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Opioids Dilaudid/hydromorphone MEGA THREAD and FAQ

Dilaudid

I've recently had surgery and been given 4mg diauladid. Typically oxys or vics are uppers to me. Will these do the same or put me on my ass?
 
Oral BA is really low so you should look into other ROAs.
 
Mr. Root said:
Oral BA is really low so you should look into other ROAs.
Click to expand...

Oral BA of hydromorphone is like 30-40%; intranasal is not quite double that, 50-60%. But really, 4mg oral is pretty good when an IV dose for acute pancreatitis is 1mg.

4mg pills are nice, I must say. So is 1mg IV. You will have a pleasant evening.
 
5-10mg = ~ 20mg oxycodone; and Hydromorphone is generally stimulating unless you ar injecting with low :tolerance, Or simply stupid high doses

It is a fast acting drug, yet the analgesic effects don't hold long; and BA% is highly variable, 11-55%, 30-40% is a decent average

Just take one or two tables as needed, every 4-8 hours, you will be fine; if you decide to snort, Just Start with 4ng as an experiment

And to be more specific, 7.5mg Hydromorphone equates to anywhere from 15-30mg oxycodone, 1.5-2mg = 10mg IV morphine, = ~20mg PO Oxycodone,?rage again 15-30mg) or 10-15mg IV oxycodone, or 7.5ng H-morphone, or, -30mg hydrocodone

Seriousky, though, K4 or it's equivalent is nothing to complain about - and don't think of injecting, simply demonstrating its potency
 
put one up your butt. crush and dissolve it in water first. then use a needleless syringe. i get them from the pharmacy. just ask the pharm tech (free!). or you can buy some baby medicine that includes one in the package, but baby medicine is expensive.

plugged dilaudid is hands down my favorite opiate high.
 
Wow..diluadid is the only medicine my doctor prescribed that I gave back to him 2 days later and asked for Percocet. This was when I first dealt with chronic pain and felt oxy worked better. Gave away a full bottle of K4s.

If I'm prescribed it again I'll try plugging.

I was given the 8mg pills 4x a day for a month after surgery and I slept that month away.

I find morphine unless also unless they are giving it to me IV at the hospital. Then I'm really messed up. They say some people can't process morphine but since it works IVing it I think that I must not process the pills well.
 
Mr. Pain 54, what was the 32mg/day post-surgery med?

I'd think post-surgery, when you're expected to sleep all day, takes different meds than chronic pain, where you're expected to go to work. So are you saying dilaudid is better for post-surgery, or not at all; or only in relation to oxycodone, either post-surgery or for chronic pain?
 
I'm sorry that I was not clear. After surgery I was given 8 mg of Dilaudid 4 times a day for a month. Although it worked for that intense pain I don't like it as a chronic pain medicine. I don't like morphine either because the morphine pills simply don't work well for me. So while I don't like either Dilaudid or Morphine, at least the 8 mg Dilaudid tablets 4 times a day took care of the intense pain after surgery. I honestly don't think morphine pills would have worked that well and I probably would have asked for a different prescription. I was already in pain management when I had the surgery and was already on methadone with oxycodone as a breakthrough Med, so changing to the 8 mg Dilaudid for a month is probably why it worked better for me. My system was not used to that medicine.

IMO I feel like Methadone in low doses works better for chronic pain and then using either oxycodone or hydrocodone as a breakthrough Med. But that's purely my experience with the type of pain I have.
 
hydroazuanacaine said:
put one up your butt. crush and dissolve it in water first. then use a needleless syringe. i get them from the pharmacy. just ask the pharm tech (free!). or you can buy some baby medicine that includes one in the package, but baby medicine is expensive.

plugged dilaudid is hands down my favorite opiate high.
Click to expand...

Hands down. I've eaten like a dozen of the 2mg ones with zero observable pain relief/buzz.

Plugged, I can use 2x2mg and it hits hard and fast but fades quickly.

My pain doctor instructed me to take the dilaudid first, wait a while and follow up with my percocet to maintain pain relief. Solid regiment if I can ever stick to it. They're great at cutting through fairly severe pain but only for a short while.
 
Dilaudid orally works best when taken every 2.5 hours.. IV is the best way to go with it IMO. It is absorbed so much better. Taken orally, you have to take sooo much to get the same effect. When taking opiates orally, I believe oxycodone is best absorbed/longest lasting. It should last 8 hours. I found that Dilaudid puts me to sleep 1 hour after I take it... especially if I am laying down. I only nod for about 20 minutes though. I found oxycodone to give me energy within 15 minutes of taking it. This is all orally. Dilaudid IV gave me that energetic feeling, but I still felt like it wore off quick. NOTE: If you take Dilaudid orally, and it is the "pms" verson of the pill (it will dissolve easily... doesn't have a hard coating on it) take it sublingually.. under the tongue.. it may increase the absorption very slightly. You could also try the grapefruit thing... when done properly, it absolutely helps the potency.
 
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Dilaudid is very short acting and is a horrid choice for maintenance without a sustained released formula. Oxymorphone would be better as an IR formula as it has a 7-9 hour half life as well as it's a metabolite of oxycodone. The other option would be to change the oxycodone to a sustained released formula and take the Dilaudid for breakthrough pain. Of course your doctor would have to approve it, but it would leave you with much more stable relief and less likely to just increase or fluctuate your dose
 
Very short? It's longer than morphine, I think, 3-4 hour half-life for hydromorphone (I think).
 
Nope you got it backwards. Morphine is ≈4-6 hours, hydromorphone ≈2-3 hours, and oxymorphone ≈7-9 hours
 
No, figure for morphine is correct. It is identical to hydromorphone, 2-3 hours.

Hydromorphone Morphine
Physicochemistry
 Molecular weight 285.388 g mol−1 285.34 g mol−1
 pKa 8.243 8.2143
 Octanol water partition coefficient 1.2843 0.743
Pharmacokinetics
 Plasma elimination half-life 2?3 h4 2?3,5 h4
 Transfer half-life plasma effect site, t1/2,ke0 18?38 min40 1.6?4.8 h37
 Volume of distribution, Vd 1.22 litre kg−1 44 1.0 litre kg−1 44
 Oral bioavailability (immediate-release formulation) 50%45 30%46
Pharmaceutical formulations
 Oral administration in solutions, capsules, or tablets with either immediate or sustained release Sustained-release hydromorphone is used once daily Sustained-release morphine is used every 12 h
 I.V. Lyophilized powder and fluid forms of morphine and hydromorphone
 Suppositories Available in Canada Available in Canada and Germany
 Transdermal Possible (no commercial brands available)
Pharmacodynamics
 [3H] DAMGO replacement (μ-opioid receptor affinity)* 0.6 nM47 1.2 nM47
 [3H] DPDPE replacement (δ-opioid receptor affinity)* ? 68.5 nM48
 [3H] U69,593 replacement (κ-opioid receptor affinity)* 55 nM 26 nM49
 [3H] N/OFQ replacement (orphan-opioid receptor affinity)* ? >10 000 nM50
 μ-opioid receptor cAMP inhibition 67%48,49,51 48%48,49,51
 δ-opioid receptor cAMP inhibition 65%48,49,51 39%48,49,51
 κ-opioid receptor cAMP inhibition 55%48,49,51 26%48,49,51
 Orphan receptor [35S]GTPγS binding ? 0%50
 
For my pain I take 1 x 5mg morphine and 1 x 1mg dilaudid. The two blend together and the pain relief of the dilaudid is somehow carried into the half life of the morphine. I'm not sure why.

I've been taking these together for 10/10 for over 2 years now and they never fail me. I also find that taking morphine with the dilaudid helps me get to sleep whereas dilaudid on its own keeps me awake.
 
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