Sometimes the pain we experience is so severe that ordinary painkillers cannot control it, right? After an accident, after a major surgery, or due to a medical condition like cancer, ordinary painkillers may not be enough. This is when your doctor may prescribe you a powerful painkiller like Hydromorphone. This is a special medicine that belongs to the class of drugs called Opioids. So, today we will talk about this medicine, its effectiveness, side effects, and how to use it safely.
What is this medicine called Hydromorphone?
Simply put, Hydromorphone is a powerful medication used to control severe pain . It is usually prescribed by a doctor when other painkillers have not helped, or when you cannot tolerate them.
It works by blocking pain signals to your brain. That is, it stops the message from traveling from the source of the pain to your brain. This greatly reduces the amount of pain you feel. It belongs to a class of drugs called opioids . In Sri Lanka, it may be available under other brand names.
Things you need to tell your doctor before taking this medicine
Because hydromorphone is a very strong drug, it is important for your doctor to know the full details of your medical condition. If you have any of the conditions listed below, be sure to tell your doctor.
| Your health condition or habit | Why is that important? |
|---|---|
| Brain tumor or head injury | In such situations, the side effects of the medication may increase. |
| Frequent drinking | When this medicine is combined with alcohol, dangerous conditions such as respiratory arrest can occur. |
| Lung, asthma, or breathing difficulties | Because hydromorphone slows breathing, it can be dangerous for people who already have respiratory problems. |
| Liver or kidney disease | Because the body's elimination process is poor, the drug can accumulate in the body and increase side effects. |
| Seizures | This medication has the potential to increase the risk of epileptic seizures. |
| A history of substance abuse | This is also a medication that carries a risk of addiction, so it is important to inform the doctor about it. |
| Taking MAOI medication within the past 14 days | MAOIs (e.g. Marplan, Nardil) are a type of medication used to treat mental illness. Taking Hydromorphone with these can cause serious reactions. |
| Being pregnant, trying to get pregnant, or breastfeeding | The medicine can affect the baby in the womb or through breast milk. |
How exactly do you use this medicine?
It is very important to follow your doctor's instructions exactly when using this medicine.
- Swallow the pill with a glass of water.
- If you experience stomach upset, take it with or after a meal.
- Take only the dose prescribed by your doctor, at the time prescribed. Never take more than the prescribed dose.
- Do not stop taking the medication suddenly without your doctor's advice.
Attention: If you think you have taken too much of this medicine, immediately contact the National Poisons Information Centre at the Colombo National Hospital or go to the Emergency Department (ETU) of the nearest hospital without delay. This is a life-threatening situation and should not be taken lightly.
And remember, this medicine is for you only. Never share it with anyone else.
What do I do if I miss a medication appointment?
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next dose at the scheduled time. Do not take a double dose to make up for a missed dose.
Other things that may interact with this medicine
Hydromorphone is a drug that can interact with other medications and alcohol, so be aware of the following:
- Alcohol
- Medicines for colds, coughs, and allergies (Antihistamines)
- Medication for anxiety or sleep
- Some medications for depression (e.g. Amitriptyline, Fluoxetine)
- Some medications for epilepsy (e.g. Phenobarbital)
- General anesthetics
- Medicines given to relax muscles during surgery
- Other opioid medications for pain or cough
This list is not complete, so it is very important to tell your doctor about all the medications you are taking, including traditional medicines and vitamins.
What should I pay attention to when taking the medicine?
It is essential to pay close attention to your body while taking this medication.
Pain and tolerance
If the dose of medicine you are given does not reduce your pain, or if the pain becomes worse, tell your doctor. When you take this medicine for a long time, your body can get used to it. This is called tolerance . Then the dose you took before may not be enough to control the pain. This is normal.
The important thing is that your body becomes accustomed to a medication, not because you are 'addicted' to it. Addiction is the use of a medication for a purpose other than a medical reason. If you are in pain, taking medication for that is a medical necessity.
Dizziness, drowsiness, and constipation
This medicine may make you feel drowsy or dizzy . Therefore, do not drive or operate machinery until you know how this medicine affects you. Be careful when doing these activities, especially if you are elderly, as you may feel dizzy or faint when standing up or sitting down too quickly.
Constipation is very common with this medication. If you are unable to have a bowel movement for 3 days, talk to your doctor. You may also experience dry mouth. Chewing sugar-free gum and drinking plenty of water can help.
What side effects might I experience?
Like any medication, Hydromorphone can cause side effects. Let's break them down into two categories.
| Side effects that require immediate medical attention | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Central nervous system depression (CNS depression) | Slow or shallow breathing, difficulty breathing, severe drowsiness, confusion. |
| Decreased adrenal function | Nausea, vomiting, loss of appetite, unusual tiredness, dizziness. |
| Low blood pressure | Dizziness, blue eyes, feeling faint. |
| Common side effects that should be reported to the doctor if they persist | |
| Constipation | Dry mouth |
| Dizziness | Headache |
| Drowsiness | Nausea and vomiting (Nausea, Vomiting) |
How do I keep my medication safe?
This is a very important matter.
- Keep it well closed and locked, out of the reach of children and pets.
- There is a potential for abuse of this medication, so protect it from theft.
- Selling this medicine or giving it to someone else is dangerous and illegal.
- Store at room temperature (15-30°C) away from light.
- Dispose of unused or expired medicine properly. If possible, flush it down the toilet.
Take-Home Message
- Hydromorphone is a powerful medication that is only prescribed by a doctor for severe pain.
- Before taking the medicine, tell your doctor about all your medical conditions and all other medications you are taking.
- Never share this medicine with others. It is for you only.
- Seek immediate medical attention if you experience a serious side effect, such as difficulty breathing.
- Avoid drinking alcohol and driving while taking this medicine.
- Always keep the medicine in a safe place out of the reach of children and pets.
- Do not stop taking the medicine suddenly without your doctor's advice.
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