{"id":4516,"date":"2025-03-31T18:12:11","date_gmt":"2025-03-31T18:12:11","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/hydromorphone-hydrochloride-txt\/"},"modified":"2025-03-31T18:12:11","modified_gmt":"2025-03-31T18:12:11","slug":"hydromorphone-hydrochloride-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/hydromorphone-hydrochloride-txt\/","title":{"rendered":"hydromorphone hydrochloride.txt"},"content":{"rendered":"

hydromorphone hydrochloride <\/h1>\n

CLINICAL USE <\/H3>
\nRelief of severe cancer pain

DOSE IN NORMAL RENAL FUNCTION <\/H3>1.3 mg 4 hourly, increasing dose as requiredSR: 4 mg 12 hourly, increasing dose as required

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :321.8<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :7.1<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 6<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :24.4 litres<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :2.5\/\u2013

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Reduce dose \u2013 start with lowest dose and titrate according to response
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Reduce dose \u2013 start with lowest dose and titrate according to response

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR <10 mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unknown dialysability. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR 10 to 20 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Alcohol: can cause dose dumping with sustained release preparations\n
  • Antidepressants: possible CNS excitation or depression with MAOIs \u2013 avoid concomitant use and for 2 weeks after stopping MAOI; possible CNS excitation or depression with moclobemide; increased sedative effects with tricyclics\n
  • Antivirals: concentration possibly increased by ritonavirSodium oxybate: enhanced effect of sodium oxybate \u2013 avoid concomitant use

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>Oral

    Rate of Administration <\/H4>\u2013

    Comments<\/H4>\u2013

    OTHER INFORMATION <\/H4>1.3 mg of hydromorphone is equivalent to 10 mg oral morphineMetabolised to mainly hydromorphone- 3-glucuronide and some hydromorphone-6-glucuronide, which also have opioid activity, and which accumulate in renal failure. May cause neuroexcitation and cognitive impairment
    \n","protected":false},"excerpt":{"rendered":"

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