Millions of Americans have access to various options to manage pain every day. Despite this, determining which pain reliever is most appropriate for your medical condition can be difficult. If you’re considering an opioid medication, you may be wondering about the differences between hydromorphone and hydrocodone and if one would work better for you than the other if your doctor is considering or prescribing them for pain control. There is a difference between these two medications, despite their similar opioid properties.
Before you decide whether you need this medication, you must first consider how each drug treats pain.
Patients who have moderate-to-severe acute pain after surgery may be treated with Dilaudid, the brand name for hydromorphone. It is possible to use hydrocodone long-term to treat lasting moderate-to-severe pain since it is less potent than hydromorphone.
While in the hospital, patients may receive Dilaudid, while outside the hospital, they may receive a less powerful opioid pain reliever, such as hydrocodone. Depending on your condition, your primary care physician can recommend which one to use. You will be prescribed medication based on several factors unique to your case, including:
- Diagnosis
- Medical condition
- Your age and other personal variables
- The form of the medication you take
- Your history with substance use disorders
The following is an overview of both medications and how they affect pain. Whenever you are taking medications, you should always consult your doctor and tell them if something is working or not. If you encounter uncomfortable symptoms, note them and let your doctor know.
What Is Hydromorphone?
Dilaudid is the trade name for hydromorphone, an opioid pain reliever. The medication is prescribed for the treatment of acute moderate-to-severe pain symptoms. However, Dilaudid may be prescribed to help manage the symptoms of long-term cancer treatment or other chronic illnesses causing severe pain.
Oral liquids and tablets are available in the form of hydromorphone. Extended-release tablets are also available to patients. As a powerful pain reliever, hydromorphone binds to mu-opioid receptors in the brain and stomach. As a pain reliever, hydromorphone is much stronger than hydrocodone since it is nearly five times more powerful. Because it is so potent, it is usually used to treat pain for a short time. Besides intravenous (IV) or intramuscular injections, the drug is also available in pill form to treat postoperative pain.
It is possible for hydromorphone to cause physical and psychological problems when misused, abused, or taken for too long. When misused and used for a long time, it can result in unstable moods, anxiety disorders, depression, and reckless behavior.
What Is Hydrocodone?
Hydromorphone and hydrocodone belong to the same drug class. This opioid medication is also prescribed to treat moderate-to-severe pain
and coughing. Morphine is also similar in strength to this hydromorphone. Despite its similarity to morphine, it has a shorter half-life, and sedation is a more likely side effect. A drug’s half-life is the time it takes the body to eliminate half of it from the bloodstream, which significantly reduces its effectiveness.
Hydrocodone use can lead to feelings of euphoria, relaxation, and general well-being for some people. Some people misuse this drug as a result of these sensations. Using substances and developing a substance use disorder results from such misuse.
Hydrocodone binds to opioid receptors all over the body—especially in the brain and spinal cord. This blocks pain signals from being sent and received, which allows patients with moderate-to-severe pain symptoms to find relief. The user perceives pain and discomfort differently, but the underlying cause remains the same. When the drug wears off, the pain can return.
Hydrocodone Combination Medications
A capsule containing an extended-release formulation of hydrocodone is sold under the brand name Zohydro ER. Pain relief is available for a longer time with the extended-release version.
Vicodin is a powerful drug physicians frequently prescribe. It contains hydrocodone and acetaminophen, which is a fever reducer. Norco, Lorcet, and Lortab are also trade names for this drug.
Frequent hydrocodone use can cause several health problems, including liver damage and acetaminophen toxicity.
Is Hydrocodone or Dilaudid Stronger?
Hydromorphone and hydrocodone are opioid medications that treat pain and can only be obtained legally through prescriptions. The potency of these medications differs, so doctors must determine how and if to prescribe them for pain management based on their potency.
Opioid strength is often compared to morphine, which is a naturally occurring opiate that has been used to treat pain for over a century. Hydromorphone is stronger than morphine. Hydrocodone is weaker, and it’s about on par with morphine in terms of strength.
Most opioid medications treat moderate-to-severe pain over the short term. Even those who take them for health reasons should be careful when using these drugs since they are highly addictive and habit-forming. If you experience pain symptoms, you could be prescribed hydrocodone or hydromorphone for a brief period. Depending on the person being treated, each case is different.
When used as directed by a doctor, drugs in this class are relatively safe when taken as part of short-term therapeutic treatment. The problem is they are highly addictive and can be abused if they fall into the wrong hands.
The Side Effects of Hydrocodone and Hydromorphone
Hydrocodone and hydromorphone’s side effects are similar to those of any other drug, so users should consider them carefully before taking them for pain management. You may be able to figure out which one would be best for you by comparing their side effects, but you should always consult a doctor before taking a new medication.
Hydromorphone Side Effects
Hydromorphone use is associated with several side effects, including:
- Dizziness
- Lightheadedness
- Low blood pressure
- Headache
- Flushed skin
- Itching
- Nausea
- Vomiting
- Constipation
- Red eyes
- Dry mouth
- Sweating
Try to avoid driving or operating any heavy machinery while using hydromorphone because it is stronger than morphine and causes sedation. If side effects are mild, they may only last a short time. Call your doctor if they persist.
Contact your doctor immediately if you experience other serious side effects of hydromorphone. In addition to the heart, eyes, and stomach, they can affect other parts of the body as well and cause:
- Blood pressure changes
- Muscle weakness
- Irregular heart rate
- Racing pulse
- Chest pain
- Headache
- Nausea and vomiting
- Bowel blockage
- Double or blurry vision
- Tremors
- Stomach pain
- Constipation
- Mood or behavior changes
- Agitation
- Hallucinations
- Confused state (disorientation)
- Anxiety, depression
Hydrocodone Side Effects
Many side effects are associated with hydrocodone use, including:
- Stomach pain
- Swollen feet, legs, or ankles
- Tremors (uncontrollable shaking)
- Tiredness or fatigue
- Cold symptoms
- Headaches
- Dizziness
- Drowsiness
- Nausea and vomiting
- Constipation
- Appetite changes
- Dry mouth
- Difficult, frequent, or painful urination
- Ear ringing
- Back pain
- Muscle tension or tightening
- Trouble falling or staying asleep
Hydrocodone use can lead to more severe side effects. If you experience any of the following symptoms, see a doctor:
- Stiffness
- Twitching
- Rapid heart rate
- Slowed or irregular heartbeat
- Coordination loss
- Nausea, vomiting, diarrhea
- Sweating
- Shivering
- Agitation
- Hallucinations
- Having trouble urinating
You should call your doctor if, after stopping hydrocodone, you notice your breathing has changed, such as noisy breathing, shallow breathing, or breathing that stops when sleeping. You should stop using hydrocodone immediately if you have broken out in hives or rashes due to an allergic reaction. Symptoms such as fainting, a slow heart rate, or a weak pulse also indicate you should stop using the medication.
You should stop using hydrocodone if you notice any of the following signs:
- Confusion
- Severe sleepiness
- Worsening tiredness
- Muscle weakness
When taking hydromorphone or hydrocodone, not everyone will experience the same side effects. It may be possible for some users to experience none at all. You should still stay on the lookout for side effects by checking the label and talking to your physician about what you can expect.
You should discuss any symptoms or signs you are concerned about with your doctor. Depending on your specific condition, they may adjust the dosage or switch you to another medication. Additionally, they can advise you on how to manage side effects.
Use Opioid Pain Relievers with Care
Drugs like hydromorphone and hydrocodone are habit-forming and have a high potential for addiction. Despite having proper prescriptions for them, people can still become physically or psychologically dependent on opioids.
There are consequences to abusing hydrocodone and hydromorphone. The following are examples of abuse:
- Not having a legitimate prescription for the medication
- Taking more than what is prescribed
- Taking the medication too often
- Combining them with other drugs, like opioids and alcohol
- Using them to achieve a high
If your pain medication isn’t working as well as it once did, or if it isn’t working at all, contact your doctor immediately. Withdrawal symptoms could happen if you stop taking your medication abruptly, but you could become dependent and addicted if you take more than prescribed.
Drug rehabilitation programs that address opioid addiction with evidence-based treatments are the best option if you are abusing pain medications and having trouble quitting.
