Dilaudid and oxycodone are prescription medications that manage severe pain. They vary in strength but have similar side effects.

Dilaudid and oxycodone are prescription opioids. Opioids are a group of strong pain-relieving drugs. These drugs lessen the strength of pain signals that reach the brain and affect your response to pain.

Dilaudid is the brand name for the generic drug hydromorphone hydrochloride. Oxycodone is the generic name and main ingredient in the brand-name drugs OxyContin and Percocet. Doctors prescribe both medications to treat severe pain when other, less potent interventions do not provide relief.

The World Health Organization (WHO) classes both Dilaudid and oxycodone as “potent opioids.” However, generic hydromorphone has a higher potency than generic oxycodone and typically has a longer duration of action.

Many medications containing oxycodone, such as Percocet, are considered “weak opioids.”

The dosing of oxycodone and Dilaudid depends on your needs, tolerability to side effects, the severity of the pain, and the drug form.

Dilaudid dosing

Dilaudid is available as an:

  • immediate-release (IR) tablet
  • IR oral solution
  • extended-release (ER) tablet
  • intravenous injection
  • suppository

IR Dilaudid is available as an oral solution or tablet. The oral solution is available in 5 milligrams (mg) or 5 milliliters (mL). The tablets are available in 2 mg, 4 mg, and 8 mg. The typical starting point for Dilaudid tablet dosing is 2–4 mg orally every 4–6 hours.

The oral solution may be taken in 2.5–10 mL doses every 3–6 hours as directed.

ER hydromorphone medications are available in 8 mg, 12 mg, 16 mg, and 32 mg and are taken once daily.

It’s also available as a 3-mg suppository taken once every 6–8 hours.

Doctors may gradually increase this dose if it fails to treat existing pain, pain severity increases, or a tolerance develops.

Oxycodone dosing

Generic oxycodone is available as an:

  • IR tablet
  • IR capsule
  • IR oral solution
  • ER tablet
  • ER capsule

IR tablets are available in 5 mg, 10 mg, 15 mg, 20 mg, and 30 mg. Capsules are available at 5 mg. The IR oral solution is available at 5 mg or 5 mL. Treatment for acute pain typically involves taking 5–15 mg every 4–6 hours.

ER tablets are available in 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, and 80 mg and are taken once every 12 hours.

ER capsules are available in 9 mg, 13.5 mg, 18 mg, 27 mg, and 36 mg and are taken once every 12 hours.

Both drugs have the potential for misuse and must only be used as prescribed. The different medications also carry specific boxed warnings.

Hydromorphone warnings

Hydromorphone comes with a black box warning on its label. This means the drug may have serious and even life threatening side effects.

Oxycodone warnings

Oxycodone can cause potentially life threatening breathing problems, especially in the first days after administration.

Drinking alcohol, taking prescription or nonprescription medications that contain alcohol, or taking illegal drugs during oxycodone treatment can increase the risk of severe complications.

Dilaudid and oxycodone have similar mechanisms of action and share many side effects, including:

Dilaudid side effects

Common side effects of Dilaudid can include:

  • lightheadedness
  • sweating
  • flushing, or reddening and warming of the skin
  • euphoria, or a feel-good effect

Oxycodone side effects

Common oxycodone side effects include:

Severe side effects

Severe, though less common, side effects include:

Get immediate medical help if you experience these symptoms. Call 911 or local emergency services.

Do not drive if you’re taking oxycodone or hydromorphone. Both drugs affect your ability to drive or use machinery. They also affect your judgment and physical skills.

Dependency and withdrawal

If you believe your pain is not being well managed with these medications, speak with your doctor right away.

If you take either drug for several weeks or months, there’s a major risk of developing a dependence. Long-term use means your body can adjust to the drug (dependence). If you suddenly stop taking it, you may experience withdrawal symptoms.

Talk with your doctor before you stop taking either medication. They can help you taper off the medication slowly, which reduces the risk of withdrawal.

Both of these drugs can also lead to overdose and are very dangerous for children. Keep your medication locked and away from any children in your household. Because hydromorphone is so potent, it could be fatal if a child takes just one ER tablet.

Both Dilaudid and oxycodone are prescription opioids. It’s essential to only take them as directed by a doctor and for the prescribed duration.

Your doctor will decide which pain medication is the right choice based on your pain symptoms and medical history.