Hydromorphone Side Effects

Medically reviewed by Drugs.com. Last updated on Oct 14, 2023.

Applies to hydromorphone: oral solution, oral tablet, oral tablet extended release.

Other dosage forms:

• injection solution

Precautions

It is very important that your doctor check your progress while you are using this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

Do not use this medicine if you are using or have used an MAO inhibitor (MAOI) including isocarboxazid [Marplan®], linezolid [Zyvox®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]) within the past 14 days.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that can make you drowsy or less alert). CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, other prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you stop using this medicine. Check with your doctor before taking any of the other medicines listed above while you are using this medicine.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

This medicine may cause adrenal gland problems. Check with your doctor right away if you have darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

Dizziness, lightheadedness, or fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve dizziness or lightheadedness.

Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.

This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

If you have been using this medicine regularly for several weeks or more, do not change your dose or suddenly stop using it without first checking with your doctor. You may be directed to gradually reduce the amount you are using before stopping treatment completely, or to take another narcotic for a while, to lessen the chance of withdrawal side effects (eg, anxiety, fever, nausea, runny nose, stomach cramps, sweating, tremors, or trouble with sleeping).

Using too much hydromorphone may cause an overdose, which can be life-threatening. Symptoms of an overdose include: extreme dizziness or weakness, slow heartbeat or breathing, seizures, trouble breathing, and cold, clammy skin. . In case of an overdose, call your doctor right away. Your doctor may also give naloxone to treat an overdose.

Using this medicine while you are pregnant may cause neonatal withdrawal syndrome in your newborn babies. Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, a high-pitched cry, irritability, shakiness or tremors, weight loss, vomiting, or fails to gain weight.

For nursing mothers taking this medicine:

• Talk to your doctor if you have any questions about taking hydromorphone or about how this medicine may affect your baby.
• Call your doctor if you become extremely tired and have difficulty caring for your baby.
• Your baby should generally nurse every 2 to 3 hours and should not sleep more than 4 hours at a time.
• Check with your doctor, hospital emergency room, or local emergency services (eg, "call 9-1-1") immediately if your baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, difficulty breathing, or limpness. These may be symptoms of an overdose and need immediate medical attention.

Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.

Using too much of this medicine may cause infertility (unable to have children). Talk with your doctor before using this medicine if you plan to have children.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Common side effects of hydromorphone

Some side effects of hydromorphone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Serious side effects of hydromorphone

Along with its needed effects, hydromorphone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking hydromorphone:

Get emergency help immediately if any of the following symptoms of overdose occur while taking hydromorphone:

Symptoms of overdose

• cold, clammy skin
• drowsiness that is so severe you are not able to answer when spoken to or, if asleep, cannot be awakened
• pinpoint (small) pupils in the eyes
• seizures
• slow heartbeat
• very slow or trouble breathing

For healthcare professionals

Applies to hydromorphone: compounding powder, injectable powder for injection, injectable solution, intravenous solution, oral capsule extended release, oral liquid, oral tablet, oral tablet extended release, rectal suppository.

General adverse events

The most common adverse effects are lightheadedness, dizziness, sedation, nausea, vomiting, sweating, flushing, dysphoria, euphoria, dry mouth, and pruritus.^[Ref]

Gastrointestinal

• Very common (10% or more): Constipation (up to 31%), nausea (up to 28%), vomiting (up to 14%),
• Common (1% to 10%): Dry mouth, dry mouth, abdominal pain, diarrhea, dyspepsia
• Uncommon (0.1% to 1%): Ileus, cramps, taste alteration, gastritis, diverticulitis
• Rare (less than 0.1%): Anal fissure, bezoar, duodenitis, impaired gastric emptying, painful defecation
• Frequency not reported: Flatulence, dysphagia, hematochezia, abdominal distension, hemorrhoids, abnormal feces, intestinal obstruction, eructation, diverticulum, gastrointestinal motility disorder, large intestine perforation
• Postmarketing reports: Oropharyngeal swelling^[Ref]

Nervous system

• Very common (10% or more): Somnolence (up to 15%), headache (up to 12%), dizziness (up to 11%)
• Common (1% to 10%): Lightheadedness, sedation, memory impairment, hypoesthesia, paresthesia
• Uncommon (0.1% to 1%): Tremor, nystagmus, increased intracranial pressure, taste alteration, involuntary muscle contractions
• Rare (less than 0.1%): Hyperreflexia
• Frequency not reported: Balance disorder, encephalopathy
• Postmarketing reports: Convulsions, drowsiness, dyskinesia, hyperalgesia, myoclonus, serotonin syndrome (with concomitant serotonergic drugs)^[Ref]

Psychiatric

• Common (1% to 10%): Dysphoria, euphoria, insomnia, anxiety, depression, nervousness, nightmares, mood swings
• Uncommon (0.1% to 1%): Agitation, altered mood, hallucination, disorientation, abnormal dreams
• Frequency not reported: Floating feelings, dreams, apprehension, panic attack, suicide ideation, aggression
• Postmarketing reports: Confusional state^[Ref]

Hypersensitivity

• Postmarketing reports: Anaphylactic reactions, hypersensitivity reactions^[Ref]

Respiratory

• Common (1% to 10%): Dyspnea
• Uncommon (0.1% to 1%): Bronchospasm, laryngospasm
• Frequency not reported: Respiratory depression, apnea, respiratory arrest, rhinorrhea, respiratory distress, hypoxia, sneezing, hyperventilation
• Postmarketing reports: Dyspnea^[Ref]

Cardiovascular

• Common (1% to 10%): Flushing, hypotension, peripheral edema, chest pain
• Uncommon (0.1% to 1%): Tachycardia, bradycardia, palpitations, syncope, presyncope, hypertension
• Frequency not reported: Circulatory depression, cardiac arrest, shock, extrasystoles
• Postmarketing reports: Peripheral edema^[Ref]

Dermatologic

• Common (1% to 10%): Sweating, pruritus, hyperhidrosis, rash
• Uncommon (0.1% to 1%): Urticaria, diaphoresis
• Frequency not reported: Erythema
• Postmarketing reports: Angioedema^[Ref]

Local

• Uncommon (0.1% to 1%): Injection site urticaria
• Postmarketing reports: Injection site reactions^[Ref]

Genitourinary

• Common (1% to 10%): Urinary retention, urinary hesitancy
• Postmarketing reports: Erectile dysfunction^[Ref]

Hepatic

• Uncommon (0.1% to 1%): Biliary tract spasm
• Rare (less than 0.1%): Biliary colic
• Postmarketing reports: Hepatic enzyme increased^[Ref]

Other

• Common (1% to 10%): Asthenia (up to 11%), pain, pyrexia, fall
• Uncommon (0.1% to 1%): Weakness, abnormal feeling, chills
• Rare (less than 0.1%): Feeling drunk
• Frequency not reported: Neonatal withdrawal syndrome, addiction, abuse, misuse, overdose, drug withdrawal syndrome, vertigo, tinnitus, malaise
• Postmarketing reports: Fatigue, lethargy^[Ref]

Metabolic

• Common (1% to 10%): Anorexia/decreased appetite, decreased weight, dehydration
• Uncommon (0.1% to 1%): Fluid retention, increased appetite, hyperuricemia^[Ref]

Musculoskeletal

• Common (1% to 10%): Arthralgia, muscle spasms, back pain, extremity pain
• Uncommon (0.1% to 1%): Muscle rigidity
• Frequency not reported: Myalgia^[Ref]

Ocular

• Uncommon (0.1% to 1%): Blurred vision, diplopia, miosis, visual impairment
• Frequency not reported: Dry eye^[Ref]

Renal

• Uncommon (0.1% to 1%): Antidiuretic effects^[Ref]

Endocrine

Hydromorphone:

• Uncommon (0.1% to 1%): Decreased libido, sexual dysfunction
• Rare (less than 0.1%): Hypogonadism

Opioids:

• Postmarketing reports: Adrenal insufficiency, androgen deficiency^[Ref]

See also:

Frequently asked questions

• Which painkiller should you use?
• Oxymorphone vs Hydromorphone - How do they compare?

Further information

Hydromorphone side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer