- Analgesia
- Sedation
- IV direct: over 2 - 3 minutes
- IV intermittent infusion
- IV continuous infusion
- PO
- IV direct: 5 - 15 mcg/kg/dose (0.005 - 0.015 mg/kg/dose) Q2-4h PRN
Hydromorphone Equivalents
1 mg | 1000 mcg |
0.1 mg/mL | 100 mcg/mL |
Dose check:
Dose___ mg multiplied by 1000 = Dose ___ mcg
Divide dose (mcg) by pt weight (kg) for ___ mcg/kg (5 - 15 mcg/kg/dose)
Volume to be administered: Divide dose (mcg) by concentration (mcg/mL) = ___ mL required for dose
- IV continuous infusion: 3 - 5 mcg/kg/hour (0.003 - 0.005 mg/kg/hour)
- PO: 0.03 - 0.06 mg/kg/dose Q4h PRN
- CNS: CNS depression, lethargy
- CVS: hypotension
- GI: ileus
- Respiratory: respiratory depression
- BP, HR
- RR, oxygen saturation
- bowel sounds, abdominal distension
CHEO:
IV direct:
- Use hydromorphone 0.04 mg/mL (40 mcg/mL) - 3 mL prefilled syringe prepared by pharmacy
- If patient receiving hydromorphone by continuous infusion, use appropriate setting on pump to administer bolus dose
IV continuous infusion:
- Use hydromorphone 0.04 mg/mL (40 mcg/mL) 20 mL prefilled syringe prepared by pharmacy
TOH:
IV continuous infusion:
- Hydromorphone 2 mg/mL
- Take 0.2 mL (0.4 mg) and add to 19.8 mL of D5W
- Final concentration: 0.02 mg/mL (20 mcg/mL)
- Solutions Compatible: D5W, 0.45%NaCl, 0.9%NaCl, D5W/0.45%NaCl, D5W/0.9%NaCl
Y-site compatible: amino acids/dextrose with up to 40 mmol/L KCl, cefotaxime, dobutamine, dopamine, epinephrine, fentanyl, furosemide, gentamicin, heparin, midazolam,milrinone, morphine, norepinephrine, SMOF, tobramycin, vancomycin
Incompatible: cefazolin, cloxacillin, phenobarbital, phenytoin
- Taketomo CK, Hodding JH, Kraus DM, Pediatric DM. Pediatric Dosage Handbook 22nd Edition. Hudson: Lexi-Comp Inc; 2015
- American Society of Health-System Pharmacists (ASHP). Handbook on Injectable Drugs 19th Edtion, Bethesda: ASHP 2017
- Association des pharmaciens des etablissements de santé du Quebec (A.P.E.S.). Care Beyond Cure: Management of Pain and Other Symptoms 4th Edition, Montreal: A.P.E.S. 2009