Dilaudid, Exalgo vs. Morphine

Dilaudid and Exalgo (hydromorphone hydrochloride) and morphine sulfate extended-release tablets opioid analgesics used to control pain.

Dilaudid and Exalgo are used for moderate to severe pain while morphine sulfate is used for pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

Side effects of Dilaudid and Exalgo and morphine sulfate that are similar include sweating, nausea, vomiting, constipation, dizziness, and drowsiness.

Side effects of Dilaudid and Exalgo that are different from morphine sulfate include flushing (warmth, redness, or tingling of skin), itching, stomach pain, diarrhea, blurred vision, double vision, headache, sleep problems (insomnia), strange dreams, and dry mouth.

Side effects of morphine sulfate that are different from Dilaudid and Exalgo include feeling uneasy and euphoric mood.

Both Dilaudid and Exalgo and morphine sulfate may interact with other central nervous system (CNS) depressants (such as sedatives, anxiolytics, hypnotics, tranquilizers, general anesthetics, phenothiazines, neuroleptics, other narcotic pain medications, muscle relaxers, other medicines that can make you sleepy or slow your breathing, and alcohol), pentazocine, buprenorphine, butorphanol, and nalbuphine.

Dilaudid and Exalgo may also interact with atropine, belladonna, benztropine, dimenhydrinate, methscopolamine, scopolamine, bladder or urinary medicines, bronchodilators, irritable bowel medicines, and ulcer medications.

Morphine sulfate may also interact with monoamine oxidase inhibitors (MAOIs), cimetidine, diuretics, anticholinergics, and PGP-inhibitors (e.g., quinidine).

Do not stop using Dilaudid, Exalgo, or morphine sulfate suddenly, or you could have unpleasant withdrawal symptoms.

Side effects of Dilaudid, Exalgo include:

Common side effects of Dilaudid include

• flushing (warmth,
• redness, or tingling of skin),
• itching,
• sweating,
• nausea,
• vomiting,
• constipation,
• diarrhea,
• stomach pain,
• dizziness,
• drowsiness,
• blurred vision,
• double vision,
• headache,
• sleep problems (insomnia),
• strange dreams, and
• dry mouth.

Serious side effects of Dilaudid include

• shallow, weak, or very slow breathing,
• trouble breathing,
• slow heart rate,
• confusion,
• lightheadedness or fainting,
• seizures (convulsions),
• cold clammy skin,
• pounding heartbeats or fluttering in your chest,
• wheezing,
• confusion,
• severe weakness or drowsiness,
• mental/mood changes (such as agitations, confusion, hallucinations),
• severe stomach or abdominal pain,
• difficulty urinating, or
• death.

After a few weeks of use, patients may develop both tolerance and physical dependence on Dilaudid and may need to be slowly weaned off the drug to avoid withdrawal symptoms.

Common side effects of Morphine include:

• constipation,
• nausea,
• drowsiness,
• dizziness,
• vomiting,
• sweating,
• feeling uneasy, and
• euphoric mood.

Dilaudid (hydromorphone hydrochloride) and Dilaudid Injection (also termed Dilaudid HP) are the tablet, liquid and IV forms of an opioid analgesic used for control of moderate to severe pain. Dilaudid is available in generic form.

Morphine sulfate extended-release tablets are an opioid agonist product indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

Dilaudid may interact with alcohol, other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, other medicines that can make you sleepy or slow your breathing, buprenorphine, butorphanol, nalbuphine, pentazocine, atropine, belladonna, benztropine, dimenhydrinate, methscopolamine, scopolamine, bladder or urinary medicines, bronchodilators, irritable bowel medicines, or ulcer medications. Tell your doctor all medications and supplements you use.

Morphine sulfate extended-release tablets may interact with other central nervous system (CNS) depressants (such as sedatives, anxiolytics, hypnotics, tranquilizers, general anesthetics, phenothiazines, neuroleptics, other opioids, and alcohol), pentazocine, nalbuphine, butorphanol, buprenorphine, skeletal muscle relaxants, monoamine oxidase inhibitors (MAOIs), cimetidine, diuretics, antocholinergics, and PGP-inhibitors (e.g., quinidine). Tell your doctor all medications and supplements you use.

Dilaudid is available in tablets in 8 mg strength, in liquid form in 5 mg strength per 5 ml of liquid, and Dilaudid Injection is available as sterile solution containing 1, 2, or 4 mg hydromorphone hydrochloride with 0.2% sodium citrate and 0.2% citric acid solution. Dosage of tablets usually begins at 2-4 mg every 4-6 hours; liquid begins at 2.5 mg (2.5 ml) every 3-6 hours and may be modified according to patient response and doctor's prescription. Dilaudid injection starting dose is 1-2 mg subcutaneously or intramuscularly every 4 to 6 hours as necessary for pain; it can also be given IV slowly over 2-3 min but respiration needs to be monitored.

For opioid-naive and opioid non-tolerant patients, the initial dose of morphine sulfate extended-release is 15 mg tablets orally every 8 to 12 hours.