Dilaudid (Hydromorphone)

What is Dilaudid (hydromorphone)?

Dilaudid is the brand name for narcotic analgesics available only through prescription. The drug is an opioid narcotic medicine that is five to ten times stronger than morphine.

The drug is an immediate-release form of hydromorphone and is prescribed for people with moderate to severe pain. It should only be taken when prescribed by a medical professional as it has a high potential for addiction and abuse.

Typically, long-term use of Dilaudid is only seen in patients with cancer pain. It relieves pain by acting on the central nervous system (CNS).

What is Dilaudid used to treat?

Dilaudid is used to alleviate moderate to severe pain. Due to its high potency, abuse potential, and overdose risk, it is generally only prescribed when other first-line analgesia treatments have not worked.

How do you take Dilaudid?

Oral Dilaudid is available in two forms: a liquid or tablet.

The usual starting dose for Dilaudid tablets for adults is 2–4mg taken every four to six hours¹ to manage pain. The dosage is determined by your medical condition and treatment response.

If you’re prescribed the oral solution, give the bottle a good shake and use a special measuring device or spoon to measure the dose accurately. You might not get the correct dose with a regular spoon.

Hydromorphone can also be given as an injection or via rectal suppositories (these might be used if you have severe nausea or cannot have an injection).

Take Dilaudid exactly as directed by your doctor. Follow the directions on your prescription label carefully, and if there is anything you do not understand, speak to your doctor or pharmacist.

Don’t take more of the drug or take it more frequently than your doctor recommends.

Don’t stop taking the drug suddenly, or without consulting your doctor.

Seeing results 

Dilaudid’s effects and results depend on how the drug is administered.

If you take the drug orally, it starts working fast, usually within 15 minutes. Its effects peak in 30 minutes to an hour.

You could expect to wait five minutes to feel the effects of the drug when it’s given intravenously, and 15 minutes when you have an intramuscular injection.

Rectal suppositories take effect in around 30 minutes.

Potential side effects of Dilaudid

Dilaudid may cause noticeable side effects, including:

• Headache

• Drowsiness

• Sweating

• Problems sleeping

• Dry mouth

• Lightheadedness

• Body pain

• Itching

• Anxiety

• Flushing

• Depression

Dilaudid can also cause more severe side effects, including:

• Swelling

• Rash

• Hives

• Trouble breathing

• Difficulty swallowing

• Seizures

• Chest pain

• Extreme drowsiness

• Fainting

Tell your doctor about any side effects you experience while taking Dilaudid, but seek emergency medical help if you have severe side effects.

Hydromorphone is classified as a Schedule II drug in the US, which indicates it has a high potential for abuse. Abusing Dilaudid can lead to serious psychological or physical dependence, with many adverse side effects.

Long-term use of Dilaudid

Typically, long-term Dilaudid use is only recommended for people with cancer pain. The drug can cause dependence and addiction when used for an extended period of time.

You may be more at risk of Dilaudid addiction if you have a substance-use problem, such as drugs and alcohol overuse or addiction. To reduce the risk of addiction, take this medication exactly as directed.

The following are signs you might be addicted to Dilaudid:

• Feeling obsessed about the next dosage

• Needing to take a larger dose

• Feeling distracted and unable to carry out everyday tasks

• Forging prescriptions

Speak to your doctor right away if you feel you are becoming dependent on Dilaudid.

Missed doses

Skip a missed dose and return to your regular dosing schedule. Do not take two doses at the same time.

Overdoses

It is possible to overdose on Dilaudid, so take care not to take more than the recommended amount.

If you think you or someone else has taken too much Dilaudid, get emergency medical help right away.

What to discuss with your doctor before taking Dilaudid

Before taking this medication, tell your doctor or pharmacist if you have any of the following conditions:

• Brain disorders, such as a brain tumor

• Breathing problems, such as asthma, sleep apnea, or chronic obstructive pulmonary disease (COPD)

• Kidney disease

• Liver disease

• Personal or family history of a substance use disorder

• Stomach/intestinal problems

If you are allergic to hydromorphone or hydrocodone, or if you have any other allergies, notify your doctor or pharmacist before taking Dilaudid.

Inactive chemicals, such as sulfites, may be present in this product and could cause an allergic response.

Stopping Dilaudid

Stopping this medicine suddenly could cause withdrawal symptoms, especially if you have been taking it for an extended period or in large doses. To avoid withdrawal, your doctor may gradually reduce your dose.

Withdrawal symptoms include restlessness, anxiety, insomnia, watery eyes, runny nose, nausea, diarrhea, sweating, muscular aches, or sudden changes in behavior.

Never stop taking Dilaudid without consulting your doctor first.

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Dilaudid and pregnancy

Tell your doctor straight away if you find out you’re pregnant while taking Dilaudid. It is not known whether Dilaudid increases the chance of pregnancy complications, miscarriage, or birth defects, but you will need to weigh up the pros and cons with your doctor.

Don’t suddenly stop taking Dilaudid if you find out you are pregnant. Your doctor can tell you if you need to stop taking the drug, and if so, how to stop taking it safely.

It is thought that Dilaudid may cause your baby to have withdrawal symptoms after birth.² Be sure to tell your delivery team that you have taken hydromorphone during pregnancy so they can check for signs of withdrawal and provide optimal care for your baby.

Dilaudid enters breast milk in small quantities. It is thought that some opioids make babies feel sleepy and experience difficulty latching, or they can cause trouble breathing. Your doctor may recommend reducing your dosage to avoid complications when breastfeeding.

Interactions with other drugs

Certain drugs can change how hydromorphone affects your body, causing it to have more or less of an effect, or for the effects to last longer.

You must tell your doctor about any prescriptions, over-the-counter medications, vitamins, and supplements you are taking or plan to take so they can ensure Dilaudid is safe for you.

Specific medication groups that interact with hydromorphone include:

• Benzodiazepines

• Monoamine oxidase inhibitors (MAOIs)

• Certain medications that block opioids, such as nalmefene, naltrexone, and samidorphan

• Some antidepressants

• Other sedative or antipsychotic medications

Don’t take hydromorphone if you have taken MAOIs in the last 14 days.

Certain lab tests, particularly amylase/lipase levels, may be affected if you are using Dilaudid, leading to erroneous results. Ensure any health professional you see knows you are taking the drug.

Allergy information

Dilaudid very rarely causes a severe allergic reaction.

Seek emergency medical assistance if you notice any symptoms of an allergic reaction, such as a rash, itching/swelling (specifically swelling of the face, tongue, and throat), extreme dizziness, or problems breathing.

Clinical trial history¹

Double-blind, controlled trials have found that single doses of Dilaudid oral solution can effectively reduce post-operative pain.

A study found that 5mg and 10mg doses of Dilaudid were comparable to 30mg and 60mg doses of morphine sulfate.

Tips and advice for taking Dilaudid

Here are some tips and advice for taking Dilaudid safely and effectively:

• You may take Dilaudid with or without food. However, if you are prone to nausea, it would be best to take it with a meal.

• If you are taking this medication in liquid form, use a special measuring device/spoon to measure the dose accurately. Using a regular spoon won’t allow you to get an accurate dose.

• If you’re taking Dilaudid in liquid suspension, give it a good shake before use.

• Get the go-ahead from your doctor before falling pregnant or breastfeeding while taking Dilaudid.

• If you have taken MAOIs in the last 14 days, please don’t take hydromorphone.

• It’s possible to develop dependency or addiction to Dilaudid. To reduce the risk of addiction, take this medication exactly as directed.