Pain is challenging for many people dealing with injuries, surgeries, and diseases. Millions of Americans can manage their pain every day by choosing from various options. But pain relievers can be difficult to choose depending on one’s medical condition. Hydromorphone and hydrocodone are both prescription opioids used to treat pain symptoms.
Since these drugs are so similar, you wonder what the difference is between hydromorphone and hydrocodone and whether one would be better for you if prescribed by your doctor. The two medications are similar in name, and both are opioids, but they are not the same. When considering prescription medications with your doctor, you have several considerations to make. In many cases, it requires a trial-and-error process.
But what is the difference between Dilaudid and hydrocodone, and which is the stronger option?
The following is an overview of both medications and how they treat pain. Any prescription drugs you are taking need to be discussed with your doctor, and if they are not working, your doctor should be aware.
What Is Dilaudid?
Dilaudid is a brand name for hydromorphone, a widely used opioid pain reliever. It’s primarily used to treat moderate to severe pain symptoms that you may experience after an injury or surgical procedure. As a pain reliever, Dilaudid may be prescribed to patients with cancer or other long-term illnesses causing severe pain.
Oral liquids and tablets of hydromorphone are available. It is also possible to administer an extended-release tablet form to patients. Dilaudid works by binding to mu-opioid receptors in the brain and body, causing strong pain-relieving effects.
As a pain reliever, hydromorphone is about five times stronger than morphine, making it considerably stronger than hydrocodone. For this reason, the drug is usually reserved for the short-term treatment of severe pain symptoms rather than long-term therapeutic use. The drug can also be administered intravenously (IV), intramuscularly, or taken as a pill to treat post-surgery pain.
Hydromorphone can cause some side effects, especially when it’s abused. Dilaudid abuse can cause physical and psychological problems. Misuse and prolonged use can result in unstable moods, anxiety, depression, reckless, unpredictable behavior, chemical dependence, and addiction. High doses can cause a potentially dangerous overdose.
What Is Hydrocodone?
Hydromorphone and hydrocodone belong to the same drug class. Hydrocodone is a potent opioid medication that is able to treat severe pain and is sometimes used to treat coughs. Its strength level is similar to morphine.
In spite of its similarity to morphine, the half-life of this drug is shorter. “Half-life” refers to how long it takes the body to remove half of the drug’s original concentration from your blood. Half-life is often used as a metric for how long you will feel the drug’s effects.
Hydrocodone users report feelings of euphoria, relaxation, and a general sense of well-being after taking it. Some people also misuse the drug because of these effects. Misusing or recreationally abusing the drug can lead to chemical dependence and addiction.
When hydrocodone binds to the body’s pain receptors in the central nervous system, it helps patients feel better and rest. It specifically binds to receptors in the brain and spinal cord, where it blocks pain signals from being sent and received by neurons.
The patient’s perception of pain and discomfort is altered and alleviated, but the source of their pain remains the same if it is left untreated.
Hydrocodone is often combined with other drugs in specific formulations to add effects to the prescription or to enhance pain-relieving effects.
Hydrocodone with no other active ingredients is sold as an extended-release capsule under the brand name prescription Zohydro ER. Compared to the regular version, the extended-release version provides pain relief that can last for a longer period.
Vicodin is a frequently prescribed powerful drug containing hydrocodone and acetaminophen for its use as a fever reducer, according to the Drug Enforcement Administration (DEA). Norco, Lorcet, and Lortab are also trade names for drugs that contain hydrocodone.
It is possible to develop acetaminophen toxicity and liver damage if combination forms of hydrocodone are misused and abused frequently.
How Are Hydrocodone and Dilaudid Different?
Hydromorphone (Dilaudid) is used to treat moderate-to-severe pain symptoms, such as pain following surgery or an injury. Due to its lower potency than hydromorphone, hydrocodone may be used long-term to treat chronic severe pain that lingers beyond just a few days.
When a patient is under medical supervision in the hospital, they may receive Dilaudid and be given a weaker prescription opioid pain reliever, such as hydrocodone, to treat their pain outside of the hospital.
You can discuss which one you should use with your primary care physician. You will be prescribed medication based on multiple factors specific to your situation, including:
- Your specific condition
- Age and other personal medical information
- Other medications you are taking
- Your history with the medication
Hydrocodone and Dilaudid: Which Is Stronger?
The opioid painkillers hydromorphone and hydrocodone are available legally only by prescription. Doctors must determine whether and how to prescribe them for pain management based on your specific needs.
A stronger opioid than morphine, hydromorphone treats acute and chronic pain, while hydrocodone is a weaker opioid that is similar in strength to morphine.
In general, opioid medications are used to treat short-term moderate-to-severe pain. All users, even those who take them for health reasons, should be cautious when using them because they are highly addictive and habit-forming. However, some diseases and injuries can lead to chronic pain issues, which can be challenging to treat effectively.
Both of these drugs are typically reserved for short-term use. Nevertheless, each case is unique because it is dependent on the individual.
When taken as directed by a doctor, drugs in this class are generally safe to use during short-term treatment. But when they are used for too long, misused, or abused, they can be highly addictive.
Comparing the Side Effects of Hydrocodone and Hydromorphone
Like all drugs, hydrocodone and hydromorphone both have side effects that should be taken into consideration before using them for pain relief. Comparing these side effects can help you determine which one would be best for you.
Hydrocodone Side Effects
According to MedlinePlus, the following side effects of hydrocodone include:
- Fatigue or tiredness
- Cold symptoms (sore throat, sneezing, stuffy nose)
- Trouble falling or staying asleep
- Dry mouth
- Back pain
- Ear ringing (also known as tinnitus)
- Appetite changes
- Stomach pain
- Difficult, frequent, or painful urination
- Swollen feet, legs, or ankles
- Muscle tension or tightening
- Tremors (uncontrollable shaking)
Hydrocodone can produce more serious side effects. Contact a doctor if you experience:
- Nausea and vomiting
- Slowed or irregular heartbeat
- Rapid heart rate
- Coordination loss
- Having trouble urinating or making bowel movements
If you stop using hydrocodone and notice changes in your breathing, such as noisy breathing, shallow breathing or sighing, or if you stop breathing when sleeping, call your doctor. Other signs of stopping hydrocodone use include:
- Allergic reaction (breaking out in hives or a rash)
- Worsening tiredness or weakness
- Severe sleepiness
Side effects will vary from person to person. Some users may not experience any symptoms. But, understanding the potential side effects can keep you aware of what to look out for if you do experience them. You should talk to your doctor if you notice any side effects that you’re concerned about. Your doctor can either adjust your dosage or switch you to a different medication.
Hydromorphone Side Effects
The side effects of hydromorphone include:
- Red eyes
- Dry mouth
- Nausea and vomiting
- Low blood pressure
- Flushed skin
Hydromorphone is a very potent sedative, so you should avoid driving or operating any machinery while using it. The side effects can be temporary and mild, but you should call your doctor if they linger. Other side effects are more dangerous and require immediate treatment:
- Confused state (disorientation)
- Anxiety and depression
- Mood or behavior changes
- Double or blurry vision
- Stomach pain
- Bowel blockages
- Nausea and vomiting
- Muscle weakness
- Blood pressure changes
- Racing pulse
- Fast or slow heart rate
- Chest pain
- Tremors (uncontrolled muscle movements)
Use Hydrocodone and Dilaudid with Care
There is a high potential and risk of addiction to hydromorphone and hydrocodone. Physical or psychological dependence can still occur even in people with proper prescriptions. Misusing either of these drugs or abusing them as recreational substances can have serious consequences.
Drug Abuse Can Include Any of the Following:
- Taking the medications without a prescription
- Taking more than what is prescribed
- Taking the medication more often than you should
- Taking them with other drugs like alcohol, depressants, and other opioids
- Using them recreationally
Let your doctor know if your pain medication is no longer working or working less effectively than before. It’s possible to experience uncomfortable and dangerous withdrawal symptoms if you suddenly stop taking your medication. Do not take more of your medication than what is prescribed because it could risk dependence and addiction.
Consider entering a drug rehabilitation program that addresses opioid addiction with evidence-based treatment if you are abusing pain medications and have a hard time quitting.