Hydromorphone
General
- Type: Opioids
- Dosage Forms: PO, SC, IM, IV, PR, PCA
- Common Trade Names: Dilaudid, Exalgo
Adult Dosing
Severe Pain
- Oral: 2-4mg PO q4-6h PRN
- IV: 0.2-1mg IV q2-3h PRN
- IM: 1-2mg IM q2-3h PRN (not recommended secondary to variable absorption)
Pediatric Dosing
Severe Pain
- > 6 months, > 50 kg: 0.5 - 2mg PO/SC/IM/IV q3-6h.
- Alternatively: 15-20 mcg/kg q3-6h.
Special Populations
- Pregnancy Rating: C
- Lactation Risk Categories: probably safe
- Renal Dosing
- Adult: mod-severe impairment: decrease start dose, amount not defined
- Pediatric: mod-severe impairment: decrease start dose, amount not defined
- Hepatic Dosing
- Adult: Child-pugh class B: decrease start dose 50-75%
- Pediatric: Child-pugh class B:decrease start dose 50-75%
Contraindications
- Allergy to class/drug
- Respiratory depression
- CNS depression
- MAO inhibitor use in prior 2 weeks
- GI obstruction or ileus
Adverse Reactions
Serious
- Respiratory Depression
- Apnea
- Hypotension
- Syncope
- Bradycardia
- Urinary retention
- Seizures
- Anaphylaxis
Common
- Nausea
- Rash
- Headache
- Fatigue
- xerostomia
- constipation
- Tremor
- urinary retention
Pharmacology
- Half-life: 2.3 hour
- Metabolism: Liver
- Excretion: urine
- Mechanism of Action:binds to various opioid receptors