- Dosages
- Side effects in children
- Warnings & precautions in children
- Contra-indications in children
-
Interactions - PK
- Renal impairment
- References
Pharmacokinetics in children
The following pharmacokinetic parameters were observed:
| Age | n | Dose | Cmax (ng/ml) | tmax (hour) | Cl (ml/min/kg) | Reference |
| 7 years | 1 | 4 mg/day in 2 doses controlled release | 1,07 | 6 | - | Babul 1995 |
| 7 years | 1 | 10 mg/day in 2 doses controlled release |
1,48 | 4 | - | Babul 1995 |
| Mean 15.3 years | 5 | 1,4 microg/kg/hour continuous IV infusion | - | - | 28,6-98,2 (mean 51,7) | Collins 1996 |
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dose recommendation of formulary compared to licensed use (on-label versus off-label)
No information is present at this moment.
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Available formulations
No information is present at this moment.
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Dosages
| Severe pain |
|---|
|
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Renal impaiment in children > 3 months
GFR ≥10 ml/min/1.73m2: Dose adjustment not required.
GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.
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The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here
Side effects
No information is present at this moment.
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The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here
Contra-indications
No information available on specific contra indications in children.
The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here
Warnings & precautions in children
Hydromorphon is a strong opoid and has a great variability in dosing between oral and intravenous administration. Caution is needed when switching from one route to the other. The bio-equivalent oral dose can be up to 3-5 times the intravenous dose. (NVK 2013, SmPC)
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Interactions
The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here
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| Natural opium alkaloids | ||
|---|---|---|
| N02AA01 | ||
| N02AA05 | ||
| N02AA59 | ||
| Phenylpiperidine derivatives | ||
|---|---|---|
| N02AB03 | ||
| N02AB03 | ||
| N02AB02 | ||
| Diphenylpropylamine derivatives | ||
|---|---|---|
| N02AC06 | ||
| N02AC03 | ||
| Oripavine derivatives | ||
|---|---|---|
| N02AE01 | ||
| Morphinan derivatives | ||
|---|---|---|
| N02AF02 | ||
| Other opioids | ||
|---|---|---|
| N02AX06 | ||
| N02AX01 | ||
| N02AX02 | ||
| Opioids in combination with non-opioid analgesics | ||
|---|---|---|
| N02AJ13 | ||
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References
- Dunbar, P. J., et al., Use of patient-controlled analgesia for pain control for children receiving bone marrow transplant, J Pain Symptom Manage, 1995, 10(8), 604-11
- Zernikow, B., et al, Pediatric palliative care: use of opioids for the management of pain, Paediatr Drugs, 2009, 11(2), 129-51
- Mundipharma Pharmaceuticals B.V., ,, SmPC Palladon (RVG 26549, 26550, 22162, 22163, 22164, 22165, 104836, 104838) 06-04-2018, www.geneesmiddeleninformatiebank.nl
- Babul, N., et al, Hydromorphone and metabolite pharmacokinetics in children, J Pain Symptom Manage, 1995, 10(5), 335-7
- Collins, J. J., et al, Patient-controlled analgesia for mucositis pain in children: a three-period crossover study comparing morphine and hydromorphone., J Pediatr, 1996, 129(5), 722-8
- Friedrichsdorf, S. J., et al, The management of pain in children with life-limiting illnesses., Pediatr Clin North Am, 2007, 54(5), 645-72
- Karl, H. W., et al, Controlled trial of morphine vs hydromorphone for patient-controlled analgesia in children with postoperative pain, Pain Med, 2012, 13(12), 1658-9
- Nederlandse Vereniging voor Kindergeneeskunde , Richtlijn Palliatieve zorg voor kinderen. Versie 1, 2013
- Nederlandse Vereniging voor Kindergeneeskunde, Richtlijn Palliatieve zorg voor kinderen. Versie 1, 2013
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Changes
Changes
