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Dilaudid

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Dilaudid

Overdosage
Contraindications

OVERDOSE

Serious overdosage with DILAUDID (hydromorphone hydrochloride) ORAL LIQUID and DILAUDID (hydromorphone hydrochloride) 8 mg TABLETS is characterized by respiratory depression, somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, constricted pupils, and sometimes bradycardia and hypotension. In serious overdosage, particularly following intravenous injection, apnea, circulatory collapse, cardiac arrest and death may occur.

In the treatment of overdosage, primary attention should be given to the reestablishment of adequate respiratory exchange through provision of a patent airway and institution of assisted or controlled ventilation. A potentially serious oral ingestion, if recent, should be managed with gut decontamination. In unconscious patients with a secure airway, instill activated charcoal (30-100 g in adults, 1-2 g/kg in infants) via a nasogastric tube. A saline cathartic or sorbitol may be added to the first dose of activated charcoal.

Supportive measures (including oxygen, vasopressors) should be employed in the management of circulatory shock and pulmonary edema accompanying overdose as indicated. Cardiac arrest or arrhythmias may require cardiac massage or defibrillation.

The opioid antagonist, naloxone, is a specific antidote against respiratory depression which may result from overdosage, or unusual sensitivity to DILAUDID (hydromorphone hydrochloride) ORAL LIQUID and DILAUDID (hydromorphone hydrochloride) 8 mg TABLETS. Therefore, an appropriate dose of this antagonist should be administered, preferably by the intravenous route, simultaneously with efforts at respiratory resuscitation. Naloxone should not be administered in the absence of clinically significant respiratory or circulatory depression. Naloxone should be administered cautiously to persons who are known, or suspected to be physically dependent on DILAUDID (hydromorphone hydrochloride) ORAL LIQUID and DILAUDID (hydromorphone hydrochloride) 8 mg TABLETS . In such cases, an abrupt or complete reversal of narcotic effects may precipitate an acute withdrawal syndrome. Since the duration of action of DILAUDID (hydromorphone hydrochloride) ORAL LIQUID and DILAUDID (hydromorphone hydrochloride) 8 mg TABLETS may exceed that of the antagonist, the patient should be kept under continued surveillance; repeated doses of the antagonist may be required to maintain adequate respiration. Apply other supportive measures when indicated.

CONTRAINDICATIONS

DILAUDID (hydromorphone hydrochloride) ORAL LIQUID and DILAUDID (hydromorphone hydrochloride) 8 mg TABLETS are contraindicated in: patients with known hypersensitivity to hydromorphone, patients with respiratory depression in the absence of resuscitative equipment, and in patients with status asthmaticus. DILAUDID (hydromorphone hydrochloride) ORAL LIQUID and DILAUDID (hydromorphone hydrochloride) 8 mg TABLETS are also contraindicated for use in obstetrical analgesia.

Last reviewed on RxList: 8/12/2011
This monograph has been modified to include the generic and brand name in many instances.

Overdosage
Contraindications
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