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Dilaudid (Hydromorphone): Uses, Side Effects & More

Peter Manza, PhD profile image
By Peter Manza, PhD • Updated Aug 10, 2023 • 6 cited sources

Dilaudid is the brand name of the potent opioid hydromorphone, which is prescribed to relieve moderate to severe pain. 

As an opioid medication, Dilaudid can suppress the central nervous system and lead to a potentially life-threatening overdose, especially when misused. 

Dilaudid is habit-forming even when taken as directed. Physical and emotional withdrawal symptoms may appear when the medication is stopped. 

Dilaudid is commonly misused, and it is highly addictive. Nearly 2.5 million Americans ages 12 and older had an opioid use disorder (OUD) involving a prescription pain reliever such as Dilaudid in 2020.[1] 

OUD is a treatable disease with several evidence-based care options that support ongoing recovery.

What Is Dilaudid?

Dilaudid is a prescription narcotic pain reliever containing the opioid drug hydromorphone. 

Dilaudid is available in tablet form, rectal suppositories, oral solutions, injectable formulations and as an extended-release tablet.

The liquid formulation is generally taken every three to six hours as needed, while the tablet is taken every four to six hours. 

The extended-release formulation is designed to be taken by those who are opioid-tolerant and require around-the-clock pain management.[2] It may be used when other treatment methods are not an option.

How Does Dilaudid Work? 

As an opioid drug, Dilaudid is a central nervous system depressant that slows heart rate and respiration while lowering blood pressure and body temperature. The drug also binds to opioid receptors in the brain to block pain. 

Many medications make up the opioid class, but Dilaudid is among the most dangerous. 

Dilaudid is between two and eight times more potent than morphine.[3] It also has a greater sedation effect and a shorter duration of action than morphine. It’s capable of working quickly and changing your central nervous system in potentially dangerous ways. 

How Do Doctors Use Dilaudid?

Dilaudid is prescribed for moderate to severe pain. If you’re in significant pain and other medications aren’t helping, your doctor might use Dilaudid. 

A history of opioid misuse can make weaker drugs less effective, so Dilaudid may be the only option that works.

Side Effects of Dilaudid

Side Effects

Dilaudid suppresses the central nervous system and can cause sedation, drowsiness, breathing problems, a slow heart rate and reduced blood pressure. 

These are other potential Dilaudid side effects:[2]

  • Anxiety
  • Constipation
  • Depression
  • Dry mouth 
  • Flushing
  • Headache
  • Itchiness
  • Joint, back or muscle pain
  • Lightheadedness
  • Sleep issues
  • Stomach pain

More severe side effects can also occur, including the following:

  • Agitation
  • Chest pain
  • Extreme drowsiness
  • Fainting
  • Hallucinations
  • Hives
  • Nausea and vomiting
  • Seizures
  • Swelling
  • Trouble swallowing or breathing
  • Inability to keep an erection
  • Irregular menstruation
  • Lack of sexual desire

If you experience serious side effects, seek immediate medical attention. You may need a different method to ease pain. 

What Should You Know Before Taking Dilaudid?

Your doctor must prescribe Dilaudid and will check your medical history before offering you the drug. Some people shouldn’t use it. 

Your doctor may discuss the following issues before prescribing Dilaudid:[4]

  • Allergies: People with a potential opioid allergy should not take Dilaudid.
  • Pregnancy: Those who are pregnant or breastfeeding should talk to their doctor first.
  • Gastrointestinal health: Dilaudid can cause abdominal issues. If you have had gastrointestinal surgery or a history of abdominal issues, it may not be ideal for you.
  • Age: The elderly or people who fall into the special risk category outlined in the FDA labeling should talk to their doctors before starting Dilaudid.[4] They should also potentially begin with a lower dose.
  • Substance misuse: The medication should be used with particular caution by those with a history of drug or alcohol misuse.

Dilaudid can also make you feel sleepy and disoriented. This can pose risks when driving or operating machinery, and extreme caution is warranted. 

Can Dilaudid Interact With Other Substances?

Dilaudid can interact with a variety of both prescription medications and supplements.[2] Before you start using this medication, tell your doctor about all the prescriptions and over-the-counter drugs you take. 

Dilaudid can interact with the following:

  • Antidepressant medications
  • Benzodiazepines
  • Buprenorphine products
  • Cough suppressants
  • Medications for glaucoma
  • Medications for irritable bowel syndrome
  • Medications for migraines
  • Medications for urinary problems and ulcers
  • Parkinson’s disease medications
  • St. John’s wort
  • Tryptophan

Dilaudid can potentially interact with even more medications than those listed. Be sure to talk to your doctor about anything you are taking before beginning Dilaudid.

Overdose Symptoms

About three-quarters of the nearly 92,000 drug overdose deaths in 2019 in the United States involved an opioid drug like Dilaudid.[5] 

Opioid drugs slow heart and breathing rates. Take too much, and those doses can lead to death. Understanding what an overdose looks like is critical, as life saving medication can reverse an episode. 

An opioid overdose can have the following signs:

  • Bluish tint to skin, nails or lips
  • Dizziness
  • Drops in blood pressure and heart rate
  • Lack of coordination and balance
  • Mental confusion or agitation
  • Nausea or vomiting
  • Pinpoint pupils
  • Sedation and an inability to wake up
  • Trouble breathing

Naloxone, available without a prescription nationwide in pharmacies like those run by CVS, can reverse an overdose if applied immediately.[6] Once you’ve delivered the dose, call 911 and follow the operator’s instructions. 

Withdrawal Symptoms

Dilaudid is a habit-forming medication. Regular use allows the brain and body to get used to its interaction, and dependence can form. When this happens, withdrawal symptoms can occur as soon as the drug wears off. 

Withdrawal symptoms can be both psychological and physical. They may include the following:

  • Abdominal pain and cramps
  • Anxiety
  • Depression
  • Diarrhea
  • Dizziness
  • Fatigue
  • Goosebumps
  • Headaches
  • Insomnia
  • Irritability
  • Muscle aches and back pain
  • Nausea and vomiting
  • Restlessness
  • Sweatiness
  • Trouble concentrating and focusing

Understand Dilaudid Misuse

Dilaudid is a commonly misused painkiller.[3] Its street names include dust, footballs, dillies, D, smack and juice

The medication is often diverted through doctor shopping, forged prescriptions, and nursing home and pharmacy robberies. 

Any use of the medication outside of its prescription and dosing directions is considered misuse. But some people take steps to make the drug more powerful, including chewing the tablets, crushing and snorting, dissolving and injecting them, or altering them to take them in a way other than intended. Misusing dilaudid in these ways makes it even more dangerous and potentially life-threatening.

Signs of Dilaudid Misuse 

These are some things to look for that can indicate Dilaudid misuse:

  • Mood swings
  • Changes in appetite and eating patterns
  • Irregular sleep schedules
  • Going to more than one doctor to get prescriptions
  • Continuing to take Dilaudid after the prescription has run out
  • Exaggerating symptoms to get more Dilaudid
  • Keeping Dilaudid close at hand in multiple locations
  • Taking more and higher doses or taking Dilaudid in between doses
  • Social withdrawal and isolation
  • Decreased interest in activities or things that were important before
  • Drop in grades at school or production at work
  • Talking a lot about Dilaudid, such as where to get it, obtaining it, and using it

Side Effects of Misuse 

Two of the most serious side effects of Dilaudid misuse are overdose and opioid use disorder (OUD). 

Dilaudid is a powerful narcotic that can lead to fatal overdose, especially if misused or taken with other substances like sedatives or alcohol. 

It is also highly addictive. Misusing the medication increases the risk of developing OUD. 

How Is Dilaudid Misuse Treated?

Treatment for Dilaudid misuse and OUD can include either inpatient or outpatient options. Both models often include the following:

  • Group and individual therapy sessions involving behavioral therapy interventions, such as cognitive behavioral therapy (CBT)
  • Counseling sessions and life skills training to learn effective coping mechanisms and strategies for managing cravings and emotions and creating healthy behaviors
  • Pharmacological treatments, which commonly involve Medication for Addiction Treatment (MAT) to minimize opioid withdrawal, reduce cravings and prevent a return to dangerous opioid use
  • Dual diagnosis treatment, as addiction often co-occurs with mental health disorders 
  • Peer support group meetings that can promote healthy social interactions and relapse prevention strategies

Treatment programs cater to each individual specifically to promote lasting recovery. If you’re misusing Dilaudid, reach out for help to create a treatment plan that’s right for you.

By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. October 2021. Accessed February 2023.
  2. Hydromorphone. National Library of Medicine. January 2021. Accessed February 2023.
  3. Hydromorphone. Drug Enforcement Administration. September 2019. Accessed February 2023.
  4. Dilaudid Oral Liquid and Dilaudid Tablets. U.S. Food and Drug Administration. Accessed February 2023.
  5. Drug Overdose Deaths. Centers for Disease Control and Prevention. March 2021. Accessed February 2023.
  6. Naloxone. CVS Pharmacy. Accessed February 2023.

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