Christina Varvatsis is a hospital pharmacist and freelance medical writer committed to educating the public on medication therapy. She strives to promote the safe and effective use of medications.
David Snyder, PharmD, BCPP, is a board-certified clinical pharmacist and psychopharmacology expert at McLean Hospital in Belmont, Massachusetts.
Dosing errors can result in an overdose or death. If you have been prescribed Dilaudid oral solution, always measure your dose with the provided measuring cup or syringe. Never use household teaspoons or tablespoons.
Opioid addiction, abuse, and misuse may occur in people who take Dilaudid. This can lead to an overdose and death. Talk with your healthcare provider about these risks, and only take Dilaudid as prescribed.
Dilaudid may cause severe and potentially deadly respiratory depression—a condition in which your breathing becomes too slow and shallow. Monitor for any signs of breathing changes, especially when starting Dilaudid or after a dose increase.
Always store your Dilaudid in a safe location, up high and out of the reach and sight of children. People who accidentally take even one dose of Dilaudid, especially children, can experience a fatal overdose.
Using Dilaudid during pregnancy for a prolonged time can cause your baby to develop neonatal opioid withdrawal syndrome after birth—a potentially deadly condition if not treated promptly. If you need to take Dilaudid during pregnancy, talk with your healthcare provider about these risks and ensure the appropriate treatment is available for your baby immediately after delivery.
Taking Dilaudid with benzodiazepines (a type of antianxiety medicine) or other medicines that cause central nervous system (CNS) depression (such as alcohol) can cause severe sedation, slowed breathing, coma, and death. Only take these medicines together if other treatments have not worked.
Dilaudid (hydromorphone) is a prescription pain medication used to treat severe pain. It is used after other pain-relieving medications have failed or cannot be tolerated.
Dilaudid belongs to a group of drugs called opioid (narcotic) analgesics, a class of highly addictive painkillers. It changes how your brain and nervous system respond to pain.
Dilaudid, a brand-name drug, contains the active ingredient hydromorphone.
Hydromorphone is available in multiple forms: an oral tablet, an oral solution, an oral extended-release (ER; long-acting) tablet, an injectable solution, and a rectal suppository.
This article will highlight Dilaudid, given in tablet and oral solution form.
Brand Name(s): Dilaudid
Therapeutic Classification: Opioid (narcotic) analgesic
Dosage Form(s): Tablet, oral solution
Dilaudid is an opioid (narcotic) pain medication used to treat severe pain after other treatments, such as non-opioid pain relievers, have failed. It is also used if other pain medicines cannot be tolerated.
Pain is one of the most common reasons adults in the United States seek medical care and can negatively impact physical functioning, mental health, and quality of life. Prescription opioids, like Dilaudid, are often prescribed to treat moderate to severe pain after surgery, an injury, or cancer-related pain.
Healthcare providers may also prescribe these medicines to treat other types of pain, such as back pain or osteoarthritis. During 2015–2018, about 6% of U.S. adults reported using one or more prescription opioids during the past month.
Dilaudid is available as an oral tablet and an oral solution.
Your healthcare provider will likely tell you to take Dilaudid every three to six hours for the oral solution or every four to six hours for the oral tablet. Dilaudid may be prescribed either as needed (to be taken only when you are experiencing pain) or at scheduled times.
If you've been prescribed the oral solution, always measure your dose with the provided measuring cup or syringe. Never use household teaspoons or tablespoons. Dosing errors can result in an overdose or death.
Take Dilaudid exactly as your healthcare provider has told you to. Do not change your dose, and use the lowest possible amount for the shortest duration. Call your healthcare provider if your pain is not controlled.
If you have been taking Dilaudid regularly, do not stop taking it without speaking to your healthcare provider first since severe withdrawal reactions can occur.
Store Dilaudid at room temperature (68 to 77 degrees F) and protect from light. Excursions may be permitted between 59 and 86 degrees F. Do not store your medication in the bathroom.
Keep Dilaudid tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet. Because even one dose can cause a deadly overdose if accidentally consumed—especially by children—it is essential that Dilaudid be stored in a secure location.
Because of the risks associated with accidental Dilaudid ingestion, any expired, unused, or unwanted Dilaudid should be immediately flushed down the toilet if a drug take-back program is not available.
Visit the FDA's website to know where and how to discard all unused and expired drugs. You can also find disposal boxes in your area. Ask your pharmacist or healthcare provider if you have any questions about the best ways to dispose of your medications.
Healthcare providers may prescribe medicines for conditions not approved by the FDA. This is called off-label use. There are no off-label uses for oral Dilaudid. However, healthcare providers may prescribe the intravenous (IV) form for pain relief and sedation in people who are critically ill in the intensive care unit (ICU).
After taking Dilaudid, you should begin to feel pain relief within 15–30 minutes, but it may take up to 30–60 minutes for the full effects.
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.
Common side effects of Dilaudid may include but may not be limited to:
Contact your healthcare provider immediately if you develop signs of a severe reaction. Call 911 if your symptoms feel life-threatening.
Severe side effects of Dilaudid may include but may not be limited to:
If you've been taking Dilaudid regularly, do not stop taking it without speaking to your healthcare provider first. Abruptly stopping Dilaudid may cause severe withdrawal symptoms, uncontrolled pain, and suicide. Your healthcare provider will likely decrease your dose slowly to avoid withdrawal symptoms.
Chronic use of opioids like Dilaudid may cause problems with fertility in both males and females. It is not known whether these effects are reversible. Talk with your healthcare provider about these risks.
Opioids like Dilaudid may cause your adrenal glands not to work as well (adrenal insufficiency), leading to potentially life-threatening effects. Adrenal insufficiency most commonly occurs in people taking opioids for longer than one month. Contact your healthcare provider if you develop any signs of adrenal insufficiency, including nausea, vomiting, loss of appetite, fatigue, weakness, dizziness, and low blood pressure.
Dilaudid may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
The following modifications (changes) should be kept in mind when using Dilaudid:
Severe allergic reaction: Avoid using Dilaudid if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.
Pregnancy: Prolonged use of opioids like Dilaudid during pregnancy can cause your baby to develop neonatal opioid withdrawal syndrome after birth—a potentially deadly condition if not treated promptly. If you need to take Dilaudid during pregnancy, talk with your healthcare provider about these risks and ensure the appropriate treatment is available for your baby immediately after delivery.
In animal studies, Dilaudid was found to cause fetal harm, including neural tube defects, skeletal abnormalities, decreased body weight, and lower survival rates . Let your healthcare provider know if you're pregnant or plan to become pregnant, and discuss the benefits and risks of taking Dilaudid during your pregnancy.
Breastfeeding: Dilaudid is present in breast milk and may harm your baby. If you need to take Dilaudid while breastfeeding, monitor your baby for increased sleepiness, trouble breathing, or limpness. Seek medical care immediately if your baby develops any of these reactions. Talk with your healthcare provider if you plan to breastfeed and discuss the benefits and risks of taking Dilaudid while nursing, as well as the different ways to feed your baby.
Adults over 65: Some older adults may be more sensitive to Dilaudid's side effects, notably slowed or shallow breathing. Older adults with more than one medical condition or who are taking several medications should use caution with Dilaudid. Your healthcare provider will likely recommend a lower starting dose to minimize your chance of a reaction.
Children: The safety and effectiveness of using Dilaudid in children have not been established.
Kidney or liver problems: Individuals with kidney or liver problems may not be able to clear medication from their bodies as easily as people with healthy organs. This means the medicine stays in the body longer and can have increased side effects. For this reason, if you have kidney or liver impairment, your healthcare provider will likely start you on a lower dose of Dilaudid and monitor you closely for side effects.
If you accidentally forget your Dilaudid dose, skip the missed dose and take the following dose at your next scheduled dosing time. Don't try to double up to make up for the missed dose.
Try to find ways that work for you to help yourself remember to keep your appointments and take your medication routinely. If you miss too many doses, Dilaudid might be less effective at controlling your pain.
The symptoms of a suspected Dilaudid overdose include:
If you think you're experiencing an overdose or life-threatening symptoms, seek immediate medical attention.
If you think you or someone else may have overdosed on Dilaudid, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn't breathing after taking Dilaudid, call 911 immediately.
It is very important that your doctor check your progress while you are using this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.
Do not use this medicine if you are using or have used an MAO inhibitor (MAOI) including isocarboxazid [Marplan®], linezolid [Zyvox®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]) within the past 14 days.
This medicine will add to the effects of alcohol and other CNS depressants (medicines that can make you drowsy or less alert). CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, other prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you stop using this medicine. Check with your doctor before taking any of the other medicines listed above while you are using this medicine.
This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.
This medicine may cause adrenal gland problems. Check with your doctor right away if you have darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.
Dizziness, lightheadedness, or fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve dizziness or lightheadedness.
Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.
This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.
If you have been using this medicine regularly for several weeks or more, do not change your dose or suddenly stop using it without first checking with your doctor. You may be directed to gradually reduce the amount you are using before stopping treatment completely, or to take another narcotic for a while, to lessen the chance of withdrawal side effects (eg, anxiety, fever, nausea, runny nose, stomach cramps, sweating, tremors, or trouble with sleeping).
Using too much hydromorphone may cause an overdose, which can be life-threatening. Symptoms of an overdose include: extreme dizziness or weakness, slow heartbeat or breathing, seizures, trouble breathing, and cold, clammy skin. . In case of an overdose, call your doctor right away. Your doctor may also give naloxone to treat an overdose.
Using this medicine while you are pregnant may cause neonatal withdrawal syndrome in your newborn babies. Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, a high-pitched cry, irritability, shakiness or tremors, weight loss, vomiting, or fails to gain weight.
For nursing mothers taking this medicine:
Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.
Using too much of this medicine may cause infertility (unable to have children). Talk with your doctor before using this medicine if you plan to have children.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Do not take Dilaudid if you:
Use caution when taking Dilaudid with the following medications:
Many other medications may interact with Dilaudid. Be sure to talk with your healthcare provider about all the medicines you take or plan to take, including over-the-counter, nonprescription products, vitamins, herbs, or plant-based medicines.
Dilaudid is an opioid (narcotic) pain medication. Other opioids include:
Choosing between a product will depend on previous treatments you've tried and your other medical conditions. You and your healthcare provider will work together to select your best option.
Dilaudid is used to treat severe pain that hasn't responded to other treatments or when other treatments can't be tolerated.
Dilaudid belongs to a group of painkillers called opioids (narcotics). It changes how your brain and nervous system respond to pain.
Many drugs interact with Dilaudid. Be particularly careful with other medicines that make you sleepy or slow down your breathing, including alcohol and anxiety medicines (like benzodiazepines). Do not take Dilaudid with monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping an MAOI.
Dilaudid starts to work within 15–30 minutes, with full effects occurring at 30–60 minutes.
Common side effects of Dilaudid include nausea, vomiting, sleepiness, tiredness, headache, dizziness, abdominal pain, and constipation.
If you're taking Dilaudid, chances are you're trying to get better control over your pain. You may have tried different approaches or treatments. While managing pain does have its challenges, there are ways to help improve your quality of life. Refer below for some general tips to support your health:
Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
DailyMed. Dilaudid- hydromorphone hydrochloride tablet.
CDC. Clinical practice guideline for prescribing opioids for pain - United States, 2022.
Kovacevic MP, Szumita PM, Dube KM, DeGrado JR. Transition from continuous infusion fentanyl to hydromorphone in critically ill patients. J Pharm Pract. 2020;33(2):129-135. doi:10.1177/0897190018786832
By Christina Varvatsis, PharmD Christina Varvatsis is a hospital pharmacist and freelance medical writer. She is passionate about helping individuals make informed healthcare choices by understanding the benefits and risks of their treatment options.
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