What is hydromorphone?

Hydromorphone is a strong opioid pain medicine only available with a prescription from a specialist doctor.

Though the names sound similar, hydromorphone is not the same as morphine — it is a much stronger medicine.

How does hydromorphone work?

Hydromorphone works directly on opioid receptors in the central nervous system. It reduces feelings of pain by interrupting the way nerves signal pain between the brain and the body.

What is hydromorphone used for?

Hydromorphone is used for the short-term relief of severe pain, where other forms of pain relief have not been effective or cannot be used.

Because it is much more potent (stronger) than morphine, hydromorphone should be prescribed by a specialist doctor.

What forms of hydromorphone are available?

Hydromorphone comes in different dosages and forms including:

• tablets
• injections

Hydromorphone is only used in specific circumstances under specialist medical care.

What are the possible side effects of taking hydromorphone?

All opioids, including hydromorphone, can have side effects that include life-threatening breathing problems. The chance of these is higher:

• when first taking hydromorphone
• after a dosage increase
• if you are older
• if you have an existing lung problem

The side effects of hydromorphone are similar to those of other opioids, and include:

• constipation
• headache or dizziness
• fatigue or drowsiness (especially right after a dose)
• loss of appetite, nausea and vomiting

Hydromorphone affects everyone differently. If your pain is not well managed while taking hydromorphone, or if you notice your medicines are making you feel unwell, speak with your pharmacist or doctor.

Always take medicines exactly as prescribed by your doctor.

What are the risks associated with hydromorphone?

Opioids are strong pain relief medicines and can cause life-threatening breathing problems.

Hydromorphone may make you feel drowsy, and make it difficult for you to drive or operate heavy machinery. If you have recently started taking an opioid medicine, or changed the dosage, you may be more likely to have an accident. Ask your doctor if it is legal for you to drive while taking hydromorphone. Also contact your car insurer, as you may not be covered for accidents that occur while you are taking hydromorphone.

If you have kidney or liver problems, your doctor may need to adjust your dosage of hydromorphone.

There are other factors that may limit your use of hydromorphone — for example, if you:

• drink alcohol
• have breathing problems
• take other medicines that can cause drowsiness, such as benzodiazepines

Your doctor is the best person to advise you on whether hydromorphone is the right medicine for you, how much you need and how long to take it for.

Opioid tolerance and dependence

If you use opioid medicines, you may also develop tolerance. This means that you may need to take larger amounts of the opioid to get the same effect. The chance of side effects also increases with a higher dose.

People who take hydromorphone may become dependent on this medicine if they use it regularly, even if they take it exactly as prescribed and for a short time only. Your doctor will monitor how you use hydromorphone to reduce your chance of harm, including through misuse, abuse and addiction.

If you are concerned that you are becoming addicted to or dependent on hydromorphone, let your doctor know so that you can get help. You can also call the National Alcohol and Other Drug Hotline (1800 250 015) for 24/7 support and treatment information.

Opioid overdose

If you take too much hydromorphone (known as an overdose), it's important to get immediate medical attention. Overdose of opioid medicines can cause you to stop breathing.

Symptoms of overdose include:

• feeling sleepy
• difficulty breathing
• loss of consciousness
• pinpoint (very small) pupils

Access to overdose-reversing medication

Naloxone is a medicine that can temporarily reverse the effects of an opioid overdose. The Australian Government is offering this medication free of charge and without a prescription to people who may experience, or witness, an opioid overdose.

Learn more about the free Take Home Naloxone program.

How do I take hydromorphone?

It is important to follow the directions given to you by your doctor or pharmacist. Your doctor will write the recommended dosage on your prescription.

If you have been taking hydromorphone for more than a short while, it is also important not to suddenly stop taking this medicine. You should gradually reduce the amount you take, under the supervision of your doctor. This will help to reduce your chance of having withdrawal symptoms.

If you are taking hydromorphone long-term, it is important to take particular care of your teeth — hydromorphone can cause a dry mouth, which may increase the chance of dental problems such as tooth decay.

Your doctor may also recommend taking a laxative regularly, as hydromorphone can cause constipation.

How do I dispose of medicines safely?

It's important you dispose of unwanted opioid medicines safely. Unused medicines can be returned to any pharmacy. Don't keep unused hydromorphone ‘just in case', as this can lead to dangerous or inappropriate use.

Keep hydromorphone out of reach of children and pets. Never throw medicines into a garbage bin or flush them down the toilet, as this is dangerous to others and harmful to the environment.

When should I see my doctor?

If your pain is not well controlled on hydromorphone, or you have any unexpected side effects, see your doctor.

Are there any alternatives to hydromorphone?

Remember that everyone's pain is unique and different pain relief medicines will work in different circumstances. Some people's pain will respond well to non-opioid medicines. You may also find that one opioid helps you manage your pain better and with fewer side effects than another.

Hydromorphone is not the same as morphine — it is much stronger, which means it can be much more dangerous if taken inappropriately. Take care not to confuse hydromorphone with morphine.

Your doctor may prescribe hydromorphone if other pain medicines, such as morphine, are not effective or if you have side effects.

Always check with your doctor or pharmacist before making any change to the dosage or type of medicine you take.

If you have chronic (long-term) pain, your doctor might suggest lifestyle changes to help manage the discomfort. This may include:

• improving your physical fitness
• activity pacing
• social activities
• relaxation techniques
• overall health management

Find out more about options for managing chronic pain.

Resources and support

Asking about your treatment or medicine is important to help you understand your options.

Here's a guide to questions you should ask your pharmacist or doctor before taking any medicine.

See also this list of medicines that contain hydromorphone to read the Consumer Medicines Information (CMI) leaflet for the brand prescribed, or:

• Call 1300 MEDICINE (1300 633 424) to talk about the medicines you are taking for your pain.
• Discuss your pain on the Pain Link helpline (1300 340 357), which is staffed by volunteers with personal experience of chronic pain.
• Go to Painaustralia to find pain services and programs in your area.
• Learn more about prescription opioids on the Choosing Wisely

Other languages

The Alcohol and Drug Foundation has translated their guide to using medicines safely into many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

Learn more about pain management on Pain Management Network.