is indicated for the management of pain in patients where an opioid analgesic is appropriate.DILAUDID-HP is indicated for the relief of moderate-to-severe pain in opioid-tolerant patients who require larger than usual doses of opioids to provide adequate pain relief.Because DILAUDID-HP contains 10 mg of hydromorphone hydrochloride per mL, a smaller injection volume can be used than with other parenteral opioid formulations. Discomfort associated with the intramuscular or subcutaneous injection of an    unusually large volume of solution can therefore be avoided.

CONTRAINDICATIONS

Hypovolemia
Patients with status asthmaticus
Hypotension
Hypersensitivity
Head injury with altered mental
DILAUDID INJECTION and DILAUDID-HP are contraindicated in patients with known hypersensitivity to hydromorphone.
DILAUDID INJECTION and DILAUDID-HP are contraindicated in patients with respiratory depression in the absence of resuscitative equipment and in patients with status asthmaticus.
DILAUDID INJECTION and DILAUDID-HP are also contraindicated for use in obstetrical analgesia.
DILAUDID-HP is contraindicated in patients who are not already receiving large amounts of opioid

Side Effects

Dizziness
Drowsiness
Altered LOC
Hallucinations
Euphoria
Mental Impairment
Lightheadedness
Bradycardia
Tachycardia
Hypotension
N/V
CNS Depression
Respiratory
Depression
Transient
Hyperglycemia

Warnings

Risk of Accidental Overdose and Death due to Medication Errors
Dosing errors can result in accidental overdose and death. Ensure that the dose is communicated clearly and dispensed accurately. A household teaspoon or tablespoon is not an adequate measuring device. Given the inexactitude of the household spoon measure and the possibility of using a tablespoon instead of a teaspoon, which could lead to overdosage, the enclosed measuring device should be used or a calibrated measuring device obtained from the pharmacist.Health care providers should recommend a calibrated device that can measure and deliver the prescribed dose accurately, and instruct caregivers to use extreme caution in measuring the
dosage.
DILAUDID-HP (high potency, 10 mg/mL ampules and vials) is a more concentrated solution of hydromorphone than DILAUDID INJECTION, and is intended for use only in opioid-tolerant patients. Do not confuse DILAUDID-HP with standard parenteral formulations of DILAUDID or other opioids, as overdose and death could result.
Respiratory Depression: Respiratory depression is the chief hazard of DILAUDID-HP. Respiratory depression occurs most frequently in overdose situations, in the elderly, in the debilitated, and in those suffering from conditions accompanied by hypoxia or hypercapnia when even moderate therapeutic doses may dangerously decrease pulmonary ventilation.
Life-Threatening Respiratory Depression
Serious, life-threatening, or fatal respiratory depression has been reported with the use of opioids, even when used as recommended. Respiratory depression, if not immediately
recognized and treated, may lead to respiratory arrest and death. Management of respiratory depression may include close observation, supportive measures, and use of opioid antagonists, WIKI