Pronunciation: di-law-did
Generic name: hydromorphone hydrochloride
Other brand names of hydromorphone hydrochloride include: Dilaudid, Exalgo, Hydrostat IR
Dosage form: oral tablets (2 mg, 4 mg, 8 mg), oral solution (5 mg/5 mL)
Drug class: Opioids

Medically reviewed by Carmen Pope, Senior Medical Editor, B. Pharm. Last updated on April 14, 2026.

What is Dilaudid?

Dilaudid is used to manage pain severe enough to require an opioid analgesic when other pain treatments, such as non-opioid pain medicines, do not treat your pain well enough or you cannot tolerate them. It is available as oral tablets and an oral solution and is a strong prescription opioid (narcotic) pain medicine.

Opioid pain medicines can put you at risk for overdose and death. Even if you take your dose correctly as prescribed, you are at risk for opioid addiction, abuse, and misuse that can lead to death.

Dilaudid first gained FDA approval on January 11, 1984.

Important information about Dilaudid

Get emergency help or call 911 right away if you take too many Dilaudid tablets or too much Dilaudid oral solution (overdose). When you first start taking Dilaudid tablets or Dilaudid oral solution, when your dose is changed, or if you take too much (overdose), serious or life-threatening breathing problems that can lead to death may occur. Ask your healthcare provider about medicines like naloxone or nalmefene that can be used in an emergency to reverse an opioid overdose.

Taking Dilaudid tablets or Dilaudid oral solution with other opioid medicines, benzodiazepines, gabapentinoids (gabapentin or pregabalin), alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death.

Never give anyone else your Dilaudid tablets or Dilaudid oral solution. They could die from taking it. Selling or giving away Dilaudid tablets or Dilaudid oral solution is against the law.

Dilaudid oral solution must be measured carefully. Confusing milligrams (mg) with millilitres (mL) can result in a fatal overdose. Always use the measuring device provided and never guess the dose.

Pregnancy: Taking Dilaudid long-term during pregnancy can cause withdrawal symptoms in your newborn, which can be life-threatening if not treated promptly. If you are pregnant or planning to become pregnant, speak with your doctor immediately.

Addiction and Misuse: Dilaudid carries a real risk of addiction, abuse, and misuse, even when taken as prescribed. Your doctor will assess your risk before prescribing and will monitor you regularly throughout treatment.

Keep Away from Children: A single accidental dose can be fatal to a child. Store Dilaudid securely out of sight and reach of children at all times.

Store Dilaudid tablets or Dilaudid oral solution securely, out of sight and reach of children, and in a location not accessible by others, including visitors to the home.

Warnings and Precautions

Increased Pain Sensitivity (OIH). In some cases, opioid medication can paradoxically make your pain worse or make you more sensitive to pain. This is known as Opioid-Induced Hyperalgesia. If your pain seems to be increasing despite taking your medication, do not assume you need a higher dose. Speak with your doctor, as reducing your dose or switching to a different opioid may actually help more.

Breathing Problems in Higher Risk Patients. If you have a chronic lung condition, are elderly, or have lost significant body weight or strength, you are at greater risk of breathing difficulties with Dilaudid. Your doctor should monitor you closely, especially when starting treatment or adjusting your dose.

Adrenal Insufficiency. Long-term opioid use can affect your adrenal glands. If diagnosed, your doctor will treat this with corticosteroid medication and will gradually reduce your opioid dose to allow your body to recover. Do not stop taking your medication suddenly without medical guidance.

Low Blood Pressure. Dilaudid can cause a significant drop in blood pressure, which may cause dizziness or fainting, particularly when standing up. Your doctor will monitor your blood pressure regularly, especially when starting or adjusting treatment. Dilaudid is not suitable for patients in circulatory shock.

Head Injuries or Brain Conditions. If you have raised pressure in the brain, a brain tumour, a head injury, or impaired consciousness, Dilaudid may not be suitable for you. It can worsen breathing difficulties and mask important neurological symptoms. Your doctor will monitor you closely if this medication is considered necessary.

Side effects

Common side effects

The most common side effects of Dilaudid are:

• Lightheadedness
• Dizziness
• Sedation
• Nausea
• Vomiting
• Sweating
• Flushing
• Dysphoria (a profound state of unhappiness, anxiety or unease)
• Euphoria (a state of intense happiness, elation, or overwhelming joy)
• Dry mouth
• Pruritus.

Other possible side effects of Dilaudid tablets and Dilaudid oral solution include constipation, headache, and abdominal pain.

Call your healthcare provider if you have any of these symptoms and they are severe.

Get emergency medical help or call 911 right away if you have:

• Trouble breathing or shortness of breath
• Fast heartbeat
• Chest pain
• Swelling of your face, tongue, or throat
• Extreme drowsiness
• Light-headedness when changing positions
• Feeling faint
• Agitation
• High body temperature
• Trouble walking
• Stiff muscles
• Mental changes such as confusion.

These are not all the possible side effects of Dilaudid tablets and Dilaudid oral solution. Call your healthcare provider for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. For more information, go to dailymed.nlm.nih.gov

Related/similar drugs

Before Taking

Do not take Dilaudid tablets or Dilaudid oral solution if you have:

• Significant respiratory depression
• Severe asthma, trouble breathing, or other lung problems.
• A bowel blockage or a narrowing of the stomach or intestines
• Known hypersensitivity to hydromorphone, hydromorphone salts, or sulfite-containing medications

Before taking Dilaudid tablets or Dilaudid oral solution, tell your healthcare provider if you have a history of:

• head injury, seizures
• problems urinating
• liver, kidney, thyroid problems
• pancreas or gallbladder problems
• abuse of street or prescription drugs, alcohol addiction, opioid overdose, or mental health problems

Tell your healthcare provider if you are:

• Noticing your pain is getting worse. If your pain gets worse after you take Dilaudid, do not take more Dilaudid without first talking to your healthcare provider. Talk to your healthcare provider if the pain that you have increases, if you feel more sensitive to pain, or if you have new pain after taking Dilaudid
• Pregnant or planning to become pregnant. Use of Dilaudid tablets and Dilaudid oral solution for an extended period of time during pregnancy can cause withdrawal symptoms in your newborn baby that could be life-threatening if not recognized and treated.
• Breastfeeding. Dilaudid tablets and Dilaudid oral solution pass into breast milk and may harm your baby. Carefully observe infants for increased sleepiness (more than usual), breathing difficulties, or limpness. Seek immediate medical care if you notice these signs.
• Living in a household where there are small children or someone who has abused street or prescription drugs.
• Taking prescription or over-the-counter medicines, vitamins, or herbal supplements. Taking Dilaudid with certain other medicines can cause serious side effects that could lead to death.

How do I take Dilaudid?

Do not change your dose. Take Dilaudid exactly as prescribed by your healthcare provider. Use the lowest dose possible for the shortest time needed.

• Measure liquid medicine with the supplied measuring device (not a kitchen spoon).
• For acute (short-term) pain, you may only need to take Dilaudid for a few days. You may have some Dilaudid left over that you did not use. See disposal information at the bottom of this section for directions on how to safely throw away (dispose of) your unused Dilaudid.
• Do not take more than your prescribed dose. If you miss a dose, take your next dose at your usual time.
• Call your healthcare provider if the dose you are taking does not control your pain.

If you have been taking Dilaudid tablets or Dilaudid oral solution regularly, do not stop taking Dilaudid tablets or Dilaudid oral solution without talking to your healthcare provider.

Dispose of expired, unwanted, or unused Dilaudid tablets or Dilaudid oral solution by promptly flushing down the toilet if a drug take-back option is not readily available. Visit www.fda.gov/drugdisposal for additional information on disposal of unused medicines.

What should I avoid while taking Dilaudid?

While taking Dilaudid, DO NOT:

• Drive or operate heavy machinery until you know how Dilaudid tablets or Dilaudid oral solution affect you. Dilaudid can make you sleepy, dizzy, or lightheaded.
• Drink alcohol or use prescription or over-the-counter medicines that contain alcohol. Using products containing alcohol during treatment with Dilaudid tablets or Dilaudid oral solution may cause you to overdose and die.

What other drugs will affect Dilaudid?

Many other drugs can be dangerous when used with Dilaudid. Tell your doctor if you also use:

• medicine for allergies, cough, asthma, blood pressure, motion sickness, irritable bowel, or overactive bladder;
• other opioid pain medicine or prescription cough medicine;
• cimetidine, verapamil, quinidine;
• sleep medicine, muscle relaxers, or other drugs that make you drowsy; or
• a benzodiazepine sedative like Valium, Klonopin, or Xanax
• mixed agonist/antagonist and partial agonist opioid analgesics: Avoid use with MS Contin because they may reduce the analgesic effect of MS Contin or precipitate withdrawal symptoms
• monoamine Oxidase Inhibitors (MAOIs): Can potentiate the effects of hydromorphone. Avoid concomitant use in patients receiving MAOIs or within 14 days of stopping treatment with an MAOI
• serotonergic drugs, such as fluoxetine, tramadol, or amitriptyline. Concomitant use may result in serotonin syndrome. Discontinue MS Contin if serotonin syndrome is suspected.

This list is not complete, and many other drugs may affect morphine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Ingredients

Active: hydromorphone hydrochloride

Inactive ingredients, oral tablets (2 mg, 4 mg, and 8 mg): lactose anhydrous and magnesium stearate. May also contain traces of sodium metabisulfite.

2 mg tablets: D&C red #30 Lake dye and D&C yellow #10 Lake dye.

4 mg tablets: D&C yellow #10 Lake dye.

Inactive ingredients, oral solution: purified water, methylparaben, propylparaben, sucrose, and glycerin. May also contain traces of sodium metabisulfite.

Company

Marketed by: Rhodes Pharmaceuticals, Wilson, NC 27893 US, http://rhodespharma.com or call 1-888-873-5329.

Frequently asked questions

• Which painkiller should you use?
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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer