Dilaudid

Overview

A medicine that is based on opioids (narcotics) and administered by healthcare experts for treating mild or severe pain in individuals is Dilaudid. It is a branded version of hydromorphone. Doctors prescribe to treat pain, buy Dilaudid online or at a pharmacy near you or at a hospital.

Generally, Dilaudid is not used in the long-term treatment of patients. The health conditions of the patients are examined While giving the dosages of this pharmaceutical drug. This is a prescription-only medicine. Hence, individuals must not take it without a medical consultation. 

Dilaudid uses:

Healthcare professionals administer dosages of Dilaudid for the treatment of the following health complications.  

1. Pain

Dilaudid is often given to patients as pain relief medicine for mild or severe pain. Sometimes, doctors may choose to administer it together with other medication drugs. 

2. Cancer-Related Pain

It is suggested to relieve patients from pain caused due to cancer. However, it is not used for the prolonged treatment of cancerous pain. 

3. Cough

In some cases, doctors may choose to give this medication a drug for suppressing coughing.

Dosages:

It is available in the form of an oral tablet, solution, injection, and liquid. Doctors typically administer Dilaudid tablets at dosage strengths of 2 mg and 4 mg. The oral solution of this medication drug is administered at dosages between 2.5 ml to 10 ml. An overdosage of Dilaudid must be avoided. 

The milligram trap

Hydromorphone is one of the most potent opioids taken by mouth. A small number of milligrams does a lot.

Why this matters: “2 mg” of hydromorphone sounds small, but it’s roughly 8 mg of oral morphine. In hospitals, the most common hydromorphone errors come from treating it as if it were morphine. At home, the risk comes from taking an extra tablet because the dose “seems low.” For a full side-by-side, see Morphine vs. Dilaudid.

Stage 1: In the hospital

Most people meet hydromorphone as an IV medicine after surgery, in the emergency department, or during cancer or sickle-cell pain crises.

• IV doses work within about 5 minutes and last 2–3 hours.
• PCA pumps (patient-controlled analgesia) let you press a button for small, pre-set doses, with a lockout so you can’t overdose. Only the patient should press it, never a visitor.
• High-potency injection (10 mg/mL) is reserved for opioid-tolerant patients, usually people already on high-dose opioids for cancer pain.
• It’s often chosen over morphine for people with kidney problems (it doesn’t produce morphine’s most troublesome kidney-cleared metabolite) and over meperidine, which most hospitals now avoid.

Nurses check your breathing rate, oxygen and sedation level regularly. Being hard to wake is the early warning sign they’re looking for.

What hydromorphone is used for

• Acute severe pain, such as after major surgery or injury, when non-opioid options aren’t enough.
• Cancer pain, including around-the-clock pain in opioid-tolerant patients. See Pain Relief Drugs for Cancer.
• Chronic severe pain in opioid-tolerant patients (extended-release tablets only).

It is not for mild pain, headache, or as-needed use in people who’ve never taken opioids at high doses.

Forms and strengths

The 8 mg tablet is a high starting dose; it’s usually for people already taking opioids who need more.

Stage 2: Going home: your discharge checklist

Before you leave the hospital with a hydromorphone prescription, make sure you know:

• Exactly how many milligrams per dose, and whether it’s tablets or liquid
• How often, and the most you can take in 24 hours
• When to stop: most post-surgery prescriptions are meant for a few days
• What to take first: many plans use acetaminophen or an NSAID first, with hydromorphone only for breakthrough pain
• Whether you have naloxone (ask for a prescription or buy it at a pharmacy without one)
• What to do about constipation: a laxative should start the same day as the opioid
• Which of your home medicines to pause, especially sleeping pills, benzodiazepines and muscle relaxants
• Who to call if pain isn’t controlled or you’re too drowsy

Stage 3: Your first week at home

Days 1–2: Pain is usually highest. Take doses on time if instructed, but don’t take an extra tablet if a dose seems weak; call instead. Have someone stay with you the first night if possible.

Days 3–4: Many people can start spacing doses further apart or using a non-opioid first. Constipation often peaks now; see What Helps With Constipation.

Days 5–7: For most surgeries, you should need hydromorphone rarely or not at all. If you still need it as often as on day 1, contact your surgeon.

Every day: No alcohol. No driving. Store tablets locked away and count them. Sleep can be disrupted by opioids; see Importance of Sleep for Health.

Call 911 and give naloxone if someone taking hydromorphone can’t be woken, is breathing very slowly or not at all, or has blue or gray lips.

If you have kidney or liver disease

• Kidneys: hydromorphone is broken down into hydromorphone-3-glucuronide, which the kidneys clear. When it builds up it can cause twitching, agitation and, rarely, seizures or hallucinations (see Pain Meds That Cause Hallucination). The label advises starting at one-quarter to one-half the usual dose, depending on severity.
• Liver: start at one-quarter to one-half the usual dose with moderate impairment.

Hydromorphone’s half-life is about 2–3 hours with normal organ function.

Stopping

After more than a few days of regular use, don’t stop suddenly. Withdrawal (restlessness, sweating, diarrhea, aching, anxiety) is unpleasant and can drive people back to the medicine. A taper, reducing the dose gradually, prevents most of it. After a short post-surgical course, many people can simply stop as pain fades.

Side Effects of Dilaudid:

Individuals may suffer from the side effects of Dilaudid after taking its oral dosages. Here is a look at those side effects.

• Headache
• Vomiting
• Nausea
• Fatigue
• Depression
• Sweats
• Lack of appetite
• Dryness in mouth
• Pain in the joints
• Weak pulse
• Muscular pain
• Spasms
• Heartburn

The health complications that could occur because of Dilaudid must be reported. Otherwise, they may get even more serious with time. 

Precautions:

People must take precautions during the Dilaudid medicine course. Those who have been using for the last 2 weeks MAO inhibitor (an antidepressant) must avoid taking Dilaudid. 

A few drugs that are known to interact with this pharmaceutical medication drug should be avoided because they are known to cause a condition called “Serotonin Tolerance”. One should also not take alcohol. 

FAQ for patients and caregivers

Is Dilaudid stronger than oxycodone?

Yes, milligram for milligram, roughly 3–4 times. That doesn’t make it “better.” The right opioid depends on the situation. See Oxycodone vs. Dilaudid and Dilaudid vs. Percocet.

Is hydromorphone the same as hydrocodone?

No. The names are similar, but hydromorphone is much more potent. Pharmacists flag this as a look-alike, sound-alike pair. See Hydrocodone vs. Hydromorphone.

My family member seems confused on Dilaudid. Is that normal?

Mild drowsiness is common. New confusion, hallucinations or muscle twitching are not; call the prescriber, especially if they have kidney problems. If they can’t be woken, call 911.

How does Dilaudid compare with Opana or fentanyl?

See Opana vs. Dilaudid and Oxycodone vs. Fentanyl for how the high-potency opioids compare.

Can Dilaudid be addictive?

Yes. It’s a Schedule II opioid with high misuse potential. See Hydrocodone Addiction for warning signs and treatment options, which include methadone and buprenorphine.

Can I buy Dilaudid online?

Only from a licensed US pharmacy with a valid prescription. As a Schedule II drug, it can’t be refilled; each fill needs a new prescription. The FDA’s BeSafeRx explains how to check a pharmacy.

Related

• Comparisons: Morphine vs. Dilaudid · Oxycodone vs. Dilaudid · Hydrocodone vs. Hydromorphone · Opana vs. Dilaudid
• Other opioids: Oxycodone · Opana ER · Methadone · Demerol
• Pain Relief Drugs for Cancer