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Hydromorphone ER Dosage
Before prescribing a dosage of hydromorphone ER, your healthcare provider will consider how you respond to the drug and other medical conditions you have, among other things. This prescription medication comes in the form of an extended-release tablet and is taken once daily. Never crush, chew, or dissolve the tablets, as this would release a dangerous amount of hydromorphone.
An Introduction to Dosing With Hydromorphone ER
The dose of hydromorphone ER (Exalgo™) your healthcare provider recommends will vary, depending on a number of factors, including:- How you respond to this drug
- The type and dose of other painkillers you have taken
- The type and severity of your pain
- Other medications you are taking
- Other medical conditions you may have.
As is always the case, do not adjust your dosage unless your healthcare provider specifically tells you to do so.
Hydromorphone ER Dosage for Pain
In clinical studies, the doses of hydromorphone ER used ranged from 8 mg up to 64 mg daily. The starting dose your healthcare provider recommends will depend mostly on the dose and type of painkillers you were previously taking.
For immediate-release oral hydromorphone, a straight mg-per-mg conversion is recommended. Simply add up the total mg of hydromorphone you take per day; this is the recommended hydromorphone ER total daily dose, given as a single dose per day.
If you are switching from any nonhydromorphone painkillers or from injected hydromorphone, your healthcare provider will need to convert your current dosage to an appropriate amount of hydromorphone ER. It is often best to slightly underestimate the dose initially, rather than overestimate, in order to avoid dangerous side effects of hydromorphone ER.
Your healthcare provider may also recommend a "rescue" medication (a short-acting painkiller) to use in addition to hydromorphone ER for times when your pain is especially severe (known as "breakthrough pain," as it breaks through your baseline, long-acting painkiller).
A rescue medication can be especially useful when you are first starting hydromorphone ER, as many healthcare providers underestimate your initial hydromorphone requirement in order to avoid dangerous side effects.
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD