If you have severe pain and haven’t found relief with certain medications, you may have other options. For example, Dilaudid and morphine are two prescription drugs used to treat pain after other medications haven’t worked.
Dilaudid is the brand-name version of the generic drug hydromorphone. Morphine is a generic drug. They work in similar ways, but they also have a few notable differences. Compare the two drugs here to learn if one may be a good option for you.
Both medications belong to a class of drugs called opioid analgesics, also known as narcotics. They work on the opioid receptors in your nervous system. This action changes the way you perceive pain to help you to feel less pain.
Hydromorphone and morphine each come in several forms and strengths. The oral forms (taken by mouth) are most commonly used. All forms can be used at home, but injectable forms are more often used in the hospital.
Both drugs can cause severe side effects and can be addictive, so you should take them exactly as prescribed. If you’re taking more than one pain medication, be sure to follow the dosage instructions for each drug carefully so you don’t mix them up. If you have questions about how to take your medications, ask your doctor or pharmacist.
The chart below further describes the features of both medications.
|What are brand names for this drug?||Dilaudid, Exalgo||Kadian, Duramorph PF, DepoDur, Infumorph, Morphabond, MS Contin|
|Is a generic version available?||yes||yes|
|What does this drug treat?||pain||pain|
|What is the typical length of treatment?||decided by your doctor||decided by your doctor|
|How do I store this drug?||at room temperature*||at room temperature*|
|Is this a controlled substance?**||yes||yes|
|Is there a risk of withdrawal with this drug?||yes†||yes†|
|Does this drug have potential for misuse?||yes¥||yes¥|
* Check the package instructions or your doctor’s prescription for exact temperature ranges.
** A controlled substance is a drug that is regulated by the government. If you take a controlled substance, your doctor must closely supervise your use of the drug. Never give a controlled substance to anyone else.
† If you’ve been taking this drug for longer than a few weeks, don’t stop taking it without talking to your doctor. You’ll need to taper off the drug slowly to avoid withdrawal symptoms such as anxiety, sweating, nausea, and trouble sleeping.
¥ This drug has a high misuse potential. This means you can get addicted to it. Be sure to take this drug exactly as your doctor tells you to. If you have questions or concerns, talk with your doctor.
A key difference between these drugs is the forms they come in. The table below lists the forms of each drug.
|intramuscular injection||not recommended||X|
|immediate-release oral tablet||X||X|
|extended-release oral tablet||X||X|
|extended-release oral capsule||X|
|oral solution concentrate||X|
Cost, availability, and insurance
All forms of hydromorphone and morphine are available at most pharmacies. However, it’s best to call your pharmacy ahead of time to make sure they have your prescription in stock.
In most cases, generic forms of drugs cost less than brand-name products. Morphine and hydromorphone are generic drugs. At the time this article was written, hydromorphone and of morphine had similar prices, according to GoodRx.com. The brand-name drugs Dilaudid and Exalgo were more expensive than the generic forms of morphine. In any case, your out-of-pocket cost will depend on your health insurance coverage.
Hydromorphone and morphine work similarly in your body. They also share similar side effects.
The chart below lists examples of side effects of hydromorphone and morphine.
|dizziness||trouble falling asleep or staying asleep||diarrhea|
|nausea||muscle, back, or joint pain||weakness|
|stomach pain and cramps||depression||nervousness|
|loss of appetite||flushing (reddening and warming of your skin)||confusion|
|dry mouth||lightheadedness when changing positions||small pupils|
|sweating||difficulty or pain when urinating|
|swelling of your eyes, face, mouth, lips or throat||itching|
|rash||blue or purple skin|
|hives||heart rate changes|
|trouble breathing or swallowing|
Interactions with either drug
Hydromorphone and morphine are narcotics that work in the same way, so their drug interactions are also similar. Interactions for both drugs include the following:
Using hydromorphone or morphine with one of these drugs raises your risk of severe constipation and not being able to urinate.
Monoamine oxidase inhibitors
You shouldn’t take hydromorphone or morphine within 14 days of taking a monoamine oxidase inhibitor (MAOI). Taking either drug with an MAOI or within 14 days of using an MAOI can cause:
- breathing problems
- low blood pressure
- extreme tiredness
Other pain medications, phenothiazines (mental health drugs), tranquilizers, and sleeping pills
Mixing hydromorphone or morphine with any of these drugs may cause breathing problems, low blood pressure, extreme tiredness, or coma. You should talk to your doctor before using hydromorphone or morphine with any of these drugs.
Interactions with morphine only
Morphine also interacts with other drugs. For example, taking morphine with a diuretic may decrease how well your diuretic works. Morphine can also increase your risk of bleeding when used with blood thinners such as warfarin. Skeletal muscle relaxants, cimetidine (a heartburn drug), and drugs that block the enzyme P-Glycoprotein, such as atorvastatin, erythromycin, and ketoconazole, can all cause trouble breathing if you take any of them with morphine.
with other medical conditions
If you have certain health issues, they may change how hydromorphone and morphine work in your body. It may not be safe for you to take these drugs, or your doctor may need to monitor you more closely during your treatment.
You should talk to your doctor before taking hydromorphone or morphine if you have breathing problems such as chronic pulmonary disease (COPD) or cor pulmonale. These drugs have been linked with serious breathing problems that can cause death.
You should also talk about your safety if you have a history of drug abuse or addiction. These drugs can be addictive and increase your risk of overdose and death.
Examples of other medical conditions you should discuss with your doctor before taking hydromorphone or morphine include:
- biliary tract problems
- kidney issues
- liver disease
- a history of head injury
- low blood pressure
- gastrointestinal obstruction, especially if you have paralytic ileus
Also, if you have an abnormal heart rhythm, talk to your doctor before using morphine. It may make your condition worse.
with your doctor
Both hydromorphone and morphine are very strong pain medications. They work in similar ways and have a lot in common, but they do have slight differences in forms, dosage, and side effects. Morphine also interacts with more drugs than hydromorphone does.
If you have questions about these drugs, talk with your doctor. They can answer your questions and select the drug that’s best for you based on your health, current medications, and other factors.