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Dilaudid (Hydromorphone): Uses, Side Effects, Risks & More

Dilaudid is a medication that may be prescribed if alternative options, such as non-opioid medications, do not give a patient suffering from pain the relief they need. 

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Dilaudid is a brand name for opioid hydromorphone. It is used to treat moderate to severe acute pain as well as severe chronic pain. 

This medication has significant abuse potential as an opioid. Though it has legitimate medical uses, it should be prescribed and used with caution. Like all opioids, it can be dangerous if abused, potentially causing severe breathing complications.

What Is Dilaudid?

Dilaudid is a brand name for the opioid hydromorphone. It is an opiate analgesic, a type of prescription painkiller. It comes in liquid, tablet, and extended-release tablet forms. 

It is important to take this drug as prescribed by a medical professional and to only change the way you use it after first talking to a doctor. 

While there are legitimate reasons to take this medication , it carries a number of serious risks, especially if abused. It can also interact dangerously if taken with a number of different drugs. These risks are discussed in the relevant sections below.

Dilaudid Uses

As an opiate analgesic (also called opioid analgesic), Dilaudid is a medication that may be prescribed if alternative options, such as non-opioid medications, do not give a patient suffering from pain the relief they need. 

It may also be prescribed if the patient cannot tolerate alternative pain medications. It is important a doctor first consider alternatives because opioids carry a number of risks that milder painkillers do not. 

Dilaudid is generally prescribed for moderate to severe acute pain or for severe chronic pain. A doctor will usually begin a patient on the lowest dose they believe may provide the relief needed, raising the dose if the initial dose proves inadequate. This is done to make sure the person isn’t taking more of the medication than is necessary to help treat their pain. 

A person’s dose may be raised over time, as it is possible to build up a tolerance to opioids, requiring more of the same medication to produce the same effect.

Side Effects

In addition to providing pain relief, hydromorphone can sometimes have the following effects:

  • Lightheadedness
  • Dizziness
  • Nausea or vomiting
  • Sweating or flushing
  • Euphoria
  • Dysphoria (a feeling of sadness or dissatisfaction; the opposite of euphoria)
  • Dry mouth
  • Sedation
  • Pruritus (itchy skin)

If the above symptoms don’t go away or seem severe, it is important to talk with a doctor. More serious symptoms hydromorphone can also cause include the following:

  • Difficulty breathing
  • Cardiac problems
  • Tremors and other muscle control issues
  • Vision impairment, including blurred vision and excessive pupil constriction
  • Confusion

If a person experiences any symptom that seems like it may be life-threatening, even if not listed above or in the “Overdose” section below, they should call 911 immediately instead of their doctor. Of significant concern are any symptoms that affect a person’s ability to breathe, remain conscious, or think clearly. 

Risks of Dilaudid Use

One notable risk of Dilaudid is its potential for abuse and addiction. Opioids can cause a sense of euphoria in users, especially in high doses, that leads some people to intentionally take more than prescribed. 

The more of an opioid a person takes, the more likely they are to develop a physical and psychological dependence on the drug. Hydromorphone can essentially “rewire” the body and brain, making a person crave more of the drug and suffer from flu-like withdrawal symptoms if they try to stop use. 

It is possible to form a dependence on hydromorphone even with normal, prescribed use. However, in this case, withdrawal will generally be more mild. 

Taking the drug only as prescribed and talking to a doctor about any cravings and withdrawal symptoms can help a person cease use more easily. A doctor can help wean a person off the drug after a period of sustained use. 

Hydromorphone Interactions

Hydromorphone should not be taken with benzodiazepines and other central nervous system (CNS) depressants. This includes alcohol. It should generally not be used with any medications or (both legal and illicit) recreational drugs that might affect a person’s breathing. 

As a general rule, it is best to always talk to a doctor about any drugs you are taking or intend to take before using opioids of any kind, including hydromorphone.

Hydromorphone can reduce the efficacy of diuretics. It can also cause complications if a person is taking anticholinergic drugs, as it can increase a person’s risk of urinary retention and/or constipation.

In some cases, taking hydromorphone with other drugs that affect a person’s serotonergic neurotransmitter system can induce what is called serotonin syndrome. This condition can be life-threatening, so doctors generally avoid prescribing these types of drugs together unless necessary. Even then, they only do so carefully.

Opioid Overdose

In high doses, hydromorphone can cause a person to experience dangerously shallow breathing. This can cause their body to no longer be taking in enough oxygen, which can be life-threatening. 

Signs of an hydromorphone overdose (and an opioid overdose in general) include the following:

  • Unusually narrowed or widened pupils
  • Shallow or slow breathing
  • Trouble breathing (gasping for air)
  • Significant drowsiness
  • Confusion or unresponsiveness
  • Cold, clammy skin
  • Slowed or stopped heartbeat 
  • Dizziness
  • Fainting
  • Muscle weakness
  • Seizure
  • Unconsciousness

An opioid overdose should be treated as a medical emergency. If a person is exhibiting the above symptoms or any other symptoms that seem life-threatening, call 911. If available, the drug naloxone should be administered, which can reverse the life-threatening effects of an opioid overdose. 

When on the phone with a 911 operator, alert them of your location as accurately as you can. Tell them the condition of the person you believe is experiencing the overdose and answer any questions they ask as accurately as possible. 

Many states have laws in place to protect people in these situations, even if illegal activities led to the overdose, to encourage people to call for help in the event of an overdose. These are generally called Good Samaritan laws.

Profile image for Dr. Alison Tarlow
Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated July 28, 2023
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