Hydromorphone Side Effects

General Information

This drug, like all medicine, has the potential to cause side effects. Many people experience no, or minor, side effects from taking this medication. Most side effects are not serious and disappear after a few days. A few side effects are serious and require the attention of a medical professional.

Manufacturers offer hydromorphone under the brand name Dilaudid. Manufacturers voluntarily pulled one extended-release form of hydromorphone, Palladone, from the market just six months after its introduction. In 2005, the FDA issued a statement that alerted consumers to the potentially fatal result of mixing Palladone with even one alcoholic drink. Alcohol harms the extended-release mechanism in Pallodone, causing the rapid release of hydromorphone, a phenomenon doctors call "dose dumping."

The adverse reactions to hydromorphone are typical of other opioids. These side effects usually decrease in intensity or stop altogether with continued use at proper doses. The most serious side effect is respiratory depression potentially leading to stopped breathing, circulatory depression, dangerously low blood pressure and shock. Respiratory depression is a condition where the lungs do not adequately exchange oxygen and carbon dioxide, characterized by slow or shallow breathing. Physicians should expect side effects and treat patients accordingly.

Side effects associated with hydromorphone may require medical treatment. According to the Drug Enforcement Agency, or DEA, emergency department visits for hydromorphone increased from fewer than 4,000 in 2004 to more than 13,000 in 2008.

Respiratory depression and apnea are the most serious hazard associated with hydromorphone tablets. Circulatory depression, respiratory arrest, shock and cardiac arrest have also occurred.

The most frequent side effects are light-headedness, dizziness, sedation, nausea, vomiting, sweating, flushing, sadness, euphoria, dry mouth and itch. These side effects are more prominent for ambulatory patients and those who are not in severe pain.

Abuse and Physical Dependence

Potential for abuse, physical dependence or addiction are possible side effects from taking this drug. The U.S. Drug Enforcement Agency, or DEA, classifies substances according to the potential for abuse. The DEA has classified this drug as a Schedule II narcotic, which means it carries a high potential for abuse and mental or physical dependence.

Physical dependence means a user will suffer withdrawal symptoms after the level of hydromorphone drops in his system, because either he has stopped taking opioids or he has taken a medication that reduces the amount of hydromorphone in his system rapidly. Withdrawal symptoms include:

  • Abdominal Cramps
  • Agitation
  • Anxiety
  • Blurred Vision
  • Insomnia
  • Restlessness
  • Sweating
  • Tremor
  • Vomiting

Some side effects can result in dangerous complications. The individual may vomit and inhale stomach contents, a complication known as aspiration. Excessive vomiting and diarrhea may result in dehydration.

Common Side Effects

The most common side effects associated with hydromorphone are not serious and disappear after taking this drug as directed for a few days. Common side effects vary slightly between various hydromorphone preparations. Continue taking hydromorphone but contact the doctor who prescribed hydromorphone if common side effects become intolerable or if they do not go away on their own.

Common side effects associated with hydromorphone, hydromorphone tablets, hydromorphone liquid, hydromorphone suppositories and hydromorphone high-potency include:

  • Constipation
  • Dizziness or Lightheadedness
  • Drowsiness
  • Dry Mouth
  • Flushing
  • Nausea or Vomiting
  • Sweating

Common side effects associated with hydromorphone extended release:

  • Constipation
  • Dizziness or Lightheadedness
  • Drowsiness
  • Fatigue
  • Headache
  • Lightheadedness
  • Nausea or Vomiting

Common side effects associated with hydromorphone extended-release capsules:

  • Constipation
  • Drowsiness
  • Dry Mouth
  • General Body Discomfort
  • Headache
  • Infection
  • Itching
  • Sleepiness
  • Sweating
  • Vomiting
  • Weakness

Serious Side Effects

Some side effects associated with hydromorphone are serious, requiring immediate medical attention. Serious side effects vary slightly between different hydromorphone formulas. Stop taking this medication immediately and contact a doctor if you experience serious side effects.

Serious side effects of hydromorphone, hydromorphone tablets, hydromorphone liquid, hydromorphone suppositories and hydromorphone high-potency

  • Fainting
  • Fast, Slow or Irregular Heartbeat
  • Hallucinations
  • Mental or Mood Changes
  • Seizure
  • Severe or Persistent Dizziness or Drowsiness
  • Severe or Persistent Headache or Vomiting
  • Shallow, Slowed or Difficult Breathing
  • Tremor
  • Trouble Urinating
  • Vision Changes

Serious side effects associated with hydromorphone extended-release:

  • Chest Pain
  • Confusion
  • Fainting
  • Fast, Slow or Irregular Heartbeat
  • Hallucinations
  • Mental or Mood Changes
  • Seizure
  • Severe or Persistent Constipation
  • Stomach Pain or Vomiting
  • Severe or Persistent Dizziness, Drowsiness or Headache
  • Shallow, Slowed or Difficult Breathing
  • Stomach Swelling
  • Tremor
  • Trouble Urinating
  • Vision Changes

Serious side effects associated with hydromorphone extended-release capsules:

  • Fast or Irregular Heartbeat
  • Feeling Faint or Dizzy
  • Hallucinations
  • Pounding In The Chest
  • Seizure

By body system Nervous system Hydromorphone may cause respiratory depression, which can be fatal. Hydromorphone is associated with nervous system side effects such as agitation, sadness, mental depression, stupor, extreme confusion and extreme sleepiness. Other nervous system side effects include increased pressure inside the skull or muscle twitches. Opioids such as hydromorphone may cause psychotic symptoms in some individuals. Cardiovascular Cardiovascular side effects have occurred only rarely in consumers of hydromorphone. Those rare occurrences of cardiovascular side effects have included low blood pressure, shock and irregular heartbeat.

Gastrointestinal Gastrointestinal side effects include constipation, nausea, vomiting and dry mouth. Hydromorphone may also cause spasms of the biliary tract, which includes the liver, gall bladder and pancreas.

Dermatologic Hydromorphone may rarely affect the skin. Dermatologic side effects include rashes and systemic contact dermatitis, a condition that causes widespread itching and inflammation of the skin. Opioids such as hydromorphone may stimulate the release of histamines to cause these rashes.

Local Local irritation may appear at the site of hydromorphone injection. These side effects include redness, swelling and pain near the injection site. Authorities report two cases of fatal neurological events following intravenous injection of hydromorphone by known IV drug users. The first individual injected two melted hydromorphone suppositories into the right arm and suffered a stroke. The second person injected ground hydromorphone tablets; this individual came to doctors unable to speak and later died.

Genitourinary Hydromorphone may cause genitourinary side effects including urinary retention.