Dilaudid vs. Oxycodone Differences and Similarities

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

Dilaudid vs. Oxycodone

What are Dilaudid and oxycodone?

Dilaudid (hydromorphone hydrochloride) is an opioid narcotic pain reliever similar to oxycodone, morphine, methadone, fentanyl, and other opioids. Hydromorphone, like other opioids, stimulates receptors on nerves in the brain to increase the threshold to pain and reduce the perception of pain.

Oxycodone is a strong opioid (narcotic) pain reliever and cough suppressant similar to morphine, codeine, and hydrocodone. The mechanism of action of oxycodone is not known but may involve stimulation of opioid receptors in the brain. Oxycodone decreases discomfort by increasing the tolerance to pain. Oxycodone also causes sedation and drowsiness, and depresses breathing.

What are the side effects of Dilaudid and oxycodone

Dilaudid Warning

  • Dilaudid-HP Injection should not be confused with other types of Dilaudid injections or other opioids, as overdose and death could result.
  • Avoid dosing errors from confusion between mg and mL when dispensing, prescribing, or administering the oral solution. Dosing errors can result in accidental overdose and death.
  • Hydromorphone exposes patients to risks of addictions, abuse, and misuse, which can lead to overdose and death.
  • Patients should be monitored closely because serious, life-threatening, or fatal respiratory depression may occur.
  • Prolonged use of hydromorphone during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. Pregnant woman should be advised of the risk of neonatal opioid withdrawal syndrome and appropriate treatment should be available.
  • Combining opioids with benzodiazepines, alcohol, or other central nervous system (CNS) depressants may result in severe sedation, respiratory depression, coma, and death.

Dilaudid Side Effects

Common side effects

Other serious side effects

  • Other serious and important side effects of hydromorphone are respiratory depression and trouble breathing.
  • Since hydromorphone is a controlled narcotic, it carries a box warning of respiratory depression and abuse potential. Use with alcohol or other medications affecting central nervous system can worsen respiratory depression and may lead to death.

Oxycodone side effects

The most frequent side effects of oxycodone include:

Other side effects of oxycodone include:

Oxycodone is used with caution in the elderly, debilitated patients, and in patients with serious lung disease because it can depress breathing.

Oxycodone can impair thinking and the physical abilities required for driving or operating machinery.

Oxycodone is habit forming. Mental and physical dependence can occur but are unlikely when used for short-term pain relief. If oxycodone is suddenly withdrawn after prolonged use, symptoms of withdrawal may develop. The dose of oxycodone should be gradually reduced in order to avoid withdrawal symptoms.

What is the dosage for Dilaudid vs. oxycodone?

Dilaudid dosage

  • The usual starting dose using immediate release oxycodone tablets is 5 to 30 mg every 4 to 6 hours. Patients who have never received opioids should start with 5-15 mg every 4 to 6 hours. Some patients may require 30 mg or more every 4 hours.
  • The usual starting dose using extended release tablets is 10 mg every 12 hours. Extended release tablets are used when around the clock treatment is required for an extended period of time. Extended release tablets should not be broken, crushed or chewed but should be swallowed whole. Braking, crushing or chewing extended release tablets may lead to rapid absorption of the drug and dangerous levels of oxycodone.
  • The 60 and 80 tablets or single doses greater than 40 mg should only be used by patients who have been using opioids and have become tolerant to opioid therapy. Administration of large doses to opioid-naïve patients may lead to profound depression of breathing.
  • The usual adult dose of the oral concentrate (20 mg/ml) is 5 mg every 6 hours.
  • The usual adult dose for the oral solution (5 mg/5 ml) is 10-30 mg every 4 hours.
  • Safe and effective use of hydromorphone in children has not been established.

Oxycodone dosage

  • The usual starting dose using immediate release oxycodone tablets is 5 to 30 mg every 4 to 6 hours. Patients who have never received opioids should start with 5-15 mg every 4 to 6 hours. Some patients may require 30 mg or more every 4 hours.
  • The usual starting dose using extended release tablets is 10 mg every 12 hours. Extended release tablets are used when around the clock treatment is required for an extended period of time. Extended release tablets should not be broken, crushed or chewed but should be swallowed whole. Braking, crushing or chewing extended release tablets may lead to rapid absorption of the drug and dangerous levels of oxycodone.
  • The 60 and 80 tablets or single doses greater than 40 mg should only be used by patients who have been using opioids and have become tolerant to opioid therapy. Administration of large doses to opioid-naïve patients may lead to profound depression of breathing.
  • The usual adult dose of the oral concentrate (20 mg/ml) is 5 mg every 6 hours.
  • The usual adult dose for the oral solution (5 mg/5 ml) is 10-30 mg every 4 hours.

What drugs interact with Dilaudid and oxycodone?

Dilaudid

Hydromorphone should be used very cautiously with medications that depress the central nervous system (for example, hypnotics, anesthetics, tranquilizers, phenothiazines, and alcohol).

Hydromorphone should be used with caution with mixed agonist/antagonist opioid analgesics (for example, pentazocine, nalbuphine, butorphanol, and buprenorphine) because it may take away the analgesic effect of hydromorphone.

Oxycodone

  • Oxycodone, like other narcotic pain-relievers, increases the effects of drugs that slow brain function, such as:
  • Combined use of the above drugs and oxycodone may lead to increased respiratory depression.
  • Oxycodone should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane) or other drugs that inhibit monoamine oxidase, for example, linezolid (Zyvox). Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. Oxycodone should not be administered within 14 days of stopping an MAOI.
  • Since oxycodone causes constipation, the use of antidiarrheals, for example, diphenoxylate and atropine (Lomotil) and loperamide (Imodium), in persons taking oxycodone, can lead to severe constipation.
  • Drugs which stimulate and also block opioid receptors for example, pentazocine, nalbuphine (Nubain), butorphanol (Stadol), and buprenorphine (Subutex) may reduce the effect of oxycodone and may precipitate withdrawal symptoms.
  • Combining oxycodone with drugs that affect activity of certain liver enzymes or discontinuing such drugs may result in fatal oxycodone overdose.
  • A fatty meal may increase the absorption of oxycodone by 27%.

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Are Dilaudid or oxycodone safe to use while pregnant or breastfeeding?

Dilaudid

  • There are no adequate studies of hydromorphone to determine safe and effective use in pregnant women.
  • Low levels of opioid medications may be excreted in breast milk; therefore, it should not be used in nursing mothers.

Oxycodone

  • Safety during pregnancy has not been established. Children born to mothers who were taking oxycodone for a prolonged period may exhibit respiratory depression or withdrawal symptoms.
  • Small amounts of oxycodone are secreted in breast milk and may cause side effects in the newborn.

Summary

Dilaudid (hydromorphone hydrochloride) and Oxycontin (oxycodone) are both opioid narcotic pain relievers. Side effects of both Dilaudid and oxycodone are similar and both are potentially addictive and causes withdrawal symptoms. Learn all the side effects, dosages, and pregnancy safety information before using this drug.

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Medically Reviewed on 12/7/2018
References
Medically reviewed by John P. Cunha, DO, FACOEP; Board Certified Emergency Medicine

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