Hydromorphone

Chemical Structure of Hydromorphone

Hydromorphone is a potent semi-synthetic opioid analgesic that is thought to be 6 to 8 times stronger than morphine. Derived from morphine, hydromorphone is used for the relief of moderate to severe pain, and more rarely as a cough suppressant. Hydromorphone is most commonly available in the form of instant-release tablets or time-released capsules.

Hydromorphone was first synthesized in Germany in 1924 and introduced to the mass market in 1926 under the brand name 'Dilaudid'. Presently, the brand name 'Dilaudid' is more widely known than the generic term 'hydromorphone', and quite often 'Dilaudid' is used generically to refer to any form of hydromorphone.

Abusers commonly inject the small, instant-release hydromorphone pills intravenously. The hydromorphone dissolves in water without the need to be heated, making the preparation of pills for injection quite simple. When injected intravenously, hydromorphone provides the user with a euphoric 'rush' that is similar to the rush felt from IV heroin. After the rush, the the high from hydromorphone has a relatively short duration compared to most other opioids.

Brand Names

Dilaudid, Palladone, Hydromorph Contin, Hydrostat, Exalgo, Dilaudid-HP

Street Names

Dillies, hydro, hydromorph, D's

Formulations

• Dilaudid - tablet, hydromorphone hydrochloride (HCl): 2 mg, 4 mg, 8 mg
• Dilaudid-HP - injection solution, hydromorphone HCl 10 mg/mL
• Palladone - capsule, hydromorphone HCl extended-release: 12 mg, 16 mg, 24 mg, 32 mg
• Hydromorph Contin - capsule, hydromorphone HCl extended-release: 3 mg, 6 mg, 9 mg, 12 mg, 18 mg, 24 mg, 30 mg
• Exalgo - tablet, hydromorphone HCl extended-release: 8 mg, 12 mg, 16 mg

Medical Uses

• relief of moderate to severe pain
• relief of severe, painful dry cough

Route of Administration

oral, intramuscular (IM), intravenous (IV), subcutaneous (SC), insufflation (snorting), rectal

Half-life

2-3 h

Medical Dosage

• pain relief: 1 to 4 mg orally every 3-4 h; 0.5 to 1 mg IV / 2-4 h as needed
• relief of cough: 1 mg orally every 3-4 h as needed

Legality

• Hydromorphone is a Schedule II drug in the United States.
Hydromorphone is a Schedule I drug in Canada.

Images

• Tablets (Instant Release)
• Tablets/Capsules (Extended Release)
• Intravenous

References

• Schumacher MA, Basbaum AI, Way WL, Opioid Analgesics & Antagonists (Chapter 31) in: Basic and Clinical Pharmacology. 12e. Katzung BG, Masters SB, Trevor AJ (Editors). McGraw-Hill / Lange, 2012.
• Felden L, Walter C, Harder S, Treede RD, Kayser H, Drover D, Geisslinger G, Lötsch J. Comparative clinical effects of hydromorphone and morphine: a meta-analysis. British Journal of Anaesthesia Sep 2011; 107(3):319-28. [PubMed] [PDF]
• Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain. United States Department of Veterans Affairs / Department of Defense, May 2010. [PDF]
• Controlled Substances - Alphabetical Order. DEA Office of Diversion Control, May 2013. [PDF]
• Controlled Drugs and Substances Act. Minister of Justice, Canada, Nov 2012. [PDF]

Related Pages

• Hydromorphone Medication Identification

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