can anyone provide their experience/insight/opinion to how 4 mg of hydromorphone compares to 10/325 of hydrocodone?

thank you

Hydromorphone is 4 times stronger according to one chart, so you'd need 16mg hydrocodone to equal 4mg hydromorphone. They have an equal duration of action, but hydromorphone acts quicker, all other things being equal.

Sources may vary.

thanks!

I'd have thought that hydromorphone is more than four times stronger than hydrocodone. It's 6-8 times more potent than morphine. I can't be certain, but I think hydro is around 70-90% as effective as morphine (not taking into account things like better oral bioavailability). Is that correct, Nephro?

It's weird how sources can vary so much sometimes. Depending on which source you use, Fentanyl (for example) is anywhere from 80 to 150 times the strength of morphine, while Buprenorphine has been estimated as anything from 30 to 75 times as potent. I've seen pethidine (meperidine) listed as a tenth or a third as strong, in two seperate (and apparently authoritative) sources.

When comparing oral routes, the bioavailability should be accounted for in the figures, so oral hydrocodone is around twice the strength of oral morphine. But the equivalence for morphine varies depending on whether it's for acute or chronic pain.

For example, 10mg morphine IV = 60mg morphine PO for acute pain, but for chronic pain it's only 30mg morphine PO, so it depends on whether the patient is opioid-naive or not as well.

Sources always vary, and the source I use was picked out of a few because it looked to be about in the middle regarding the equivalences.

Unfortunately since it's a PDF job, it's saved as a document and not a web site, and the site it's apparently from can't be found:

http://www.musc.edu/pharmacyservices/medusepol/opiodanalgesicfinal.pdf

which is a shame. Perhaps somebody might be able to find the original link to the site based on the link. Meanwhile I'll have a search through my somewhat disorganised favourites.

I have found that oral dilaudid is not as good as oral oxy or hydrocodone.Alot of members here have reported the same thing.Iv hydromorphone is a very good pain med but the oral just isnt good at least to me and some others here.

I think 2-3mg dilaudid offers the same as 10mg hydro, but it's not euphric like hydro.It is VERY good for pain. I was on it for 2 years and oxy, it's way better at pain control THAN OXY. I think why most people don’t like, is because it causes very little euphoria, and docs are just starting realize this. This is the same with opana, dilaudid's big brother, 5 times stronger than oxy , and it causes very little euphoria put kills pain better than anything. At my local e.r. they hand it out like candy. My wife was 6 mon ths pregnant with a tooth abscess the gave her a lidocane shot and 30 #4mg dilaudid. Over the past 4 years every time we went in for different things, broken bones, ect; every time DILAUDID. Next time you take dilaudid look at your eyes, pinned glazed, and you look like you are on heroin, but you won't feel euphoria.

mrb321,

That is really interesting, I had no idea of that. So what about other side effects such as drowsiness or loss of energy, constipation etc. For me oxy does not limit me, it actually can give me energy, but something like demerol or stadol will completely knock me out drooling.

Painstaking

The dilaudid pills just make me a lil tired but the shots are more intense than anything i have ever had.I dont know the strength you had or the dose they give here at the er but the euphoric is so intense you want to vomit.Its very strange how its a med that has no middle to it.Either it works great for you or its trash.The pills to me are worth nothing at 4mg.My perco 10's are much better.Oth if you get the iv or inj it is totally great on pain.

Oral hydromorphone has been prescribed for me at times. My opinion is that even the pills produce quite a euphoric effect. I have no personal experience with hydromorphone injections.

However, your experiences regarding the euphoria caused by hydromorphone injections, versus oral usage (pills) are very much in line with general viewpoints regarding the effects of the drug. I have heard that people who use the drug principally for its euphoric effect consider taking the drug in pill form a "wasted" experience. If you remember the movie, "Drugstore Cowboy," the main target of the characters' pharmacy heists was Dilaudid powder.

This is just my opinion, but I'd take the hydrocodone over the hydromorphone anyday. My doctor prescribed it(dilaudid) once (4mg) and they didn't work for the pain at all. I was back in his office in 3 days feeling like I was going to die. He prescribed percocets 10mg and they worked much better.

I've never had IV hydromorphone but I assume it's much stronger that way. The pills were really useless for me and I never even used the rest of the bottle. Just got rid of it, like I did with all medicines at that time that didn't work (yeah, I was stupid; I never thought of taking 8mgs at one time to see if it might work better. I always just went by my doctor's instructions).

I'm on Opana right now, and it causes no euphoria but gets rid of the pain, so I don't think that, in my case, I thought the hydromorphone didn't work because of the lack of euphoria.

I had the dilaudid IV the last time i went to the ER. The nurse said it would feel like i had had 10 drinks. I thought gross, that would make me want to vomit!! But it actually worked great on the pain and they gave me a second shot before sending me home. I really loved that Dr it was the first time in years i was pain free even if it was only for a few hours. I have never had the pills that i remember.

This forum is not to discuss suppliers. This thread is to discuss hydromorphone vs. hydrocodone and not the companies offering it.

Thanks for your support

hydromorphone has a pretty low oral bio-availability. its most efficient in IV. I had this a fentanyl, and morphine for IV after my car wreck. the first few days were a little fuzzy with all of me falling asleep.

Dee - when I had major surgery, I had a Morphine pump. I hated it. I'd fall asleep, thought I slept for hours and it was 5 minutes! A long couple of days. After 2 days - give me pills, please. And then I just wanted to go home. Drains and all.

Meds react differently for different people. I have always been sensitive. I have never taken Dilaudid. I have read that it pretty powerful. I am OK with what I take. And that is key.

Hydomorphone is much stronger than Hydrocodone, my understanding.

OK, my friend. Hugs. Rain

hydromorphine is retardedly more potent than hydrocodone.

but like I said, it almost does no good in pill form.

but I liked my morphine pump I had in the hospital. every 10 minutes it would allow you to push the button again, it gave out 1mg everytime.

I would prefer the hydrocodone. I prefer to deal with pills.

Dee, for me, it was necessary. They pulled the pectoral muscles up and inserted the expanders (I opted for the implants). Never would have done it had I understood I'd be "filleted" LOL. I researched it before hand, but never got good info about the implants. Very, very painful. So the pump was good. But I tired of it quickly.

Yes, you can press that button and I did, but I grew weary of the go to sleep - it's only 5 minutes etc. It's kinda humiliating when the nurse has to pull up your panties.

BUT, when you need it, you do. And I did. And you did too.

I don't know about equivalents. I have always thought the hydromorphone was much stronger than hydrocodone. But I guess in pill form it is not. Never taken it.

Many on here prefer the hydrocodone. I guess there is a reason for that. And, if it provides needed pain relief - that is the key.

OK, TMI. Sorry.

Rain

I think many of them prefer hydrocodone on here because you don't really get scripted a vial of hydromorphone liquid.

but yes, in the hospital I was given liquid hydromorphone, liquid fentanyl, and liquid morphine. along with percocets, and percalone (just oxycodone)