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Opioid

Hydromorphone

Semisynthetic μ-agonist · Dilaudid

Mechanism: μ-opioid receptor agonist; ~5–7× more potent than morphine.

Calculate dose for your patient

Enter weight (kg or lb). Always verify before administration.

Computed weight
70.0 kg · 154.3 lb
Post-op analgesia
0.35 mg – 1.4 mg
= 0.35–1.40 mL (1 mg/mL)
Exceeds typical adult max 1 mg — cap and reassess.
Adult: 0.2–1 mg IV; peak 15 min.

Weight is saved on this device for the next calculator you open.

Full dose calculator
Onset
5–10 min IV
Duration
3–4 h
Metabolism
Hepatic glucuronidation.

Dosing

Adult
IV: 0.2–0.5 mg q3–4 h. PCA demand: 0.1–0.3 mg q6–10 min.

Indications

  • Acute & chronic pain
  • PCA

Contraindications

  • Severe respiratory depression

Side Effects

  • Sedation
  • Respiratory depression
  • Pruritus

Clinical Pearls

1Preferred over morphine in renal failure (no clinically active metabolite).

References & Further Reading

  1. 1
    Textbook

    Flood P, Rathmell JP, Shafer S. Stoelting's Pharmacology and Physiology in Anesthetic Practice. 5th ed. Philadelphia: Wolters Kluwer; 2015.

  2. 2
    Textbook

    Gropper MA, Miller RD, Cohen NH, et al., eds. Miller's Anesthesia. 9th ed. Philadelphia: Elsevier; 2020.

  3. 3
    Textbook

    Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, Ortega R, Sharar SR, Holt NF. Clinical Anesthesia. 8th ed. Philadelphia: Wolters Kluwer; 2017.

  4. 4
    Textbook

    Adriano A, Morris R, eds. 2021 CA-1 Tutorial Textbook (15th Ed.). Stanford University Medical Center, Department of Anesthesiology.

Citations are provided to direct further study. Always check the most current edition of guidelines and society recommendations — the information in this chapter is a teaching summary, not primary source material.