What is Hydromorphone?

Hydromorphone (brand names: Dilaudid, Exalgo) is a strong opioid analgesic prescribed for the management of moderate to severe pain, especially in patients who require continuous, around-the-clock pain relief and for whom alternative treatments are inadequate.

It works by binding to mu-opioid receptors in the brain and spinal cord, altering the way the body perceives and responds to pain.

Important Information

  • Hydromorphone is highly potent (stronger than morphine).

  • Misuse, abuse, or overdose can cause respiratory depression, coma, or death.

  • Should only be used under strict medical supervision.

  • It is habit-forming and carries a high risk of addiction and dependence.

  • Extended-release formulations (like Exalgo) must not be broken, crushed, or chewed.

What to Know Before Taking Hydromorphone

Tell your doctor if you have:

  • Breathing problems (asthma, COPD, sleep apnea)

  • Liver or kidney disease

  • Head injury, seizures, or brain tumors

  • Low blood pressure or heart rhythm disorders

  • Mental health or substance abuse history

  • Pregnancy or breastfeeding (may cause withdrawal symptoms in the baby)

How to Take Hydromorphone

  • Take exactly as prescribed by your doctor.

  • Usually taken orally in immediate-release (every 4–6 hours) or extended-release (once daily) form.

  • Do not share this medicine with anyone.

  • Avoid alcohol, sedatives, or other opioids unless specifically approved by your doctor.

Hydromorphone dosage

Your hydromorphone dosage will depend upon your age, medical condition, the form of Hydromorphone you take, other medical issues you have, type and severity of your medical condition, and reaction to the initial treatment. Usual adult dosage of Hydromorphone HCL for severe pain:

  • Oral pills- 2 mg to 4 mg orally every 4 to 6 hours as needed
  • Oral liquid- 2.5 mg to 10 mg orally every 3 to 6 hours as needed
  • Extended-release- for those who are opioid-tolerant

This medication is not under the recommendation for use by anyone younger than 18 years.

 

Possible Side Effects

Common:

  • Drowsiness, dizziness, headache

  • Nausea, vomiting, constipation

  • Dry mouth

  • Sweating

Serious:

  • Slow or shallow breathing

  • Extreme sleepiness or difficulty waking

  • Seizures

  • Confusion, hallucinations

  • Allergic reactions (rash, swelling, difficulty breathing)

Seek emergency help if you notice trouble breathing or loss of consciousness.