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What is the ratio for hydromorphone to hydrocodone?

SummerWinter

SummerWinter

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I have been taking 16mg hydromorphone (Dilaudid) extended release for back pain with 10/325 hydrocodone (Norco) for breakthrough pain. I am going to be two days short this month. I get my refill Sunday 3/19. My last dose was 10pm 3/16, so right about now is when I would normally be taking it. Because it’s extended release, it lasts 24 hours or more. I’ve gone up to about 30 hours with no repercussions. My question is how much Norco will it take to compensate for the lack of ER hydromorphone? I’m aware it is much stronger than hydrocodone. Am I totally screwed or can I squeeze by using Norco without too bad of a withdrawal experience?

*I read that hydromorphone is 5x stronger than hydrocodone. So 16mg hydromorphone over a 24 hour period would equal 80mg hydrocodone or approximately 8 Norco taken throughout the day. Is my math right?
 
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Snafu in the Void said:
Hydromorphone is 4x stronger than hydrocodone according to the opioid equivalency chart.

I would take 15-20mg hydrocodone every 4 hours.

You're not going to experience withdrawal by switching to hydrocodone. You'll be fine for 2 days.
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as an oxy user would you recommend using dillies if I can get access to them and can I take enough orally or do I need to snort it... shooting is out of the question for me
 
Delmonte421 said:
as an oxy user would you recommend using dillies if I can get access to them and can I take enough orally or do I need to snort it... shooting is out of the question for me
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I’m assuming dillies are hydro morphine pills? I used to use hydromorphone pills and I tried snorting didn’t feel it really. Then IV and it worked but man wasn’t really much to write home about. It was just a rush for like 30 awconds to a minute and a small buzz maybe lasted 15-30 min but maybe it was a H tolerance issue. Idk.

First time I did hydromorphone I was floured in a hospital setting, but my tolerance as really low. It still didn’t last super long tho. I guess I’m just not a big fan. I’d take them if they were lying around the house but I won’t buy them ever again. Again, maybe a tolerance issue.

Oxy was much better imo
 
Juicewrldfan said:
I’m assuming dillies are hydro morphine pills? I used to use hydromorphone pills and I tried snorting didn’t feel it really. Then IV and it worked but man wasn’t really much to write home about. It was just a rush for like 30 awconds to a minute and a small buzz maybe lasted 15-30 min but maybe it was a H tolerance issue. Idk.

First time I did hydromorphone I was floured in a hospital setting, but my tolerance as really low. It still didn’t last super long tho. I guess I’m just not a big fan. I’d take them if they were lying around the house but I won’t buy them ever again. Again, maybe a tolerance issue.

Oxy was much better imo
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I would be eating or snorting it
 
Delmonte421 said:
I would be eating or snorting it
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Yeah. I quit IVing anything years ago and the idea disgusts me unless it’s in a hospital setting.

I mean you can try the hydromorphone but I just would prefer oxy over that personally. Not really sure you will get much out of it but you very well might.
 
Juicewrldfan said:
I’m assuming dillies are hydro morphine pills? I used to use hydromorphone pills and I tried snorting didn’t feel it really. Then IV and it worked but man wasn’t really much to write home about. It was just a rush for like 30 awconds to a minute and a small buzz maybe lasted 15-30 min but maybe it was a H tolerance issue. Idk.

First time I did hydromorphone I was floured in a hospital setting, but my tolerance as really low. It still didn’t last super long tho. I guess I’m just not a big fan. I’d take them if they were lying around the house but I won’t buy them ever again. Again, maybe a tolerance issue.

Oxy was much better imo
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That’s so funny. Everyone loves oxy but it does nothing for me. My pain management doctor had me on both the extended release and immediate release versions. Neither worked very well. He said it all has to do with our livers and what they can and can’t breakdown. So apparently I don’t have the necessary enzymes to make oxy work for me.
 
Snafu in the Void said:
Hydromorphone is 4x stronger than hydrocodone according to the opioid equivalency chart.

I would take 15-20mg hydrocodone every 4 hours.

You're not going to experience withdrawal by switching to hydrocodone. You'll be fine for 2 days.
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I got my hydromorphone ER this morning. I made it through the weekend with very little discomfort. Last night was was a little iffy but still not bad at all. Thank you so much for your help and reassurance.
 
im about to grab a bunch of 8mg dillies and my question is that its gotta be snorted right? I cant eat enough to match 80mg of oxy? I would have to snort two to match one 80 of oxy? 16mg times 4 is 64mgvso I guess that answers my question. I have a 350mg a day habit and need to move to dilutes and im unsure how Long they last without having to redone and how much I have to take and if snorting the only way and eating them is a huge waste
 
SummerWinter said:
How much stronger is hydromorphone than oxycodone?
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You have to factor ROA into that question.

Orally oxy is 90% and hydro morph is like 30%

When you IV both hydro is stronger by mass and has a rush that oxy does simply not possess….really no other opioid has this unique rush…I’ve heard oxymorohone does but I only found that IV rush in hydro

Oxy lasts longer in all situations due to longer half life
 
Yes, I meant orally. I got myself in the same stupid situation where I am going to be three days shy of my refill date for Hydromorphone ER 16 mg. Last time I had Norco (hydrocodone) to get me through without withdrawals, this time I will have oxycodone. I think oxycodone is stronger than hydrocodone, but I don’t know how that breaks down in terms of how much I need to take to not get sick.
 
I was able to see my PM dr and got an increase of the ER so I’ll be getting them today. Don’t have to go without and try to supplement. As soon as I am stable on the correct higher dose of the hydromorphone ER, I want to get rid of the Norco altogether. I will never be able to take it “normally”.
 
I now take 24mg hydromorphone ER (extended release) with Percocet 10/325mg for breakthrough pain. I have two days coming up without the hydromorphone. If I go by a roughly 3:1 ratio, does that mean I have to take 7.5 hydrocodone every approximately four hours?
 
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