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Hydromorphone

Pain Relief

Brand names:

Dilaudid®

Often used for:

Pain

What is hydromorphone?

Hydromorphone is an opioid medicine used to manage pain. It works by reducing nerve signals and the feelings of pain.

This medicine may be given in the clinic, hospital, or at home.

Hydromorphone has fast-acting and long-acting forms. Follow dosing instructions carefully. The care team may ask you to keep a record of the doses your child takes, so they can prescribe the best possible pain control.

Hydromorphone is a strong medicine. When used over a long period of time it may cause physical dependence. Physical dependence is when the body starts to rely on the medicine. Stopping hydromorphone too fast can result in unwanted side effects. Your care team will monitor for this and develop a plan if the medicine must be stopped.

Your care team may talk to you about having a medicine called naloxone available while taking hydromorphone. Naloxone is a rescue medicine that can reverse the life-threatening effects of an opioid overdose. Your care team may teach you and your family how to use this medicine in case an overdose of hydromorphone ever happens. 

May be given into a vein by IV

May be given as a tablet by mouth

May be given as a liquid by mouth

Possible side effects

Nausea
Decreased appetite
Constipation
Feeling dizzy or shaky
Itching
Slower than normal rates of breathing
Low blood pressure
Fast, slow, or abnormal heartbeat
Seizures (rare)
Vomiting
Drowsiness, feeling tired, or feeling weak
Dry mouth
Problems urinating (peeing)
Breathing problems while sleeping (sleep apnea)
Mood changes, such as feeling sadder or happier than usual
Allergic reaction – Call your care team right away if your child has symptoms of an allergic reaction. These may include:  
- Rash, hives, or itching 
- Flu-like symptoms such as chills, aches, headache, or fever  
- Dizziness 
- Shortness of breath, coughing, or tightness in the throat   
- Swelling of the face or neck

This medicine can cause serious breathing problems. If your child has slow, shallow breathing or trouble breathing, call your care team right away. 

Side effects should decrease after taking hydromorphone for a few days. Tell the doctor or pharmacist if side effects increase while taking this medicine.

Not all patients who take hydromorphone will have these side effects. Common side effects are in bold, but there may be others. Please report any symptoms or side effects to your doctor or pharmacist.  

Find more information on side effects.

Tips for patients and families

Be sure to discuss all questions and instructions with your doctor or pharmacist.

Do not take this medicine more often or in greater amounts than recommended.
If taking this medicine regularly, increase fluid and fiber intake to help prevent constipation. Tell the care team if your child has not had a bowel movement (poop) in 3–5 days. They may need to take a stool softener or laxative to relieve constipation.
Do not give your child medicines that contain alcohol or allow your child to drink alcohol while they take this medicine.
This medicine may make your child dizzy or drowsy. Do not let your child do anything that could be dangerous until you see how this medicine affects them.
Have your child stand up slowly if they have been sitting or lying down. This will lower the chance of feeling dizzy or passing out.
If your child has been taking this medicine regularly or for a long time, they should not stop this medicine until the care provider instructs. Stopping hydromorphone without slowly decreasing the dose can lead to withdrawal symptoms. These include feeling restless, diarrhea, headache, sweating, muscle cramps, trouble sleeping, nausea, or vomiting. If these symptoms occur, call your doctor or pharmacist right away. It could mean the dose is being decreased too fast.
Certain medicines can interact with hydromorphone. These include other medicines that can make you sleepy such as: diphenhydramine (Benadryl®), promethazine, diazepam, lorazepam, and antidepressants. Tell your doctor and pharmacist about all medicines your child takes.
It is important that patients tell the care team if they are sexually active, pregnant, or breastfeeding.

Hydromorphone at home

This medicine can be taken with or without food. Take with food if stomach upset occurs. Taking the medicine with meals may lessen stomach problems.
Tablet: Swallow tablet whole. Do not crush, chew, or break the tablet unless the pharmacist tells you the tablet can be cut in half.
Extended release tablet: Do not crush, chew, or break the tablet.
Liquid: Use the measuring device that comes with the medicine. Throw away syringes for liquid medicine after each use. Do not reuse.
In case of a missed dose, give the missed dose as soon as possible. If it is near the time for the next dose, skip the missed dose. Do not give 2 doses at the same time.
Do not share this medicine with anyone or give it for reasons other than prescribed.
Call 911 or take your child to an emergency room right away if your child does not respond, answer, or react like normal. Get medical help right away if your child feels unusually sleepy or dizzy, passes out, or will not wake up.
Do not use the medicine past the expiration date.
Follow instructions for safe handling, storage, and disposal.

This medicine may be habit forming when used for a long time. Watch for signs of misuse: 

Taking the medicine in a way that is different than prescribed
Taking more medicine than is prescribed
Taking the medicine “just in case,” even when not in pain 
Changes in sleeping patterns 
Poor or risky decision-making
Saying they have lost this medicine to get another prescription written

Learn more about hydromorphone

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Always check the medication label. Many medicines look the same. Do not take any new medicine, including over-the counter medicines or supplements, without checking with your doctor or pharmacist. Talk to your doctor or pharmacist about what to do in the case of a missed dose, allergic reaction, or medical emergency.

This information is not intended to be a complete guide and is not a substitute for talking with your provider. Medicine names, appearance, formulas, or availability may vary by clinic location. Always follow the instructions given by your care team.

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Reviewed: April 2024