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Hydromorphone HCl 4 mg/ml Oral Liquid

FDA-approved generic
Dose form
Oral Liquid
Active ingredients
Hydromorphone Hydrochloride

Our Hydromorphone HCl 4 mg/ml Oral Liquid is a specially crafted medication designed for oral use, ensuring a precise and manageable mode of administration. This liquid formulation is particularly beneficial for patients who experience difficulty swallowing pills, such as those in pediatric and geriatric groups. By providing this medication in liquid form, we aim to facilitate ease of use and dosage accuracy, enhancing patient comfort and treatment efficacy.

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For prescribers
Prescription details
RxThis formula
Dose formSee below
Quantity____
SigAs directed by prescriber
Refills____
PharmacyBayview Pharmacy, Warwick RI, NCPDP 4106882
Copy prescription detailsOrder form
Controlled substance: e-prescribe (EPCS) from your EHR. Faxed and phoned prescriptions cannot be accepted for this preparation.
Send it from your EHR, or fax to (401) 284-4506. How to e-prescribe this formula
Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
To prescribe, you must be a verified prescriber.
To prescribe, you must be in a state where we hold an active out-of-state pharmacy license.
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This medication requires a prescription from your doctor
Ships within 1 to 2 business days after pharmacist verification
HSA and FSA eligible
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Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.

For prescribersSign in for prescription details and order forms.
Compounded preparations are prepared by Bayview pursuant to a prescription for an individual patient. They are not FDA-approved and have not been evaluated by FDA for safety or effectiveness.
Hydromorphone Hydrochloride
Oral Liquid
65adc7cf4b52cbfa1a4ac7c4
Service area

Can we ship this formula to your state?

Bayview fills prescriptions for patients in Connecticut, Florida, Maine, Massachusetts, New Hampshire, New Jersey, Pennsylvania and Rhode Island. New York patients are served on a limited basis while nonresident pharmacy registration is pending.

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Formula Information

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Hydromorphone HCl 4 mg/ml Oral Liquid is a potent opioid analgesic specifically formulated for oral administration. This liquid medication is designed to provide pain relief for patients who require consistent and controlled analgesia. The 4 mg/ml concentration allows for precise dosing tailored to the individual needs of the patient. This dosage form is particularly beneficial for patients who have difficulty swallowing pills, such as those with dysphagia, or for those who require an alternative to solid oral dosage forms, including pediatric and geriatric populations.

The medication works by binding to the mu-opioid receptors in the brain and spinal cord, altering the perception of and response to pain. It is commonly used in the management of moderate to severe pain that is not responsive to non-opioid analgesics. Hydromorphone is known for its rapid onset of action and effectiveness in pain control, making it a valuable option for patients suffering from conditions such as cancer pain, postoperative pain, and other acute or chronic pain syndromes.

It is crucial for prescribers to consider the potential for opioid addiction, abuse, and misuse, which can lead to overdose and death. Therefore, careful patient selection, proper dosing, and thorough monitoring are essential. Patients should be advised on the risk of respiratory depression, especially when initiating therapy or increasing the dose. Additionally, patients should be counseled on potential side effects, including constipation, nausea, dizziness, and sedation, and informed about the importance of adhering to prescribed dosages.

For prescribers and patients considering Hydromorphone HCl 4 mg/ml Oral Liquid, it is important to understand that this medication should only be used in cases where alternative treatment options are inadequate. The liquid formulation allows for flexible dosing, which can be adjusted according to the patient's pain level and response to treatment. As with all opioid medications, a comprehensive pain management plan should be developed, and the lowest effective dose should be used for the shortest duration necessary.

If you have any questions or require further information about Hydromorphone HCl 4 mg/ml Oral Liquid, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is dedicated to providing the highest level of care and support to ensure the safe and appropriate use of this medication.

Drug Interactions

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Hydromorphone HCl is an opioid analgesic used for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. As with all opioids, there are significant risks from the use of hydromorphone which can be potentiated by a variety of drug interactions. It is crucial for both patients and prescribers to be aware of these potential interactions to avoid adverse effects or reduced efficacy of treatment.

Central Nervous System (CNS) depressants, including other opioids, sedatives, hypnotics, general anesthetics, phenothiazines, tranquilizers, and alcohol, can enhance the depressant effects of hydromorphone. Concomitant use may result in profound sedation, respiratory depression, coma, and death. When such combined therapy is contemplated, the dose of one or both agents should be reduced. Patients should be closely monitored for signs of respiratory depression and sedation.

Anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which can lead to paralytic ileus. Patients should be monitored for symptoms of urinary retention or reduced gastric motility when hydromorphone is used concomitantly with anticholinergic drugs.

MAO inhibitors (MAOIs) can interact with hydromorphone to produce confusion, hyperactivity, and significant depression of respiration or coma. The use of hydromorphone should be avoided in patients receiving MAOIs or within 14 days of stopping such treatment.

Drugs that affect the serotonergic neurotransmitter system, such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs), can lead to serotonin syndrome. If concomitant use is warranted, careful observation of the patient is advised, particularly during treatment initiation and dose increases.

Mixed agonist/antagonist and partial agonist opioid analgesics may reduce the analgesic effect of hydromorphone or precipitate withdrawal symptoms. Avoid the use of mixed agonist/antagonist (e.g., butorphanol, nalbuphine, pentazocine) and partial agonist (e.g., buprenorphine) analgesics in patients who have received or are receiving a course of therapy with a full opioid agonist analgesic, including hydromorphone.

Hydromorphone is metabolized by the liver, and its clearance may be affected by inhibitors and inducers of the cytochrome P450 enzyme system. For example, the concomitant use of CYP3A4 inhibitors, such as macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g., ketoconazole), and protease inhibitors (e.g., ritonavir), can reduce the metabolism of hydromorphone and increase its exposure, which may result in increased or prolonged opioid effects. Conversely, CYP3A4 inducers, such as rifampin, carbamazepine, and phenytoin, may reduce the plasma concentration of hydromorphone, potentially resulting in decreased efficacy or onset of a withdrawal syndrome in a patient who had developed physical dependence to hydromorphone.

Because of these potential interactions, it is important to review all medications, including over-the-counter drugs and herbal supplements that the patient is taking. Adjustments to the dosage of hydromorphone or the concomitant medication may be necessary. Patients should be advised to report any signs of sedation, respiratory depression, or other concerning symptoms promptly. If you have any questions or require further information regarding drug interactions with hydromorphone HCl 4 mg/ml Oral Liquid, please reach out to us at Bayview Pharmacy for assistance.

How Does it Work

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Hydromorphone HCl 4 mg/ml Oral Liquid is a potent opioid analgesic specifically designed for oral use. This formulation works by directly affecting the central nervous system to relieve pain. Hydromorphone, the active ingredient, binds to opioid receptors in the brain and spinal cord, mimicking the effects of endogenous pain-relieving compounds known as endorphins. By activating these receptors, hydromorphone decreases the perception of pain and the emotional response to pain.

The liquid form of hydromorphone HCl is particularly beneficial for patients who have difficulty swallowing pills or tablets, such as those with dysphagia, or for those who require a more easily titratable form of medication, such as the pediatric or geriatric population. The 4 mg/ml concentration allows for precise dosing, which is critical in managing pain while minimizing the risk of opioid-related side effects. The oral liquid formulation also offers a rapid onset of action, as the medication does not need to be dissolved in the stomach before absorption, unlike solid dosage forms.

Hydromorphone is indicated for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. It is particularly useful in managing acute pain, chronic pain, and pain associated with cancer. Due to its potency, it is typically reserved for use in patients who are already opioid-tolerant or those with pain that has not responded to non-opioid analgesics. As with all opioids, the use of hydromorphone should be closely monitored by healthcare professionals to support the safe and appropriate pain management, and to mitigate the risks of addiction, abuse, and misuse.

It is important for both patients and prescribers to understand that while hydromorphone provides significant pain relief, it also has the potential for serious side effects, including respiratory depression, sedation, and hypotension. Patients should be counseled on the proper use of this medication, potential side effects, and the importance of adhering to prescribed dosages. Additionally, this medication should be used in conjunction with a comprehensive pain management plan that may include non-pharmacological interventions and other pain relief strategies.

If you have any questions about the use of Hydromorphone HCl 4 mg/ml Oral Liquid or its suitability for specific pain management needs, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to provide guidance and support to ensure the safe and appropriate use of this medication.

Other Uses

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The Hydromorphone HCl 4 mg/ml Oral Liquid formulation is primarily indicated for the management of pain severe enough to require an opioid analgesic, for which alternative treatments are inadequate. However, this potent opioid may have applications beyond its typical use in pain management, although these uses are less common and should always be initiated under strict medical supervision due to the risk of addiction and other serious side effects.

In certain clinical circumstances, hydromorphone oral liquid may be considered for the off-label management of dyspnea, particularly in palliative care settings where other treatments have not been successful. The reduction of breathlessness in end-stage diseases, such as advanced cancer, COPD, or heart failure, has been an ancillary benefit observed with opioids like hydromorphone. Moreover, this liquid formulation can also be beneficial in cases requiring careful titration of doses when initiating opioid therapy or during opioid rotation to manage side effects or to achieve better pain control.

Another instance where Hydromorphone HCl Oral Liquid might be used is in instances where a continuous opioid infusion is not feasible, such as in home-based palliative care. Oral liquids can provide flexibility in dosing intervals and allow for rapid dose adjustments to manage fluctuating pain levels. Additionally, in patients undergoing procedural sedation for minor surgeries or diagnostic procedures, hydromorphone oral liquid may be used as a part of multimodal analgesia, although this is rare and is usually conducted in a controlled hospital setting.

It's important to note that while there are other potential uses for Hydromorphone HCl Oral Liquid, these should not be attempted without careful consideration of the risks involved and should only be prescribed by healthcare professionals familiar with the drug's pharmacological profile. If you, as prescribers or patients, are considering the use of this formulation for any indications other than the primary approved uses, or require information regarding appropriate dosing and administration, please reach out to us at Bayview Pharmacy for guidance. Our team is committed to ensuring the safe and appropriate use of medications and is available to answer any questions or provide consultations as needed.

As always, when dealing with powerful opioids such as hydromorphone, the potential for abuse, addiction, and serious side effects must be taken into account, and these medications should be prescribed with caution, following all relevant guidelines and regulations.

Frequently Asked Questions

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What is Hydromorphone HCl 4 mg/ml Oral Liquid used for?

Hydromorphone HCl 4 mg/ml Oral Liquid is used to relieve moderate to severe pain in patients where an opioid analgesic is appropriate. It can be particularly beneficial for those who have difficulty swallowing pills or require precise dosage adjustments.

How should Hydromorphone HCl Oral Liquid be administered?

The medication should be taken orally. The exact dosage and frequency will be prescribed by a healthcare provider. It is important to measure doses with an accurate measuring device such as an oral syringe or a medication cup.

Can Hydromorphone HCl Oral Liquid be taken with food?

Yes, Hydromorphone HCl Oral Liquid can be taken with or without food. However, to reduce the risk of gastrointestinal side effects, it is often recommended to take it with food or milk.

What should I do if I miss a dose of Hydromorphone HCl Oral Liquid?

If you miss a dose, take it as soon as you remember. If it is near the time of your next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Are there any potential side effects of Hydromorphone HCl Oral Liquid?

Yes, like all medications, Hydromorphone HCl Oral Liquid may cause side effects. Common side effects include dizziness, lightheadedness, nausea, vomiting, constipation, sweating, and dry mouth. If any of these effects persist or worsen, contact your doctor or pharmacist promptly.

Can I drink alcohol while taking Hydromorphone HCl Oral Liquid?

No, consuming alcohol while taking Hydromorphone can increase the risk of dangerous side effects or overdose. It is important to avoid alcoholic beverages and any products that contain alcohol while on this medication.

How should I store Hydromorphone HCl Oral Liquid?

Store the medication at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Make sure the bottle is tightly closed when not in use.

Is Hydromorphone HCl Oral Liquid habit-forming?

Yes, Hydromorphone is an opioid and has the potential for addiction, abuse, and misuse. It should be taken exactly as prescribed by your healthcare provider to minimize the risk of addiction.

What should I avoid while taking Hydromorphone HCl Oral Liquid?

Avoid driving, using heavy machinery, or performing any activity that requires alertness until you are sure you can perform such activities safely. Also, avoid consuming alcohol and any products that may interact with the medication.

What do I do in case of an overdose?

In the event of an overdose, seek immediate medical attention. Overdose symptoms may include slow breathing, severe drowsiness, cold and clammy skin, and fainting. It is essential to have someone call for emergency help as an overdose can be life-threatening.

About this compounded preparation

This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.

The conditions listed on this page are indications prescribers have ordered this preparation for. They are not FDA-approved indications, and listing them is not a statement that this preparation is effective for them.

A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice — discuss your situation with a licensed healthcare provider.

This preparation is a controlled substance. Additional prescribing, refill, and shipping restrictions apply, and the states Bayview can dispense it to are narrower than for non-controlled preparations.

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.
For prescribers

How to e-prescribe this formula

Controlled substance: e-prescribe only (EPCS). Faxed, phoned, and handwritten prescriptions cannot be filled. Rhode Island law (R.I. Gen. Laws § 21-28-3.18) requires Schedule II to V prescriptions to be transmitted electronically.
1

Find Bayview in your EHR's pharmacy directory

Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.

NCPDP4106882NPI1750455143Address3844 Post Rd, Warwick, RI 02886Phone(401) 284-4505Fax(401) 284-4506
2

Enter the formula as a compound

Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.

Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.

3

Copy the prescription details

RxFormula name
Dose formDose form
Quantity________
SigAs directed by prescriber
Refills____
PharmacyBayview Pharmacy, Warwick RI, NCPDP 4106882
Copy prescription details

Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.

4

Send it

Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.

Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.

Do not use Notes to Pharmacy for the formula. Some EHRs keep that field internal and never transmit it. A prescription that arrives without the formula is delayed while we call your office.

Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.

Hydromorphone HCl 4 mg/ml Oral Liquid
Oral Liquid
controlled

Take orally

As needed