Hydromorphone: pharmacology and clinical applications in cancer patients

  title={Hydromorphone: pharmacology and clinical applications in cancer patients},
  author={Nabeel Sarhill and Declan Walsh and Kristine A. Nelson},
  journal={Supportive Care in Cancer},
Abstract Hydromorphone is a more potent opioid analgesic than morphine and is used for moderate to severe pain. It can be administered by injection, by infusion, by mouth, and rectally. Oral bioavailability is low. The kidney excretes hydromorphone and its metabolites. Some metabolites may have greater analgesic activity than hydromorphone itself but are unlikely to contribute to the pharmacological activity of hydromorphone. With the exception of pruritus, sedation and nausea and vomiting… 

Hydrocodone and Acetaminophen

The combination of hydrocodone with acetaminophen is much more efficacious in several randomized studies without any significant changes in adverse effects.

Hydromorphone Prescription for Pain in Children—What Place in Clinical Practice?

The current data do not support any advantage of hydromorphone over morphine, both in terms of efficacy and safety in children, and Morphine should remain the treatment of choice for moderate and severe nociceptive pain in children and hydomorphone should be reserved as alternative treatment.

The Efficacy and Incidence of Side Effects in Patient Controlled Analgesia Using Hydromorphone

Intravenous PCA, with hydromorphone, was effective in controlling postoperative pain, with fewer eide effects than morphine, as reported in the literature.

Proceedings of the Symposium "Updates of the Clinical Pharmacology of Opioids with Special Attention to Long-Acting Drugs" Hydromorphone

There is no evidence that hydromorphone has any greater abuse liability than other opioids, and further research is needed to address remaining areas of uncertainty.

The Side Effects of Morphine and Hydromorphone Patient-Controlled Analgesia

There was no systematic difference between morphine and hydromorphone in opioid-related side effects and neither was there any difference in efficacy of pain control or patient satisfaction when patients self-titrated to equal drug effect as measured by equianalgesia and pupillary miosis.

The metamorphosis of hydromorphone.

The FDA has recently approved the first commercially available extended-release formulation, a once-daily hydromorphone for the management of moderate to severe pain in opioid tolerant individuals with an anticipated extended period of use.

Hydromorphone use for acute pain: Misconceptions, controversies, and risks.

There are limited data regarding how acute parenteral administration of opioid analgesics in the setting of high rates of preexisting chronic opioid use (medical or nonmedical) may contribute to or reinforce addictive behavior, making the potential contribution of rising HM administration to subsequent prescription opioid abuse and overdose uncertain.

The effect of hydromorphone for postoperative analgesia in children

It is demonstrated that hydromorphone can be effectively used for postoperative pain relief in young patients and there were no significant differences in adverse events and satisfaction score of analgesia between two groups.



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In animal studies, heroin and 6-acetylmorphine are both more potent and faster acting than morphine as analgesics, effects attributed to their greater lipid solubility and subsequent penetration of the blood-brain barrier.

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The saliva sampling for the hydromorphone concentration was found to be a useful noninvasive technique for the estimation of the elimination half‐life of hydromOrphone.

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Promethazine premedication should be reserved for situations where the use of intravenous anaesthetics is anticipated and may prove to be a useful drug in certain other situations where too rapid inactivation of the principal drug presents a therapeutic problem.

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The fact that methadone ratio is different according to the opioid dose used previously should be taken into careful consideration by the clinician in order to avoid severe toxicity or death during switchover.

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The purpose of this study was to review the analgesic dose ratios for methadone compared with hydromorphone and propose doses ranging from 1:6 to 1:10.