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Hydromorphone 20 mg/mL Intravenous Infusion

Hydromorphone 20 mg/mL Intravenous Infusion is a compounded medication delivered through a sterile intravenous bag, ensuring precise and controlled administration directly into the patient's bloodstream.

This formulation is specifically designed for end-of-life hospice care, providing effective management of severe pain and discomfort associated with terminal illnesses.

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Formula Information

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Hydromorphone 20 mg/mL Intravenous Infusion is a potent opioid analgesic formulation specifically designed for use in end-of-life hospice care. This formulation is delivered via an intravenous bag, a sterile container that ensures the safe and effective administration of the medication directly into the patient's bloodstream. The intravenous route allows for rapid onset of action, providing immediate relief from severe pain, which is crucial in managing the complex symptoms associated with terminal illnesses.

In hospice care, the primary goal is to enhance the quality of life for patients who are in the final stages of their illness. Hydromorphone, a semi-synthetic derivative of morphine, is known for its strong analgesic properties, making it an ideal choice for managing severe pain that is unresponsive to other treatments. By using a 20 mg/mL concentration, this formulation offers a high degree of precision in dosing, allowing healthcare providers to tailor the treatment to the individual needs of each patient, ensuring optimal pain control while minimizing potential side effects.

The use of an intravenous infusion allows for continuous and controlled delivery of hydromorphone, maintaining consistent plasma levels and providing sustained pain relief. This method of administration is particularly beneficial for patients who may have difficulty swallowing or absorbing oral medications due to their condition. Additionally, the intravenous route bypasses the gastrointestinal tract, reducing the risk of nausea and vomiting, which are common side effects of opioid therapy.

For prescribers, it is essential to consider the patient's overall health status, including liver and kidney function, as these can affect the metabolism and excretion of hydromorphone. Careful monitoring and dose adjustments may be necessary to ensure safety and efficacy. It is also important to assess the patient's opioid tolerance and history of opioid use to determine the appropriate starting dose and titration schedule.

Patients and their families should be informed about the potential side effects of hydromorphone, which may include drowsiness, dizziness, constipation, and respiratory depression. It is crucial to have open communication with the healthcare team to address any concerns and to adjust the treatment plan as needed to ensure comfort and dignity during end-of-life care.

If you have any questions or require further information about this formulation, please do not hesitate to reach out to us. Our team of compounding pharmacists at Bayview Pharmacy is here to support you and provide the necessary guidance to ensure the best possible outcomes for patients in hospice care.

Drug Interactions

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Hydromorphone 20 mg/mL intravenous infusion is a potent opioid analgesic used primarily in end-of-life hospice care to manage severe pain. As with any opioid medication, it is crucial to be aware of potential drug interactions that may affect the efficacy and safety of the treatment. Understanding these interactions is essential for both patients and prescribers to ensure optimal care and minimize adverse effects.

Concomitant use of hydromorphone with other central nervous system (CNS) depressants, such as benzodiazepines, barbiturates, or other opioids, can result in additive CNS depression. This may lead to profound sedation, respiratory depression, coma, or even death. It is vital to monitor patients closely and adjust dosages accordingly when these medications are used together.

Hydromorphone is metabolized primarily by the liver enzyme CYP3A4. Therefore, drugs that inhibit or induce this enzyme can alter hydromorphone plasma concentrations. CYP3A4 inhibitors, such as ketoconazole, erythromycin, or ritonavir, may increase hydromorphone levels, potentially leading to enhanced effects and increased risk of toxicity. Conversely, CYP3A4 inducers like rifampin, carbamazepine, or phenytoin may decrease hydromorphone levels, reducing its efficacy. Dose adjustments may be necessary when these drugs are co-administered.

Patients taking monoamine oxidase inhibitors (MAOIs) or those who have recently discontinued them should avoid using hydromorphone, as this combination can lead to severe and unpredictable reactions, including serotonin syndrome, characterized by symptoms such as agitation, hallucinations, rapid heart rate, and increased body temperature.

Additionally, the use of hydromorphone with serotonergic drugs, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants, may increase the risk of serotonin syndrome. Patients should be monitored for symptoms of serotonin syndrome, and any signs should be addressed immediately.

Alcohol consumption should be avoided while receiving hydromorphone treatment, as it can exacerbate the sedative effects and increase the risk of respiratory depression. Patients should be advised to avoid alcohol and any medications containing alcohol during treatment.

For patients with renal or hepatic impairment, the clearance of hydromorphone may be reduced, leading to increased plasma concentrations and prolonged effects. Careful monitoring and potential dose adjustments are recommended in these populations to prevent adverse effects.

It is essential for prescribers to review a patient's complete medication profile, including over-the-counter drugs and supplements, to identify potential interactions before initiating hydromorphone therapy. Patients should be encouraged to communicate any new medications or changes in their regimen to their healthcare provider promptly.

If you have any questions or require further information regarding hydromorphone 20 mg/mL intravenous infusion and its potential drug interactions, please reach out to us at Bayview Pharmacy. Our team of knowledgeable compounding pharmacists is here to assist you in providing safe and effective care for your patients.

How Does it Work

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Hydromorphone 20 mg/mL Intravenous Infusion is a potent opioid analgesic specifically formulated for administration via an intravenous bag, which is a sterile container designed to deliver medications directly into the bloodstream. This method of delivery ensures that the medication is rapidly absorbed and distributed throughout the body, providing immediate and effective pain relief. The intravenous route is particularly beneficial in end-of-life hospice care, where managing severe pain and ensuring patient comfort are of utmost importance.

Hydromorphone works by binding to the mu-opioid receptors in the central nervous system, which are part of the body's natural pain control system. By activating these receptors, hydromorphone alters the perception of pain and emotional response to pain, leading to significant analgesic effects. This mechanism of action makes it highly effective in managing severe pain that is often experienced by patients in hospice care, where other pain management strategies may not be sufficient.

The formulation of hydromorphone at a concentration of 20 mg/mL allows for precise dosing adjustments tailored to the individual needs of each patient. This is crucial in hospice care, where patients may have varying levels of pain and different responses to opioid medications. The ability to customize the dosage ensures that patients receive the optimal amount of medication needed to achieve comfort without unnecessary side effects.

In addition to its analgesic properties, hydromorphone can also help alleviate other symptoms commonly experienced by hospice patients, such as shortness of breath and anxiety, further enhancing the quality of life during end-of-life care. The controlled administration through an intravenous bag allows healthcare providers to closely monitor and adjust the treatment as needed, ensuring that the patient's comfort is maintained at all times.

For prescribers, it is important to consider the patient's overall condition, previous opioid use, and potential for opioid tolerance when determining the appropriate dosage of hydromorphone. Close monitoring for signs of respiratory depression, sedation, and other opioid-related side effects is essential to ensure safe and effective use of this medication.

If you have any questions or need further information about Hydromorphone 20 mg/mL Intravenous Infusion for hospice care, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to assist you with any inquiries or concerns you may have.

Other Uses

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Hydromorphone 20 mg/mL intravenous infusion is primarily known for its vital role in end-of-life hospice care where it provides significant relief from severe pain, ensuring a more comfortable and dignified transition for patients. However, this formulation's potential utility extends beyond this primary indication, demonstrating efficacy in a variety of settings where robust pain management is critically required. It is often deployed in the management of acute pain resulting from major surgical procedures, particularly in cases where oral administration is not feasible due to patient condition or the required immediacy of analgesic effect. The intravenous route allows for rapid onset and precision in dosing, crucial in sensitive clinical scenarios.

In intensive care units, hydromorphone IV infusion can be invaluable for patients requiring prolonged sedation and analgesia due to serious traumatic injuries or extensive surgeries. This formulation offers a controlled and sustained approach to pain management, reducing the risk of oversedation and allowing better manipulation of the drug delivery according to the dynamic needs of critically ill patients. Additionally, it can be used effectively in palliative care settings for non-hospice patients experiencing chronic pain refractory to other treatments, providing a potent option for those suffering from conditions such as advanced cancer or severe neuropathic pain.

Hydromorphone, by virtue of its potency and efficacy, might also be considered in the context of managing severe non-cancer pain, such as in patients with complex regional pain syndrome or when high doses of other opioids have failed to provide relief. It is important, however, that such uses are carefully considered and monitored by healthcare professionals due to the high risk of dependency and adverse effects associated with opioid therapies. For patients and prescribers considering the use of Hydromorphone 20 mg/mL intravenous infusion, close consultation with pain management specialists and compounding pharmacists, like those at Bayview Pharmacy, is essential to ensure safety and optimal outcomes. Should you have any questions, or wish to explore if this formulation could be suitable for your specific patient case, please reach out to us for comprehensive support and guidance.

Frequently Asked Questions

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What is Hydromorphone 20 mg/mL Intravenous Infusion used for?

Hydromorphone 20 mg/mL Intravenous Infusion is primarily used for pain management in end-of-life hospice care. It helps provide relief for patients experiencing severe pain, ensuring comfort during their final stages of life.

How is the Hydromorphone IV infusion administered?

The Hydromorphone IV infusion is administered intravenously, meaning it is delivered directly into the patient's bloodstream through a catheter in a sterile intravenous bag, allowing for precise dosing.

What are the benefits of using an intravenous bag for this medication?

An intravenous bag is a sterile container that allows for the administration of customized compounded medications like Hydromorphone, providing precise and controlled treatment, which is crucial in managing severe pain effectively.

Is the dose of Hydromorphone adjustable?

Yes, the dose of Hydromorphone can be adjusted based on the patient's response to the treatment and the level of pain experienced, under the guidance of a healthcare professional.

Are there any side effects of Hydromorphone infusion?

Possible side effects of Hydromorphone infusion may include dizziness, nausea, constipation, light-headedness, and drowsiness. Serious side effects are rare but can occur, and medical attention should be sought if they do.

Can Hydromorphone infusion be used in patients with kidney or liver issues?

Hydromorphone should be used with caution in patients with kidney or liver issues. The healthcare provider will assess and modify the treatment plan as necessary to ensure patient safety.

What precautions should be taken during Hydromorphone infusion?

During Hydromorphone infusion, patients should be monitored closely for any adverse reactions or changes in their condition. It is important to follow the infusion protocol set by healthcare professionals strictly.

Can this infusion be administered at home?

Hydromorphone IV infusion is typically administered in a healthcare setting due to the need for professional monitoring and the potential risks involved. However, in some cases, and with proper support, it may be possible for it to be administered at home by trained caregivers.

How long does it take for the infusion to work?

The effects of Hydromorphone infusion can be felt within minutes due to its direct delivery into the bloodstream. Full analgesic effects will vary based on individual patient response and dosage.

Can other medications be taken alongside Hydromorphone IV infusion?

It is important to inform the healthcare provider of all medications being taken, as some may interact negatively with Hydromorphone. A healthcare professional will provide guidance on whether other medications can be safely combined with this treatment.

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Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.