HYDROMORPHONE (DILAUDID ®) | ||||||||||||||||
The authors make no claims of the accuracy of the information contained herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. | ||||||||||||||||
Usual Diluents | ||||||||||||||||
D5W, NS | ||||||||||||||||
Standard Dilutions [Amount of drug] [Infusion volume] [Infusion rate] | ||||||||||||||||
[ 20 mg ] [100 ml ] [ Titrate ] [ 50 mg ] [100 ml ] [ Titrate ] [0 - 100 mg] [100 ml] [Titrate]EXP: 24 hours RT/REF. Usual rate: 0.2 to 2 mg/hr. | ||||||||||||||||
Stability / Miscellaneous | ||||||||||||||||
WARNINGS Drug Dependence Infants born to mothers physically dependent on Hydromorphone Hydrochloride Injection will also be physically dependent and may exhibit respiratory difficulties and withdrawal symptoms. Impaired Respiration Head Injury and Increased Intracranial Pressure Hypotensive Effect Hydromorphone Hydrochloride Injection should be administered with caution to patients in circulatory shock, since vasodilation produced by the drug may further reduce cardiac output and blood pressure. Pharmaco*kinetics Following intravenous administration of Hydromorphone Hydrochloride Injection to normal volunteers, the mean half-life of elimination was 2.64 ± 0.88 hours. The mean volume of distribution was 91.5 liters, suggesting extensive tissue uptake. Hydromorphone Hydrochloride Injection is rapidly removed from the blood stream and distributed to skeletal muscle, kidneys, liver, intestinal tract, lungs, spleen and brain. Hydromorphone Hydrochloride Injection also crosses the placental membranes. In terms of area under the analgesic time-effect curve, hydromorphone is approximately 8 times more potent than morphine (i.e., 1.3 mg of hydromorphone produces analgesia equal to that produced by 10 mg of morphine). After intramuscular administration, hydromorphone has a slightly more rapid onset and slightly shorter duration of action than morphine. The duration of Hydromorphone Hydrochloride Injection analgesia in the non-tolerant patient with usual doses may be up to 4 to 5 hours. However, in tolerant subjects, duration will vary substantially depending on tolerance and dose. Dose should be adjusted so that 3 to 4 hours of pain relief may be achieved. Source: [package insert] Dosing: Mechanically-ventilated pts: 0.7 - 2 mg q1-2h prn or start infusion: 0.5 - 1 mg/hr. PCA: Usual concentration: 0.2 mg/ml. Demand dose (usual): 0.1 - 0.2 mg (range: 0.05 - 0.5mg). Lockout: 5-15 min. 4 hour limit: 4-6 mg. Epidural: Bolus: 0.4-1.5 mg. Infusion conc: 0.05 - 0.075 mg/ml. Infusion rate: 0.04 - 0.4 mg/hr. Demand dose: 0.15mg. Lockout: 30 minutes. Alternatively (per Lexi-drugs 2012): Bolus: 0.4 -1 mg. Infusion rate: 0.03 - 0.3 mg/hour. Demand dose: 0.02 - 0.05mg. Lockout: 10-15 minutes. IM/SC: (opiate naive) Start: 0.8 - 1 mg q4-6h prn. Usual range: 1-2 mg q3-6h prn. |
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