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Generic Name: Hydromorphone
Product Name: Dilaudid


Dilaudid is used in the treatment of moderate to severe pain.


Hydromorphone is an opioid analgesic similar to morphine and is thought to be eight times as strong. Opioid analgesics work directly on the central nervous system, where they act on specific opioid receptors. The exact nature of this interaction is not fully understood.

By interacting with these receptors Hydromorphone, like other opioids, can cause analgesia without causing loss of consciousness, although sedation is commonly seen. Opioid analgesics also act on the respiratory control centre of the brain, causing a decrease in breathing rate and depth. Due to an effect on organs that contain smooth muscle (stomach, intestines, gallbladder etc), opioids also cause a number of gastrointestinal effects.

Dose advice

Dilaudid HP (high potency) is intended for use in narcotic tolerant patients only. Overdose and death could result if this preparation is used in non-tolerant patients.Dependence may develop after several weeks of continuous therapy, but may arise more quickly. Doses should be titrated for individual patients, and increases may be required if tolerance develops.


Dosage depends on nature, severity and pathophysiology of pain as well as concurrent medical status of the patient. All patients should be started on a conservative dose and have the dose increased according to response. The lowest effective dose should be used at all times.

Non-opioid tolerant patients:

  • Oral: 2-4mg every four hours.
  • IM or SC: 1-2mg every 4-6 hours.
  • IV: 0.5-1mg given slowly over 2-3 minutes.
  • PCA: background infusion of 0.1mg/hr with patient administered boluses of 0.2mg no more often than every 5 minutes to a maximum of 1.2mg/hr.

Patients currently receiving opioids:

  • Dose varies substantially depending on patient’s tolerance and should be calculated based on dose of opioid currently being taken. For example:
    • 10mg IM morphine is equivalent to 1.3-2mg Hydromorphone.
    • 300-400mg oral pethidine is equivalent to 6.5-7.5mg oral Hydromorphone.
  • Appropriate dose, route of administration and timing of doses should be individualised to each patient. Periodic assessment of patient response is essential in achieving adequate pain relief in safe circumstances.



Common side effects

  • Lightheadedness.
  • Dizziness.
  • Sedation.
  • Nausea and vomiting.
  • Sweating.
  • Dysphoria.
  • Euphoria.
  • Dry mouth.
  • Itching.

Uncommon side effects

  • Weakness.
  • Headache.
  • Agitation.
  • Tremor.
  • Alterations of mood.
  • Blurred vision.
  • Transient hallucinations.
  • Insomnia.
  • Chills.
  • Changes in heart rate.
  • Palpitations.
  • Fainting.
  • Changes in blood pressure.
  • Constipation.
  • Diarrhoea.
  • Taste disturbance.
  • Cramps.
  • Urinary retention or hesitancy.
  • Hives.
  • Skin rashes.

For further information talk to your doctor.

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Posted On: 22 July, 2003
Modified On: 1 January, 1970


Created by: myVMC