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 healthcare provider or pharmacist.

The chart below further describes the features of both medications.

Hydromorphone Morphine
What are brand names for this drug?DilaudidKadian, Duramorph PF, Infumorph, Morphabond ER, Mitigo
Is a generic version available?yesyes
What does this drug treat?painpain
What is the typical length of treatment?decided by your healthcare providerdecided by your healthcare provider
How do I store this drug?at room temperature* at room temperature*
Is this a controlled substance?**yesyes
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 healthcare provider’s prescription for exact temperature ranges.

** A controlled substance is a drug that’s regulated by the government. If you take a controlled substance, your healthcare provider 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 healthcare provider. You’ll need to taper off the drug slowly to avoid withdrawal symptoms such as anxiety, sweating, nausea, diarrhea, 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 healthcare provider tells you to. If you have questions or concerns, talk with your healthcare provider.

A key difference between these drugs is the forms they come in. The table below lists the forms of each drug.

FormHydromorphoneMorphine
subcutaneous injectionX
intravenous injectionXX
intramuscular injectionXX
immediate-release oral tabletXX
extended-release oral tabletXX
extended-release oral capsuleX
oral solutionXX
oral solution concentrate X
rectal suppository***

*These forms are available but not FDA-approved.

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 drug Dilaudid was more expensive than the generic forms of morphine. In any case, your out-of-pocket cost will depend on your health insurance coverage, your pharmacy, and your dose.

Hydromorphone and morphine work similarly in your body. They also share similar side effects.

The chart below lists examples of more common side effects of hydromorphone and morphine.

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Both drugsHydromorphoneMorphine
dizzinessdepressionSame common side effects as for both drugs
drowsinesselevated mood
nauseaitchiness
vomitingflushing (reddening and warming of your skin)
lightheadednessdry mouth
sweating
constipation

Each drug can also cause respiratory depression (slow and shallow breathing). If taken on a routine basis, they each can also cause dependence (where you need to take a drug in order to feel normal).

Here are several drug interactions and their effects.

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:

Anticholinergics

Using hydromorphone or morphine with one of these drugs raises your risk for 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:

Other pain medications, certain antipsychotic drugs, anxiety drugs, and sleeping pills

Mixing hydromorphone or morphine with any of these drugs may cause:

  • breathing problems
  • low blood pressure
  • extreme tiredness
  • coma

You should talk to your healthcare provider before using hydromorphone or morphine with any of these drugs.

Each drug may have other drug interactions that can increase your risk for serious side effects. Be sure to tell your healthcare provider about all prescription drugs and over-the-counter products that you’re taking.

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 healthcare provider may need to monitor you more closely during your treatment.

You should talk to your healthcare provider before taking hydromorphone or morphine if you have breathing problems such as chronic obstructive pulmonary disease (COPD) or asthma. 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 healthcare provider before taking hydromorphone or morphine include:

Also, if you have an abnormal heart rhythm, talk to your healthcare provider before using morphine. It may make your condition worse.

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
  • side effects

If you have questions about these drugs, talk with your healthcare provider.

They can answer your questions and select the drug that’s best for you based on:

  • your health
  • current medications
  • other factors