Hydromorphone (dihydromorphinone) Cas 466-99-9

Hydromorphone, also known as dihydromorphinone, and sold under the brand name Dilaudid among others, is a morphinan opioid used to treat moderate to severe pain.^[7] Typically, long-term use is only recommended for pain due to cancer.^[9] It may be used by mouth or by injection into a vein, muscle, or under the skin.^[7] Effects generally begin within half an hour and last for up to five hours.^[7] A 2016 Cochrane review (updated in 2021) found little difference in benefit between hydromorphone and other opioids for cancer pain.^[10]

Common side effects include dizziness, euphoria, sleepiness, nausea, itchiness, and constipation.^[7] Serious side effects may include abuse, low blood pressure, seizures, respiratory depression, and serotonin syndrome.^[7] Rapidly decreasing the dose may result in opioid withdrawal.^[7] Generally, use during pregnancy or breastfeeding is not recommended.^[11] Hydromorphone exerts its effects by activating opioid receptors, mainly in the brain and spinal cord.^[7] Hydromorphone 2 mg IV is equivalent to approximately 10 mg morphine IV.^[9]

Hydromorphone was patented in 1923.^[12] Hydromorphone is made from morphine.^[13] Hydromorphone is a therapeutic alternative on the World Health Organization’s List of Essential Medicines.^[14] It is available as a generic medication.^[7] In 2022, it was the 233rd most commonly prescribed medication in the United States, with more than 1 million prescriptions.^[15][16]