Proper Use

Drug information provided by: Micromedex

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. This is especially important for elderly patients, who may be more sensitive to the effects of pain medicines. If too much of this medicine is taken for a long time, it may become habit-forming (causing mental or physical dependence).

Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.

If you are using the extended-release capsules or tablets:

  • Hydromorphone extended-release capsules or tablets are for use in opioid-tolerant patients only. If you are uncertain whether or not you are opioid-tolerant, check with your doctor before using this medicine.
  • This medicine comes with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.
  • Take this medicine at the same time each day, with or without food.
  • Swallow the tablet whole. Do not crush, break, or chew it.
  • While taking this medicine, part of the tablet may pass into your stools. This is normal and is nothing to worry about.

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.

Be careful not to handle crushed or broken tablets. If you have contact with broken or crushed tablets or spilled oral liquid, wash your skin or the affected areas with soap and water right away.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (extended-release capsules):
    • For moderate to severe pain:
      • For patients switching from other narcotic medicines:
        • Adults—The capsule is given once a day. Your first dose will depend on the amount of other narcotics you have been taking every day. Your doctor will determine your dose and may increase the dose as needed. For patients switching from fentanyl transdermal, this medicine should be started at least 18 hours after the removal of the fentanyl patch.
        • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (extended-release tablets):
    • For moderate to severe pain:
      • For patients switching from regular hydromorphone forms:
        • Adults—The tablet is given once a day. The total amount of milligrams (mg) per day is the same as the total amount of regular hydromorphone that is taken per day.
        • Children—Use and dose must be determined by your doctor.
      • For patients switching from other narcotic medicines:
        • Adults—The tablet is given once a day. Your first dose will depend on the amount of other narcotics you have been taking every day. Your doctor will determine your dose and may increase the dose as needed. For patients switching from fentanyl transdermal, this medicine should be started at least 18 hours after the removal of the fentanyl patch.
        • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (liquid):
    • For pain:
      • Adults—At first, 2.5 to 10 milliliters (mL) or one-half to two teaspoonfuls every 3 to 6 hours as needed. Your doctor may increase your dose as needed.
      • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (tablets):
    • For pain:
      • Adults—At first, 2 to 4 milligrams (mg) every 4 to 6 hours. Your doctor may increase your dose as needed.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Hydromorphone can cause serious unwanted effects or fatal overdose if taken by children, pets, or adults 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.

Flush the unused medicine down the toilet or take it to a community take-back program when available.