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Hydromorphone, also known as dihydromorphinone, and sold under the brand name Dilaudid among others, is an opioid used to treat moderate to severe pain.^[4] Typically, long-term use is only recommended for pain due to cancer.^[6] It may be used by mouth or by injection into a vein, muscle, or under the skin.^[4] Effects generally begin within half an hour and last for up to five hours.^[4]

Common side effects include dizziness, sleepiness, nausea, itchiness, and constipation.^[4] Serious side effects may include abuse, low blood pressure, seizures, respiratory depression, and serotonin syndrome.^[4] Rapidly decreasing the dose may result in opioid withdrawal.^[4] Generally, use during pregnancy or breastfeeding is not recommended.^[7] Hydromorphone is believed to work by activating opioid receptors, mainly in the brain and spinal cord.^[4] Hydromorphone 2 mg IV is equivalent to approximately 10 mg morphine IV.^[6]

Hydromorphone was patented in 1923.^[8] It is on the World Health Organization’s List of Essential Medicines.^[9] It is available as a generic medication.^[4] In 2017, it was the 205th most commonly prescribed medication in the United States, with more than two million prescriptions.^[10][11] Hydromorphone is made from morphine