Hydromorphone

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Information about Hydromorphone

Hydromorphone and oxymorphone are semisynthetic derivatives of morphine and potent opiate agonists which are used predominantly to treat moderate-to-severe pain.

Liver safety of Hydromorphone

Neither hydromorphone nor oxymorphone have been linked to serum enzyme elevations during therapy or to clinically apparent liver injury.

Mechanism of action of Hydromorphone

Hydromorphone and oxymorphone are semisynthetic derivatives that both act by engagement in cell surface opiate receptors (predominant µ type receptors) that are found in the central nervous system, but also heart, lung, vascular and intestinal cells. Current indications are for moderate to severe pain, pre- and postoperative analgesia, and as an adjunct to anesthesia.

FDA approval information for Hydromorphone

Hydromorphone was approved for use in the United States in 1984 and is still widely used in treatment of moderate-to-severe pain and, in low doses, as an antitussive.

Dosage and administration for Hydromorphone

Hydromorphone is available generically and under the brand name Dilaudid as tablets of 2, 4 and 8 mg, as an oral solution of 5 mg/5 mL and as suppositories of 3 mg. Solutions for injection (1 to 10 mg/mL) are also available. The usual dose of hydromorphone in adults is 2 to 10 mg orally every 3 to 6 hours or 2 to 4 mg by injection every 4 to 6 hours. Lower doses (1 mg orally) are used for treatment of cough.

Clinical use of Hydromorphone

Oxymorphone was approved for use in the United States in 1959 and remains in clinical use. Current indications are for treatment of moderate to severe pain, alleviation of anxiety associated with dyspnea of pulmonary edema and as an adjunct to general anesthesia and preoperative sedation. Oxymorphone is available generically and under the brand name Numorphan and Opana in standard tablets of 5 and 10 mg, extended release tablets of 5 to 40 mg, suppositories of 5 mg and as a solution for injection of 1 mg/mL. The usual dose of oxymorphone is 5 to 20 mg orally of the standard tablets every 4 to 6 hours or 1 to 1.5 mg by injection every 4 to 6 hours.

Side effects of Hydromorphone

The side effects of hydromorphone and oxymorphone are similar to those of other opiates and include sedation, respiratory depression, confusion, euphoria, agitation, constipation, abdominal bloating, nausea, vomiting and constipation.

DEA controlled substance classification of Hydromorphone

Both drugs are controlled substances and classified as Schedule II drugs, indicating that it has medical usefulness, but also a high potential for physical and psychological dependency and abuse.

Full and partial opiod agonists:

Opiate antagonists:


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