Hydromorphone Side Effects

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

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