Palladone, sometimes known by its generic name hydromorphone hydrochloride, is an opioid painkiller. The drug comes in extended-release capsules and is used by opioid-tolerant adults with constant (around-the-clock) pain that is moderate to severe and expected to last for weeks or longer. It is only prescribed when alternative treatment options are inadequate due to the high risks of addiction, abuse and misuse with opioids, even at recommended doses, and the greater risks of overdose and death with extended-release opioid formulations. It works by binding to certain receptors in the brain and nervous system used by the body’s natural “pain relievers.

Palladone is not for occasional or “as-needed” use and it should not be the first narcotic pain medicine prescribed for pain. Palladone is not for patients who need narcotic pain medicine for a short time. Use in non-narcotic-tolerant patients could be life-threatening, as they have not built up the tolerance needed for this medication. In addition, overestimating the dose of this drug when switching from another narcotic can cause death by overdose on the first dose. Palladone extended-release capsules can cause serious side effects, including breathing problems that can lead to death, if used in the wrong way. PalladoneTM is a Schedule II, federally controlled substance because it contains an opioid (narcotic) pain medicine that can be a target for people who abuse prescription medicines or street drugs.

Palladone Usage

Palladone is the extended-release version of hydromorphone hydrochloride and should only be given to adults suffering from chronic moderate to severe pain, expected to last for a long period of time. The drug is most often used for someone dealing with severe pain due to cancer. These extended-release capsules should only be started after the user has been taking other narcotic (opioid) medicines and his or her body has gotten used to them (opioid tolerant).

Side Effects of Palladone

As with most opioid medications, side effects can occur. The following make up the most common side effects of Palladone, common meaning more than 1 in 100 people experience these side effects:

  • Constipation,
  • Nausea,
  • Vomiting,
  • Nervousness,
  • Dizziness,
  • Drowsiness,
  • Itching,
  • Dry mouth,
  • Sweating,
  • Weakness

Palladone can cause serious side effects including death, especially if used or abused in a non-medicinal manner. Emergency medical help is needed if any of the following severe side effects occur:

  • Trouble breathing,
  • Extreme drowsiness with slowed breathing,
  • Shallow breathing (little chest movement with breathing),
  • Faintness,
  • Dizziness,
  • Confusion or other unusual symptoms.

It is important to note that someone with the following medical conditions should not use Palladone:

  • If you are pregnant, planning to become pregnant, or are breast-feeding,
  • If you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement,
  • If you have ever had alcoholism, substance abuse, or narcotic dependence; if you consume more than 3 alcoholic drinks per day; or if you have a family history of these problems,
  • If you have considered or attempted suicide; or if you have major depression or hallucinations,
  • If you have an acute head injury, increased pressure in the head, brain injury or tumor, epilepsy, or seizures (convulsions),
  • If you have an acute stomach or intestinal problem; chronic inflammation and ulceration of the bowel; low blood volume; recent abdominal surgery; adrenal gland problems; enlargement of the prostate gland; gallbladder problems; heart failure; lung disease, including shortness of breath; kidney or liver problems; low blood pressure; underactive thyroid; or urinary blockage or problems urinating.

Addiction, Abuse & Misuse of Palladone

According to a 2010 study from the National Institute on Drug Abuse, almost 2 million Americans were addicted to or abusing prescription opioids like Palladone. Palladone exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death. Serious, life-threatening, or fatal respiratory depression may occur. All patients prescribed Palladone must be monitored regularly for the development of these behaviors or conditions. The chance of addiction is higher in patients that have been addicted to or abused other medications, street drugs, or alcohol or if they have a history of mental problems.

Palladone capsules are not meant to be broken, crushed, dissolved, chewed or opened. If all of the medicine is released in your body at once, you could experience very serious side effects, including death from overdose. The capsule must be swallowed whole. Prolonged use of Palladone during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts.

Taking Palladone with alcohol can be especially dangerous. When mixed together, dose dumping occurs, meaning chemicals meant to be released over time into the bloodstream are released all at once. This can lead to breathing issues, respiratory depression and death for the user. This same dosage dumping effect can occur if someone attempts to chew, crush or dissolve the capsule instead of swallowing it whole.

Withdrawal from Palladone

Since addiction to Palladone causes a physical change in brain chemistry, withdrawal and detox symptoms often occur if someone suddenly stops taking the drug.

Common Palladone withdrawal symptoms include:

  • Restlessness
  • Insomnia
  • Runny Nose
  • Yawning
  • Sweating
  • Chills
  • Muscle Pain
  • Joint Pain
  • Dilated pupils
  • Weakness
  • Anxiety
  • Nausea
  • Diarrhea
  • Vomiting
  • Low blood pressure
  • Decreased heart rate
  • Slow breathing

Withdrawal symptoms begin to occur one to four days after the last dose of Palladone and can last more than one week. Although they are not life-threatening in most cases, they can be uncomfortable. Withdrawing from Palladone should be done under the care of a physician or drug rehabilitation clinic.