Hydromorphone overdose

Definition

Hydromorphone is a prescription medicine used to relieve severe pain. Hydromorphone overdose occurs when someone takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.

This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with has an overdose, call the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

Hydromorphone is a type of morphine. Hydromorphone is an opioid narcotic, which means it is an extremely powerful drug that can cause very deep sleep.

People who take hydromorphone for pain should not drink alcohol. Combining alcohol with this drug increases the chance for dangerous side effects and overdose symptoms.

Where Found

Medicines with these names contain hydromorphone:

• Dilaudid
• Hydrostat
• Exalgo

Other medicines may also contain hydromorphone.

Symptoms

Symptoms of a hydromorphone overdose include:

• Bluish-colored fingernails and lips
• Breathing problems, including slow and labored breathing, shallow breathing, or no breathing
• Cold, clammy skin
• Low body temperature
• Coma
• Confusion
• Constipation
• Dizziness
• Drowsiness
• Fatigue
• Flushing of the skin
• Itching
• Lightheadedness
• Loss of consciousness
• Low blood pressure
• Muscle twitches
• Nausea and vomiting
• Pinpoint pupils
• Spasms of the stomach and intestines
• Weakness
• Weak pulse

Warning: A severe overdose of hydromorphone can cause death.

Home Care

This can be a serious overdose. Seek medical help right away.

Before Calling Emergency

Have this information ready:

• Person's age, weight, and condition
• Name of the product (ingredients and strengths, if known)
• Time it was swallowed
• Amount swallowed
• If the medicine was prescribed for the person

DO NOT delay calling for help if you don't have this information.

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

Take the container to the hospital with you, if possible.

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may be done include:

• Blood and urine tests
• Chest x-ray
• CT scan (computerized tomography or advanced imaging)
• ECG (electrocardiogram, or heart tracing)

Treatment may include:

• Fluids through a vein (by IV)
• Medicine to reverse the effect of the hydromorphone and treat symptoms
• Activated charcoal
• Laxative
• Breathing support, including a tube through the mouth into the lungs and connected to a breathing machine (ventilator)

Outlook (Prognosis)

People who quickly receive medicine (called an antidote) to reverse the effect of hydromorphone can recover within 1 to 4 hours. They may need to stay in the hospital for more doses of the antidote.

Complications such as pneumonia, muscle damage from lying on a hard surface for a long period of time, or brain damage from lack of oxygen may result in permanent disability. However, unless there are complications, long-term effects and death are rare.

References

Aronson JK. Opioid receptor agonists. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:348-380.

Nikolaides JK, Thompson TM. Opioids. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 156.