When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to hydromorphone.

How to Use This Medicine:
Suppository

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• Never take rectal suppositories by mouth.
• Wash your hands with soap and water before and after using this medicine. Remove the foil or wrapper from the suppository before inserting it.
• To make the suppository easier to insert, you may use a lubricating gel such as K-Y® Jelly, but do not use petroleum jelly (Vaseline®).
• Lie on your left side with your left leg straight or slightly bent, and your right knee bent upward. Gently push the pointed end of the suppository into the rectum about 1 inch.
• Keep lying down for about 15 minutes to keep the suppository from coming out before it melts. Then, wash your hands again.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• You may store the suppositories in the refrigerator, but do not freeze them.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some foods and drugs can affect how hydromorphone works.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.
• Do not drink alcohol while you are using this medicine. Do not take any medicine with alcohol in it.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, lung disease or breathing problems, or digestion problems. Also tell your doctor if you have Addison disease or other thyroid disorder, a head injury, an enlarged prostate, problems with urination, or a history of drug or alcohol abuse.
• This medicine may cause severe breathing problems.
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• Too much of this medicine can cause death. Symptoms of an overdose include extreme dizziness or weakness, trouble breathing, slow heartbeat, seizure, and cold, clammy skin.
• This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
• This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.
• Long-term use: Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Extreme weakness, shallow breathing, slow heartbeat, sweating, cold or clammy skin
• Lightheadedness, dizziness, or fainting
• Severe constipation or stomach pain
• Slow or uneven heartbeat
• Trouble breathing

If you notice these less serious side effects, talk with your doctor:

• Mild sleepiness or tiredness
• Mood changes or feelings of extreme happiness or sadness
• Nausea or vomiting

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088