What is Hydromorphone: Uses, Warnings & Interactions

Updated May 14, 2025  •  Published Dec 30, 2020

Hydromorphone overview

BRAND NAMES:

  • Dilaudid, Exalgo

Generic Names:

  • Hydromorphone Hcl

Uses:

  • Treats moderate to severe pain. This medicine is a narcotic pain reliever.

Therapeutic Classes:

  • Central Nervous System Agent, Analgesic

Forms:

  • Long Acting Tablet, Liquid, Tablet, Long Acting Capsule

How it’s taken:

  • By mouth

What is Hydromorphone used for?

Hydromorphone is a medication used to treat moderate to severe pain. Hydromorphone belongs to a class of medications called semisynthetic opiates. Hydromorphone is also referred to as an opioid analgesic. Hydromorphone is a generic drug also sold under the brand names Dilaudid, Exalgo, and Palladone. Hydromorphone was first synthesized in 1924. In 1926 the drug was introduced into the market for the first time.

What form(s) does Hydromorphone come in

  • Long Acting Tablet

  • Liquid

  • Tablet

  • Long Acting Capsule

What are common Hydromorphone doses?

  • Tablet 2MG

  • Tablet 4MG

  • Tablet 8MG

  • Vial 1ML of 2MG/ML

  • Vial 20ML of 2MG/ML

  • Box 6 Suppository

  • Bottle 473ML of 1MG/ML

  • Crtrdg-Ndl 1ML of 1MG/ML

  • Crtrdg-Ndl 1ML of 2MG/ML

  • Crtrdg-Ndl 1ML of 4MG/ML

  • Ampule 1ML of 1MG/ML

Common Hydromorphone prescriptions

  • HYDROmorphone HCl
    1ml of 1mg/ml ampule

  • HYDROmorphone HCl
    1ml of 2mg/ml ampule

  • HYDROmorphone HCl
    1ml of 4mg/ml ampule

  • HYDROmorphone HCl
    473ml of 1mg/ml bottle

  • HYDROmorphone HCl
    1ml of 1mg/ml crtrdg-ndl

  • HYDROmorphone HCl
    1ml of 2mg/ml crtrdg-ndl

  • HYDROmorphone HCl
    1ml of 4mg/ml crtrdg-ndl

  • HYDROmorphone HCl
    5ml of 1mg/ml cup

  • HYDROmorphone HCl
    0.5ml of 1mg/ml syringe

  • HYDROmorphone HCl
    1ml of 1mg/ml syringe

  • HYDROmorphone HCl
    1ml of 2mg/ml syringe

  • HYDROmorphone HCl
    2mg tablet

  • HYDROmorphone HCl
    4mg tablet

  • HYDROmorphone HCl
    8mg tablet

  • HYDROmorphone HCl
    1ml of 2mg/ml vial

  • HYDROmorphone HCl
    20ml of 2mg/ml vial

How to take Hydromorphone

  • Oral liquid: Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup. If you get any of the oral liquid on your skin, rinse it with cool water right away.

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you. An overdose can be dangerous. Follow directions carefully so you do not get too much medicine at one time.

  • Swallow the extended-release capsule whole. Do not crush, break, or chew it.

  • Swallow the extended-release tablet whole. Do not crush, break, or chew it.

  • If you take the extended-release tablet, part of the tablet may pass into your stools. This is normal and is nothing to worry about.

  • Hydromorphone extended-release capsules or tablets work differently than regular hydromorphone tablets, even at the same dose. Do not switch from one form to another unless your doctor tells you to.

  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.

  • Missed dose: Extended-release capsules or tablets: If you miss a dose, skip the missed dose and take your next dose at the usual time the next day. Do not double doses.Oral liquid: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Drop off any unused narcotic medicine at a drug take-back location right away. If you do not have a drug take-back location near you, flush any unused narcotic medicine down the toilet. Check your local drug store and clinics for take-back locations. You can also check the DEA web site for locations. Here is the link to the FDA safe disposal of medicines website: www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Store the medicine in a safe and secure place. Do not throw unused medicine in the trash. Ask your pharmacist about the best way to dispose of medicine you do not use.

  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.

  • Swallow the extended-release tablet whole. Do not crush, break, or chew it.

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Store the medicine in a safe and secure place. Do not throw unused medicine in the trash. Ask your pharmacist about the best way to dispose of medicine you do not use.

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you. An overdose can be dangerous. Follow directions carefully so you do not get too much medicine at one time.

  • Missed dose: Extended-release capsules or tablets: If you miss a dose, skip the missed dose and take your next dose at the usual time the next day. Do not double doses.Oral liquid: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

  • Oral liquid: Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup. If you get any of the oral liquid on your skin, rinse it with cool water right away.

  • If you take the extended-release tablet, part of the tablet may pass into your stools. This is normal and is nothing to worry about.

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Drop off any unused narcotic medicine at a drug take-back location right away. If you do not have a drug take-back location near you, flush any unused narcotic medicine down the toilet. Check your local drug store and clinics for take-back locations. You can also check the DEA web site for locations. Here is the link to the FDA safe disposal of medicines website: www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm

  • Hydromorphone extended-release capsules or tablets work differently than regular hydromorphone tablets, even at the same dose. Do not switch from one form to another unless your doctor tells you to.

  • Swallow the extended-release capsule whole. Do not crush, break, or chew it.

What to do if you miss a dose of Hydromorphone

Hydromorphone contraindications

  • This medicine is not right for everyone. Do not use it if you had an allergic reaction to hydromorphone or sulfites, or if you have severe lung or breathing problems, or stomach or bowel blockage (including paralytic ileus).

Hydromorphone warnings

  • Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, lung disease or breathing problems (such as asthma or COPD), an underactive thyroid, adrenal problems, cystic fibrosis, pancreas problems, gallbladder problems, an enlarged prostate, trouble urinating, or stomach or bowel problems. Tell your doctor if you have a history of head injury, brain tumor, seizures, depression, or alcohol or drug abuse.

  • This medicine may cause the following problems:High risk of overdose, which can lead to deathRespiratory depression (serious breathing problem that can be life-threatening)Serotonin syndrome, when used with certain medicines

  • This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.

  • Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.

  • 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. Sit or lie down if you feel dizzy. Stand up carefully.

  • This medicine could cause infertility. Talk with your doctor before using this medicine if you plan to have children.

  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

  • This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.

Hydromorphone interactions

  • Do not use this medicine if you are using or have used an MAO inhibitor within the past 14 days.

  • Some medicines can affect how hydromorphone works. Tell your doctor if you are using any of the following: Blood pressure medicineDiuretic (water pill)Medicine to treat depressionPhenothiazine medicine

  • Do not drink alcohol while you are using this medicine.

  • Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol. Tell your doctor if you are also using buprenorphine, butorphanol, nalbuphine, pentazocine, or a muscle relaxer.

  • 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. Sit or lie down if you feel dizzy. Stand up carefully.

  • This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.

  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Hydromorphone side effects

Serious Side Effects

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing

  • Anxiety, restlessness, fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, seeing or hearing things that are not there

  • Blue lips, fingernails, or skin

  • Trouble breathing or slow breathing

  • Extreme dizziness or weakness, shallow breathing, slow or uneven heartbeat, sweating, cold or clammy skin, seizures

  • Severe confusion, lightheadedness, dizziness, fainting

  • Severe constipation, stomach pain, or vomiting

Less Serious Side Effects

  • Mild constipation, nausea, or vomiting

  • Mild sleepiness or tiredness