202 Hydromorphone
Generally the drug should be avoided by persons suffering from asthma,
urinary retention, enlarged prostate, deficient adrenal or thyroid glands, gall-
bladder trouble, or epilepsy.
Abuse factors.Dependence can develop after hydromorphone has been
taken regularly for several weeks. Although tolerance is unusual for medical
effects of drugs, tolerance has been observed when hydromorphone is used
for pain relief, with patients needing more of the drug for the same amount
of relief.
Heroinaddicts find hydromorphone to be a satisfactory substitute. Through
cross-tolerance hydromorphone can reduce opiate withdrawal symptoms, and
the drug has been used as an experimental medication in programs trying to
switch opiate addicts tomethadoneorbuprenorphine.
Drug interactions.Normally hydromorphone should not be taken along
with antihistamines or various tranquilizers and antidepressants, including
monoamine oxidase inhibitors (MAOIs, found in some antidepressants and in
other medicine). Taking hydromorphone andcocainetogether can increase
each drug’s effects.
Cancer.Hydromorphone does not seem to cause cancer.
Pregnancy.In general the drug fails to produce birth defects, but some did
appear when pregnant hamsters received 600 times the normal human dose.
The potential for malformations is unknown among infants from pregnant
women who use the drug in a medical context. Infants can be born with
dependence if the mother has used hydromorphone during pregnancy. The
drug is used to ease childbirth. Whether the substance passes into a nursing
mother’s milk is unknown but is considered safe for the infant.
Additional information.The cough syrup form of Dilaudid may contain
tartrazine (FD&C Yellow No. 5) to which some persons are allergic, particu-
larly if they are allergic to aspirin.
Additional scientific information may be found in:Hill, J.L., and J.P. Zacny. “Comparing the Subjective, Psychomotor, and Physiological
Effects of Intravenous Hydromorphone and Morphine in Healthy Volunteers.”
Psychopharmacology152 (2000): 31–39.
“Hydromorphone HCl.” InTherapeutic Drugs, ed. C. Dollery. 2d ed. New York: Chur-
chill Livingstone, 1999. H69–H71.
McBride, D.C., et al. “Dilaudid Use: Trends and Characteristics of Users.”Chemical
Dependencies4 (1980): 85–100.
Walker, D.J., and J.P. Zacny. “Subjective, Psychomotor, and Physiological Effects of
Cumulative Doses of Opioid Mu Agonists in Healthy Volunteers.”Journal of
Pharmacology and Experimental Therapeutics289 (1999): 1454–64.