hydromorphone hydrochloride at a glance
Medicine class
Strong opioid analgesic and full mu-opioid receptor agonist.
Licensed role
Relief of severe pain in cancer in adults and people aged over 12 years.
Key safety point
It can cause dependence, drowsiness and dangerously slow breathing, especially with alcohol or other sedatives.
Driving
Do not drive until you know how it affects you, and never drive if sleepy, dizzy or otherwise impaired.
What is hydromorphone hydrochloride used for?
Selected UK products are licensed for:
Relief of severe pain in cancer.
Prolonged-release oral treatment in adults and children aged 12 years and over.
Intravenous or subcutaneous injection or infusion in adults and adolescents over 12 years, normally managed by healthcare professionals.
How does hydromorphone hydrochloride work?
It activates mu-opioid receptors in the brain and spinal cord, reducing how pain signals are perceived. This action can also cause sleepiness, slow breathing and reduced bowel movement.
hydromorphone hydrochloride preparations and strengths
Capsule
Route: Oral
Strengths: 1.3 mg, 2 mg, 4 mg, 8 mg, 16 mg, 24 mg
How to take hydromorphone hydrochloride
Use it exactly as prescribed. Do not stop suddenly unless urgent medical care requires otherwise.
Swallow prolonged-release capsules whole with water.
A capsule may be opened and its pellets sprinkled onto cold soft food. Swallow the pellets intact.
Never crush, chew or dissolve prolonged-release pellets; this can rapidly release a potentially fatal amount.
Injection or infusion is normally prepared and administered by a doctor or nurse.
Avoid alcohol because it can increase sedation and breathing problems.
hydromorphone hydrochloride side effects
Common or expected effects
- Constipation
- Feeling or being sick
- Dizziness or sleepiness
- Headache
- Reduced appetite
- Dry mouth or abdominal discomfort
- Itching or increased sweating
- Confusion, anxiety or difficulty sleeping
Get urgent medical advice
- Slow, shallow or difficult breathing
- Extreme sleepiness, collapse or inability to wake
- Swelling of the face, lips, mouth or throat, wheezing or a widespread rash
- Severe abdominal swelling or pain with inability to pass stools or wind
- New breathing pauses during sleep or marked daytime drowsiness
- Seizures or severe confusion
hydromorphone hydrochloride in pregnancy
It is not generally recommended during pregnancy or labour unless a specialist considers it clearly necessary. Regular exposure can cause neonatal withdrawal, while use around delivery may suppress the newborn’s breathing.
hydromorphone hydrochloride while breastfeeding
It is not recommended while breastfeeding. Small amounts enter breast milk, and serious infant sedation and breathing problems have been reported. Discuss an alternative analgesic with the prescriber.
hydromorphone hydrochloride interactions
Tell the prescriber or pharmacist about all medicines, non-prescription products and alcohol use.
Benzodiazepines and other sedatives
Combined effects can cause profound sleepiness, respiratory depression, coma or death.
Gabapentin or pregabalin
The combination increases the risk of opioid overdose and respiratory depression.
Common questions about hydromorphone hydrochloride
Answers are fully visible for fast scanning and source review.
Can prolonged-release capsules be opened?
Yes. The intact pellets may be sprinkled onto cold soft food and swallowed without chewing.
Can it be taken with alcohol?
Alcohol should be avoided because it can increase sleepiness, loss of consciousness and dangerous breathing suppression.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.