Hydromorphone

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Hydromorphone is a very strong pain reliever (opioid analgesic). It is a derivative of morphine - another very pain-relieving ingredient in opium (the dried milky sap of the opium poppy). Hydromorphone is used in medicine for severe and extremely severe pain conditions (such as cancer patients). Read more about the use, effects and side effects of hydromorphone!

This is how hydromorphone works

Hydromorphone has a strong analgesic effect by blocking opioid receptors in the brain. Its analgesic potency is 7.5 times stronger than that of morphine, from which it is derived.

In addition to pain relief, the receptor blockade also has other effects. Hydromorphone has a respiratory depressive effect (i.e., breathing is reduced), sedative (dampening) and antitussive (cough suppressant).

Hydromorphone uptake, breakdown and excretion

The active ingredient can be taken orally as a capsule or administered directly into the bloodstream (as an injection / infusion). The effects set in after one to two hours (oral use) or after ten to 20 minutes (intravenous use). The pain reliever is metabolized in the liver and mainly excreted in the urine. About 2.6 hours after administration, half of the active ingredient left the body (half-life).

When is hydromorphone used?

Hydromorphine is used to relieve severe and extremely severe pain. Such pain can be triggered, for example, by tumors or after operations.

This is how hydromorphone is used

The dosage of the pain reliever depends on the type and severity of the pain, the individual response of the patient to the active substance, his state of health (liver and kidney function) and his age or body weight. Use and dosage are carefully monitored because hydromorphone can be addictive, among other things.

What are the side effects of hydromorphone?

Occasional hydromorphone side effects include nausea and vomiting, spasms of the smooth muscles (such as the bile ducts, bronchi, and bladder), confusion, dizziness, headache, decreased breathing (respiratory depression), sedation (depression), and constipation.

Some patients experience constriction of the pupils (miosis), euphoria, and changes in heart rate and blood pressure. The pain reliever can also be addictive.

What should be considered when using hydromorphone?

Absolute contraindications: Anyone who is allergic to the active ingredient or has an intestinal obstruction (ileus) must not receive hydromorphone under any circumstances. The same applies if someone has taken MAO-type antidepressants in the previous 14 days.

In the following cases, the pain reliever may only be given if the expected benefit outweighs the potential risks (relative contraindications):

Opioid addiction
Breathing problems (respiratory failure, respiratory drive disorder)
low blood pressure with low blood volume
enlarged prostate (prostatic hyperplasia) with residual urine
inflammatory bowel disease, which is the narrowing (obstruction) of the bowel
Inflammation of the pancreas (pancreatitis)

In addition, children under the age of twelve are not allowed to receive oral hydromorphone supplements. The pain reliever should not be administered intravenously to children under one year of age.

Interactions

Hydromorphone can interact with other active substances taken at the same time. The simultaneous intake of central depressant drugs (such as anesthetics, antidepressants, etc.) can increase the respiratory depressive, sedative and blood pressure lowering effect of hydromorphone.

In combination with parasympatholytic drugs, intestinal paralysis (paralytic ileus) can develop. Parasymaptholytics include, for example, agents against irritable bladder and asthma.

Medicines that put a strain on the liver metabolism can inhibit the breakdown of hydromorphone and thereby increase its concentration in the blood.

pregnancy and breast feeding period

If possible, hydromorphone should not be given during pregnancy and breastfeeding - only if the expected benefit for the mother is greater than the risk for the child. However, a short-term / one-time application seems to be justifiable.