Hydromorphone is a potent opioid analgesic used for the management of moderate to severe pain. It is a semi-synthetic derivative of morphine and is available in various formulations, including oral tablets, liquid solutions, and injectable forms. Some common brand names for hydromorphone include Dilaudid, Exalgo, and Palladone.

Mechanism of Action:

Similar to other opioids, hydromorphone acts as an agonist at the mu-opioid receptors in the central nervous system. By binding to these receptors, it inhibits the transmission of pain signals and alters the perception of pain.

Pain Management:

Hydromorphone is primarily used to manage moderate to severe pain, such as pain associated with surgery, injury, cancer, or other medical conditions causing intense pain.


Hydromorphone is available in various formulations, including immediate-release tablets, extended-release tablets, and injectable forms. The extended-release forms are designed to provide a more prolonged duration of pain relief.

Dosage and Administration:

The dosage of hydromorphone is determined based on the severity of pain, the patient's response, and their previous opioid exposure. Healthcare providers carefully titrate the dose to achieve adequate pain control while minimizing side effects.

Side Effects:

Common side effects of hydromorphone include drowsiness, dizziness, constipation, nausea, and vomiting. Serious side effects may include respiratory depression, which is a potentially life-threatening condition where breathing becomes slow and shallow.

Risk of Tolerance and Dependence:

Prolonged use of hydromorphone can lead to the development of tolerance, requiring higher doses for the same level of pain relief. It may also result in physical dependence, and abrupt discontinuation can lead to withdrawal symptoms.

Caution and Monitoring:

Due to its potency, hydromorphone is prescribed with caution, especially in patients who are opioid-naive. Regular monitoring by healthcare providers is essential to manage potential side effects and adjust the treatment plan as needed.

Abuse Potential:

Like other opioids, hydromorphone has the potential for abuse and addiction. It should be used only under the supervision of a healthcare professional, and patients with a history of substance abuse should be closely monitored.

Hydromorphone is available in various strengths, and the specific strengths may vary depending on the formulation and the country in which the medication is prescribed. The strengths are commonly expressed in terms of the amount of hydromorphone hydrochloride present in each dosage form. Here are some common strengths and formulations of hydromorphone:

Immediate-Release Tablets:

Hydromorphone immediate-release tablets are available in strengths such as 2 mg, 4 mg, and 8 mg. These are typically taken every 4 to 6 hours as needed for pain relief.

Extended-Release Tablets:

Extended-release formulations are designed to provide prolonged pain relief over an extended period, allowing for less frequent dosing. Common strengths include 8 mg, 12 mg, 16 mg, and 32 mg.

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