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Exalgo is a high dose opiate in a time released tablet form.
From the package insert warning:
"EXALGO tablets are to be swallowed whole and are not to be broken, chewed, dissolved, crushed or injected. Taking broken, chewed, dissolved or crushed EXALGO or its contents leads to rapid release and absorption of a potentially fatal dose of hydromorphone."
Besides great risk of death due to injecting a dose of a strong opiate meant to be time released over many hours, the powders used to make a tablet can damage the capillaries - this can result in kidney damage, retinal damage (loss of vision), mini-stroke, pulmonary embolism. Infection is also of concern. This is not always obvious in IV drug abusers until damage is done from bacteria settling on heart valves or in the retina of the eye (which can cause a need for open heart surgery to replace or repair heart valves or irreversible blindness).