7 Dilaudid Side Effects You Should Know About

GoodRx Health

Most people experience pain at some point in their lifetime, whether it's from surgery, an injury, or aging. In some cases, opioid medications are prescribed to treat moderate to severe pain, but usually only after nonopioid pain medications haven't worked.

One example of an opioid that treats severe pain is Dilaudid (hydromorphone). It's available as an injectable, immediate-release and extended-release tablets, and an oral liquid. And like all opioids, it can cause side effects. Dilaudid also has serious risks to be aware of.

Dilaudid side effects at a glance

While Dilaudid can effectively treat pain, it can cause side effects. Dilaudid side effects are often mild and can be managed at home. Common Dilaudid side effects include:

• Nausea and vomiting

• Drowsiness

• Dizziness

• Constipation

• Sweating

• Flushing (redness in the skin)

• Dry mouth

• Itching

Serious Dilaudid side effects are rare, but it's still important to be aware of the possibilities. Taking large dosages of Dilaudid (or taking it long term) increases the risk of serious side effects such as:

• Slowed breathing (respiratory depression), which can be life-threatening

• Increased pain

• Severely low blood pressure

• Seizures

• Low cortisol levels

Dilaudid also carries several boxed warnings - the most severe type of warning the FDA can apply to a medication. These boxed warnings are for significant risks such as:

• Misuse, leading to opioid use disorder

• Overdose, especially when taken with certain substances such as alcohol or benzodiazepines

• Opioid withdrawal symptoms in newborns

• Accidental ingestion, especially in children

Here, we'll dive deeper into seven notable Dilaudid side effects and risks. We'll also discuss how to prevent or manage them - and when to seek emergency medical care.

1. Nausea and vomiting

One of the most common Dilaudid side effects is nausea. But vomiting can also occur.

You can do some things at home to help keep nausea and vomiting related to Dilaudid at bay. For example, some research shows that limiting head movement and resting can prevent nausea and vomiting. Staying hydrated and eating smaller (but more frequent) meals throughout the day can also help.

Nausea related to Dilaudid is likely to improve after your body gets used to the medication. But let your prescriber know if it doesn't subside, especially if it's limiting your ability to function normally. They may recommend reducing your Dilaudid dosage or switching to another medication.

If you experience severe abdominal pain, fainting, or brown/black urine, seek emergency care.

2. Drowsiness

Drowsiness is another common Dilaudid side effect. This is more likely to happen with higher dosages of Dilaudid.

Dilaudid is often taken throughout the day, so avoiding daytime drowsiness may be difficult. When you first start taking Dilaudid, avoid doing tasks that require alertness, such as driving, operating heavy machinery, or moving heavy objects. And wait until you see how Dilaudid affects you before resuming these activities.

You should also try to avoid combining Dilaudid with other medications that may worsen drowsiness. These medications include:

• Benzodiazepines, such as alprazolam (Xanax)

• Antihistamines, such as diphenhydramine (Benadryl)

• Muscle relaxers, such as cyclobenzaprine (Amrix)

• Sleep medications, such as zolpidem (Ambien)

• Gabapentinoids, such as gabapentin (Neurontin)

• Barbiturates, such as phenobarbital

Additionally, avoid drinking alcohol while taking Dilaudid because it may worsen drowsiness. Combining alcohol or the above medications (especially benzodiazepines) with Dilaudid can also increase your risk of overdose, which we discuss more below.

If you notice you're excessively tired while taking Dilaudid, let your prescriber know. They may recommend decreasing your dosage or switching to another medication.

3. Dizziness

Like drowsiness, dizziness from Dilaudid may make some activities, like driving, unsafe. So when you first start taking Dilaudid, or if your dosage is increased, wait to see how your body responds before doing activities that require alertness.

Dizziness related to Dilaudid may improve as your body adapts to the medication. In the meantime, find a safe place to sit whenever you feel dizzy. And take steps to minimize your risk of falling. This includes clearing your home of tripping hazards, like wires, and placing commonly used items within reach so you don't have to use a step stool.

Ongoing dizziness can lead to falls and injuries, which can be especially dangerous for older adults. So if your dizziness doesn't improve, speak to your prescriber about what to do next.

4. Constipation

Opioids like Dilaudid commonly cause constipation. Constipation from Dilaudid can last for as long as you take the medication. So when you start treatment, focus on preventing constipation by increasing your fiber and fluid intake. Exercising may also help relieve constipation.

Additionally, you can ask your prescriber if they recommend over-the-counter (OTC) laxatives to prevent constipation. A common approach is to combine two medications:

1. A stimulant laxative, such as senna (Senokot) or bisacodyl (Dulcolax)

2. A stool softener, such as docusate (Colace)

Severe constipation may require medical attention. Some signs that your constipation is more serious could include sharp abdominal pain, rectal bleeding, or continuous vomiting.

5. Dependence and misuse

Dilaudid is a controlled substance, which means that it carries a risk for dependence and misuse.

Dependence occurs when the body gets used to taking Dilaudid. This could cause opioid withdrawal symptoms if the medication is stopped suddenly. Dependence can happen to anyone taking Dilaudid, even when it's taken as prescribed. But it's more likely to occur if you take higher dosages for a long period of time.

If you take Dilaudid in a way that's different from how it's prescribed, that's called misuse. This can lead to opioid use disorder. Taking more Dilaudid than prescribed and taking it for longer than prescribed are signs of Dilaudid misuse.

Talk to your prescriber if you're finding it difficult to follow their directions for taking Dilaudid. They can help you decide what to do next. Or if you have a history of substance use disorder, let your prescriber know before starting treatment with Dilaudid. An opioid may not be the best option for you in this case.

If you or someone you know struggles with substance use, help is available. Call SAMHSA's National Helpline at 1-800-662-4357 to learn about resources in your area.

6. Overdose

Overdose is perhaps the most serious risk associated with Dilaudid. Signs of an opioid overdose include pinpoint pupils, pale skin, and slowed or irregular breathing. Other overdose symptoms include low blood pressure and slowed heart rate.

Misusing Dilaudid increases your risk of overdose. Your risk is also higher if you take other medications or substances with sedative effects, such as muscle relaxers, benzodiazepines, or illegal drugs. To minimize your risk of an overdose, only take Dilaudid exactly as prescribed. And avoid other medications and substances that can increase your risk of a Dilaudid overdose.

If you or someone you live with is prescribed Dilaudid, it's a good idea to keep naloxone (Narcan) in your home and on your person. Narcan is a medication that can quickly reverse the effects of an opioid overdose. You can get it OTC without a prescription. And you may be able to access it for free.

If you think someone is having an opioid overdose, administer Narcan if you have it. Even if you're unsure, it's still best to use Narcan if you think there's a chance opioids are contributing to overdose symptoms. Administering Narcan won't cause harm, even if opioids aren't present in a person's system.

Keep in mind that administering Narcan doesn't eliminate the need to go to the hospital in an overdose situation. Narcan's effects wear off quickly, so the person will still need emergency care.

Check out another GoodRx Health article for instructions on how to administer Narcan.

7. Withdrawal

If your body is dependent on Dilaudid, you may experience opioid withdrawal symptoms if you stop taking the medication. These symptoms might include sweating, shaking, and diarrhea. You may also experience mood changes, such as increased anxiety.

While opioid withdrawal is uncomfortable, it's rarely life-threatening. However, if you and your prescriber agree that you should stop taking Dilaudid, they'll likely recommend decreasing your dosage slowly over time. This can help minimize withdrawal symptoms.

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