Dilaudid IV & Injecting | Dosing, Side Effects, & Abuse Potential
Dilaudid (hydromorphone) is used in both tablet and injection forms in modern healthcare. However, because of its potency and potential to cause serious side effects, Dilaudid injections should be carefully dosed under close medical supervision.
Dilaudid is a brand name prescription painkiller made with hydromorphone, a potent semi-synthetic opiate/opioid agonist that treats moderate to severe pain as well as chronic pain in extended-release forms.
Hydromorphone is similar in effect to other strong opioids such as hydrocodone, oxycodone, and fentanyl.
As a strong opioid analgesic, Dilaudid injections play an important role in pain management in medical contexts. However, it also has a very high potential for abuse, addiction, overdose, and physical dependence.
Dilaudid is produced in two injection dosage formulations: Dilaudid Injection and Dilaudid-HP Injection.
Dilaudid Injection strengths include 1 mg/mL, 2 mg/ML, 4 mg/mL single dose vials. Dilaudid-HP Injection (high potency) is a 10 mg/mL vial and is intended only for use in opioid-tolerant patients.
All Dilaudid injections are intended for non-oral administration, meaning that the drug is administered through either intravenous, subcutaneous, or intramuscular injection.
Dilaudid Injection Dosages
Dilaudid injections are only administered by a healthcare professional in a medical setting. This provider also determines the correct dosage for each specific patient.
As a general guideline, adult patients who are not opioid tolerant may receive an initial dose of 1-2 mg every 2-3 hours as needed.
In patients who are already opioid tolerant, initial dosage is equianalgesic, which means they’re provided with an initial dose of Dilaudid that is roughly equivalent with their current medication and dosage in terms of pain relief.
After your initial dose, your healthcare provider may adjust your dosage, through a process called titration, to administer the lowest possible dose of Dilaudid that still provides effective analgesia/pain control.
Side Effects Of Dilaudid Injection
Common side effects associated with hydromorphone include:
- warm, flushed, or tingling skin
- nausea and vomiting
- stomach pain
- blurry or impaired vision
- dry mouth
Potentially serious side effects and adverse events may also occur, including:
- allergic reaction
- respiratory depression (suppressed breathing)
- slow heart rate and low blood pressure
- lightheadedness or fainting
- severe abdominal pain
- clammy skin
- irregular or pounding heartbeat
- mental confusion
Contact your healthcare provider or seek immediate medical attention if you experience these adverse reactions.
Abuse Potential Of Dilaudid Injections
In most cases, Dilaudid injections are only administered in healthcare settings by trained medical professionals. This makes it less likely that the medication will be diverted and misused.
However, there are still situations in which Dilaudid abuse does occur. And because it is an immediate-release drug already prepared for injection use, Dilaudid Injection is a potentially attractive target for drug abuse.
If abused, Dilaudid Injection carries the same risks as other forms of injection opioid abuse, including:
- infections and injection-related diseases (bacteremia, endocarditis, hepatitis, botulism, HIV, and skin infections)
- collapsed veins, abscesses, embolisms, and scarring
- tolerance and physical dependence
- addiction and personality/behavioral changes
- increased risk of respiratory depression and overdose, especially if mixed with other CNS depressants
As a strong central nervous system depressant, hydromorphone interacts with opioid receptors to provide pain relief and slow down overall mental and physical activity. However, at high doses the effects of Dilaudid on breathing and other critical physical functions can be life-threatening.
This is why it is so dangerous to take more of your medication than prescribed, or to mix Dilaudid with other CNS depressant drugs including alcohol, benzodiazepines, and muscle relaxants.
Signs and symptoms of a Dilaudid overdose may include:
- confusion, disorientation, or agitation
- severe sedation and drowsiness
- gasping, gurgling, or other signs of interrupted breathing/apnea
- hypothermia and cold, clammy skin
- blue-tinted lips and extremities
- pinpoint pupils
- becoming unresponsive (coma)
If you suspect an overdose has occurred, call 911 and provide first aid, including naloxone (Narcan), until help arrives.
Other Dilaudid Injection Precautions
Other precautions related to Dilaudid Injection may include:
- risk of dizziness, lightheadedness, or fainting when rising from a lying or sitting position
- risk of impairment that may make it unsafe to drive or operate machinery
- risks regarding fertility, pregnancy, breastfeeding, and newborns
- risks related to serotonin syndrome when Dilaudid injection is used with other serotonin-increasing drugs and supplements
- precautions related to pre-existing conditions including paralytic ileus, pancreatitis, head injury, chronic pulmonary disease, renal insufficiency, hypotension, sulfite sensitivity, and others
- increased risks specific to patients aged 65 and older
- risks related to physical dependence, withdrawal symptoms, and a recommendation to taper-down one’s dosage over time before discontinuation
- certain potential drug interactions
- Food and Drug Administration (FDA) — DILAUDID® and DILAUDID-HP® INJECTION https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019034s018lbl.pdf
- National Library of Medicine: MedlinePlus — Hydromorphone Injection: MedlinePlus Drug Information https://medlineplus.gov/druginfo/meds/a601148.html