FDA-filed SPL labeling · retrieved through openFDA

Hydromorphone

Hydromorphone is a strong opioid pain reliever used to manage severe pain when other treatments are not adequate, available as oral tablets, oral solution, extended-release tablets, injectable solution, and rectal suppositories.

Brand names DilaudidExalgo
Drug classes Full Opioid Agonists
Rx Schedule CII Forms 5 Routes Oral · Intramuscular; Intravenous; Subcutaneous · Intramuscular, Intravenous, Subcutaneous · Rectal
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 20 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveMay 14, 2026
Clinical labels in scope 20
AvailabilityRx
Earliest approval/marketing year 1972
FDA-listed product records 240
Boxed warningYes
How we combine label and product data →
Other forms & routes:
Hydromorphone at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Hydromorphone is a powerful prescription opioid for managing severe pain when other options have failed, available in oral, injectable, and rectal forms — with a high-potency injectable and extended-release tablet reserved for opioid-tolerant patients only. Its most serious risks are life-threatening respiratory depression, addiction, and fatal outcomes from misuse or accidental ingestion, especially in children. Always take it exactly as prescribed, never combine it with alcohol or sedatives without your doctor's guidance, and keep naloxone accessible in case of overdose.
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert

Hydromorphone carries serious, life-threatening risks that every patient and caregiver should know.

  • Dosing errors can be deadly: The oral solution can be confused between milligrams (mg) and milliliters (mL), or mixed up with other concentrations. Always use a proper measuring device — never a kitchen spoon.
  • Addiction, abuse, and misuse: Even when used as prescribed, hydromorphone can lead to addiction or be misused, which can result in overdose and death.
  • Breathing can slow or stop: Dangerous or fatal respiratory depression (slowed or stopped breathing) can happen, especially when starting the medicine or after a dose increase. If someone is hard to wake up, breathing very slowly, or not breathing — call 911 immediately.
  • Accidental ingestion by children can be fatal: Even one dose can kill a child. Store securely and out of reach.
  • Combining with other sedating drugs or alcohol is extremely dangerous: Using hydromorphone together with benzodiazepines, alcohol, or other central nervous system depressants can cause profound sedation, stopped breathing, coma, and death.
  • Use during pregnancy: Long-term use during pregnancy can cause a serious withdrawal condition in the newborn (neonatal opioid withdrawal syndrome), which can be life-threatening if not quickly recognized and treated.
Read the full warning on DailyMed →

📖 Hydromorphone: Patient Information Guide

A plain-language walkthrough of Hydromorphone — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Hydromorphone is an opioid pain reliever indicated for severe pain when other treatments are not adequate, across several formulations:

  • Oral tablets and oral solution — for pain severe enough to require an opioid, when alternatives have not worked or are not expected to work
  • Extended-release (ER) tablets — for severe, persistent pain needing around-the-clock opioid treatment for an extended time; for opioid-tolerant patients only; not for as-needed use
  • Injectable solution (intramuscular, intravenous, subcutaneous) — for severe pain requiring an opioid when alternatives are inadequate
  • High-potency injectable formulation (HPF) — specifically for opioid-tolerant patients who require higher opioid doses; patients must continue around-the-clock opioids while using this formulation
  • Rectal suppositories — for severe pain when an opioid is required and alternatives are inadequate
  • All formulations are reserved for patients for whom non-opioid analgesics or combination opioid products are not effective, not tolerated, or expected to be insufficient
⚙️How it works

Hydromorphone is a semi-synthetic opioid derived from morphine. It works as a full opioid agonist — it binds to and activates mu-opioid receptors in the brain and spinal cord, which are the same receptors involved in the body's natural pain control system. This activation reduces how intensely the brain processes pain signals. Unlike some other pain medicines, there is no built-in ceiling on how much pain relief it can provide — but higher doses also raise the risk of serious side effects, especially dangerously slow or stopped breathing.

As doses rise, the relationship between drug levels in the blood and side effects like nausea, sedation, and respiratory depression becomes more pronounced. In patients who have taken opioids long-term, tolerance to some side effects can develop over time.

💊How it's taken

How and how often you take hydromorphone depends entirely on which form is prescribed — always follow your prescriber's instructions exactly.

  • Oral tablets and oral solution: Taken by mouth; frequency is individualized. The oral solution must be measured with an accurate graduated device — never a household teaspoon or tablespoon.
  • Extended-release tablets: Taken once daily by mouth, with or without food. Swallow whole — do not crush, chew, or dissolve. For opioid-tolerant patients only.
  • Rectal suppositories: Typically every 6 to 8 hours for adults, as directed.
  • Injections: Given by a healthcare professional in a clinical setting.

Never stop taking hydromorphone suddenly if you have been on it regularly — abrupt discontinuation can cause serious withdrawal symptoms. Talk to your prescriber about how to taper safely if it needs to be stopped.

🤒Side effects — in detail

The most commonly reported side effects with hydromorphone include:

  • Constipation
  • Nausea and vomiting
  • Drowsiness (somnolence)
  • Headache
  • Dizziness
  • Fatigue or weakness
  • Itching (pruritus)
  • Dry mouth and excessive sweating

Get emergency help immediately for any signs of slowed or stopped breathing, extreme sedation you cannot be roused from, or chest pain. Contact your doctor promptly for signs of adrenal insufficiency (persistent nausea, severe tiredness), unusual pain sensitivity, mood changes, or difficulty urinating.

⚠️Warnings & precautions
  • Respiratory depression (dangerously slowed breathing): The most serious risk. Can occur at any time, but is greatest when starting therapy or increasing the dose. Fatal in some cases. Call 911 immediately if someone is breathing very slowly or cannot be woken.
  • Addiction, abuse, and misuse: Hydromorphone is a Schedule II controlled substance. Addiction can occur even at prescribed doses. Patients with a personal or family history of substance use disorder or mental illness are at higher risk.
  • Accidental ingestion by children: Even one dose can be fatal. Store securely.
  • Combining with CNS depressants or alcohol: Extremely dangerous — can result in coma or death. This includes benzodiazepines, sleep aids, antipsychotics, gabapentinoids, other opioids, and alcohol.
  • Neonatal opioid withdrawal syndrome: Prolonged use during pregnancy can cause serious withdrawal in the newborn.
  • Opioid-induced hyperalgesia: In some cases, the medication can paradoxically increase pain sensitivity over time.
  • Severe hypotension (very low blood pressure): Can occur, especially in patients with circulatory problems.
  • Head injury or increased intracranial pressure: Use with caution; hydromorphone can worsen these conditions.
🔀What it interacts with

Hydromorphone has several important drug and substance interactions that can be dangerous or even life-threatening:

  • Benzodiazepines and sedatives/sleep aids — dramatically increase risk of fatal respiratory depression and coma; avoid combining unless absolutely necessary and under close medical supervision
  • Alcohol — adds to sedation and breathing suppression; avoid entirely
  • Other opioids — additive sedation and respiratory depression
  • MAO inhibitors (MAOIs) — can cause severe toxicity including respiratory depression and serotonin syndrome; do not use within 14 days of stopping an MAOI
  • Antidepressants (SSRIs, SNRIs, TCAs) and other serotonergic drugs — risk of serotonin syndrome (agitation, fever, rapid heart rate, muscle twitching)
  • Gabapentin or pregabalin — increased sedation and breathing risk when combined
  • Muscle relaxants — may worsen respiratory depression
  • Anticholinergic drugs — increases risk of constipation severe enough to cause bowel obstruction, and urinary retention
  • Diuretics (water pills) — opioids can reduce their effectiveness; monitor for fluid changes

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • You are not opioid-tolerant — extended-release tablets and the high-potency injectable are contraindicated in opioid-naive patients due to risk of fatal respiratory depression
  • You have significant respiratory depression or severe uncontrolled asthma, especially in an unmonitored setting
  • You have a known or suspected bowel blockage (paralytic ileus) or narrowed gastrointestinal tract — contraindicated for extended-release tablets
  • You have a known allergy or severe hypersensitivity reaction (anaphylaxis) to hydromorphone
  • You are pregnant — long-term use can cause neonatal opioid withdrawal syndrome in the newborn; not recommended near the time of delivery
  • You are breastfeeding — hydromorphone passes into breast milk; breastfeeding is not recommended during treatment
  • You are elderly (65+) — more sensitive to side effects, especially breathing problems; dose adjustments are typically needed
  • You have moderate or severe liver disease — drug levels can increase significantly; severe hepatic impairment warrants using an alternative analgesic
  • You have moderate or severe kidney disease — drug levels may increase; consider an alternate analgesic for severe impairment
  • You have a personal or family history of substance use disorder or mental health conditions — higher risk of addiction; requires careful monitoring
🚑If you take too much

An overdose of hydromorphone can cause extremely slow or stopped breathing, deep sedation progressing to unconsciousness or coma, limpness of the muscles, pinpoint pupils, cold and clammy skin, and dangerously low blood pressure — and can be fatal. If you suspect an overdose, call 911 immediately and, if available, administer an opioid overdose reversal agent such as naloxone.

For extended-release tablets specifically, the drug continues to be released from the tablet for up to 24 to 48 hours after ingestion, so medical monitoring must continue even after initial treatment with a reversal agent, since the reversal agent wears off faster than the drug itself.

📡Pharmacodynamics — effects in the body

Hydromorphone directly depresses the brain's respiratory centers in a dose-dependent way, reducing the body's response to rising carbon dioxide levels — which is why breathing slows. It also causes the pupils to constrict (become very small, or "pinpoint"), slows movement through the stomach and intestines (leading to constipation), and can cause blood vessels to widen, sometimes resulting in a drop in blood pressure when you stand up (orthostatic hypotension). With longer-term use, it can interfere with hormone pathways, potentially reducing sex hormone levels and affecting fertility, libido, and menstrual cycles.

🔬Pharmacokinetics — how your body processes it

When taken as extended-release tablets, hydromorphone is absorbed gradually, with blood levels rising over 6 to 8 hours and remaining stable for up to 18 to 24 hours; the average half-life is about 11 hours. It is processed primarily in the liver and approximately 75% of a dose leaves the body through the urine, mostly as metabolites. Patients with moderate liver disease can have blood levels four times higher than normal, and moderate-to-severe kidney disease also raises drug exposure significantly — making dose adjustments or alternative medications necessary in those groups. Food does not meaningfully affect the absorption of the extended-release tablet formulation.

📦How to store it

Store at 20° to 25°C (68° to 77°F) . Protect from light. Store hydromorphone hydrochloride oral solution and hydromorphone hydrochloride tablets securely and dispose of properly.

📄 Written from Hydromorphone’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

100

Supplements & herbs that interact with Hydromorphone

100 supplements and herbal products have documented interactions with Hydromorphone in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 7
  • Moderate · 78
  • Minor · 15
Every supplement checked against Hydromorphone — ranked by severity The full interaction hub: 7 major · 78 moderate · 15 minor · every one linked to its full report. Check Hydromorphone against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Hydromorphone — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is hydromorphone and why did my doctor prescribe it instead of something else?
Hydromorphone is a strong opioid pain reliever — think of it as a more concentrated relative of morphine. Your doctor prescribed it because your pain is severe enough that other options, like non-opioid medicines or milder opioid combinations, either haven't worked or aren't expected to give you enough relief. It's only meant for pain that truly needs a medication at this level.
Is it safe to take a sleep aid, anxiety pill, or have a glass of wine while on this?
This is one of the most important things to understand about hydromorphone: combining it with alcohol, benzodiazepines (like Xanax or Valium), sleep aids, or any other sedating substance can be extremely dangerous — it can cause your breathing to slow down or stop entirely, which can be fatal. Please let every prescriber and your pharmacist know you're taking hydromorphone before starting any new medicine, including over-the-counter sleep aids.
What side effects should I expect, and which ones should make me call for help right away?
The most common side effects are constipation, nausea, drowsiness, dizziness, and headache — many people find these manageable, especially after the first few days. However, if you or someone around you notices very slow or shallow breathing, extreme difficulty staying awake, or lips or fingernails turning bluish, call 911 immediately — those are signs of a dangerous overdose. Having naloxone (an overdose reversal medicine) at home is strongly recommended.
I've heard opioids are addictive — should I be worried about that with hydromorphone?
It's a fair concern and an important one to be honest about. Hydromorphone is a Schedule II controlled substance, which means addiction can happen even when it's used exactly as prescribed. Your risk is higher if you or a family member has had issues with substance use or certain mental health conditions. That doesn't mean you shouldn't take it if you genuinely need it — it just means you and your doctor should check in regularly, use the lowest effective dose for the shortest time needed, and store it safely where others can't access it.
If I'm pregnant or thinking about getting pregnant, is this safe to take?
Taking hydromorphone for a long period during pregnancy can cause your newborn to go through opioid withdrawal after birth — a condition called neonatal opioid withdrawal syndrome — which can be serious if it's not caught and treated quickly. It's also not recommended while breastfeeding because it does pass into breast milk. If you are pregnant or planning to be, talk to your doctor right away so you can weigh the risks and plan together.
Can I stop taking hydromorphone whenever I want if I feel better?
Please don't stop suddenly, especially if you've been taking it regularly for a while. Stopping abruptly can trigger serious withdrawal symptoms. Your prescriber can guide you through a gradual taper — slowly reducing the dose over time — so your body can adjust safely. If your pain has changed or you feel like you no longer need it, that's absolutely the right conversation to have with your doctor.
Is Hydromorphone available over the counter?
Hydromorphone is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
Is Hydromorphone a controlled substance?
Yes — Hydromorphone is a federally controlled substance (Schedule II) in the United States, so how it is prescribed, refilled and dispensed is regulated by the DEA.
When was Hydromorphone first available?
Hydromorphone has been available in the United States since at least 1972, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Hydromorphone?
Hydromorphone is supplied by 38 manufacturers listed in the FDA NDC Directory, including Hospira, Inc., Fresenius Kabi USA, LLC, Hikma Pharmaceuticals USA Inc..

💬 Answers drafted from Hydromorphone’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Hydromorphone comes

Hydromorphone is available in 5 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Tablet

By mouth
Brands Dilaudid
Available strengths 3 strengths
76 FDA-listed product records

Extended-release tablet

By mouth
Available strengths 4 strengths
52 FDA-listed product records

Oral solution

By mouth
Brands Dilaudid
Available strengths 2 strengths
14 FDA-listed product records

Rectal suppository

Rectal
Available strengths 1 strength
4 FDA-listed product records

📊 Hydromorphone across the U.S. market

How Hydromorphone appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

5
Dose forms
38
Manufacturers
2
Brand names
240
FDA-listed product records
1972
First marketed

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Also listed with the FDA, not a patient dose form: Powder (18) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Hospira, Inc.11%
Fresenius Kabi USA, LLC11%
Hikma Pharmaceuticals USA Inc.10%
Bryant Ranch Prepack8%
Rhodes Pharmaceuticals L.P.7%
Padagis US LLC6%
Other makers48%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Hydromorphone is used

A general measure of how commonly Hydromorphone is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Hydromorphone is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

367,041
Medicaid prescriptions filled (Q1–Q4 2025)
$15.5M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Hydromorphone prescribed? Of the 1,596 medications we measure, Hydromorphone ranks #296 by Medicaid prescriptions — more than 81% of them.

Where Hydromorphone ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Hydromorphone product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 2 mg oral tablet is the most-dispensed Hydromorphone product — about 25% of these Medicaid prescriptions.

hydromorphone hydrochloride 2 MG Oral Tablet Most dispensed

90,160 Medicaid prescriptions (Q1–Q4 2025) 25% of Hydromorphone prescriptions shown $1.1M gross reimbursement (before rebates) ≈ $12 per prescription (gross)

Summed across the 4 of 56 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 897696

1 ML hydromorphone hydrochloride 1 MG/ML Cartridge

68,102 Medicaid prescriptions (Q1–Q4 2025) 19% of Hydromorphone prescriptions shown $3.4M gross reimbursement (before rebates) ≈ $49 per prescription (gross)

Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1724383

0.5 ML hydromorphone hydrochloride 1 MG/ML Prefilled Syringe

63,403 Medicaid prescriptions (Q1–Q4 2025) 17% of Hydromorphone prescriptions shown $3.8M gross reimbursement (before rebates) ≈ $60 per prescription (gross)

Summed across the 3 of 9 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1433251

hydromorphone hydrochloride 4 MG Oral Tablet

63,212 Medicaid prescriptions (Q1–Q4 2025) 17% of Hydromorphone prescriptions shown $1.1M gross reimbursement (before rebates) ≈ $18 per prescription (gross)

Summed across the 5 of 76 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 897702

1 ML hydromorphone hydrochloride 2 MG/ML Injection

21,706 Medicaid prescriptions (Q1–Q4 2025) 6% of Hydromorphone prescriptions shown $1.3M gross reimbursement (before rebates) ≈ $60 per prescription (gross)

Summed across the 3 of 7 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1724276

1 ML hydromorphone hydrochloride 1 MG/ML Prefilled Syringe

18,691 Medicaid prescriptions (Q1–Q4 2025) 5% of Hydromorphone prescriptions shown $2.3M gross reimbursement (before rebates) ≈ $122 per prescription (gross)

Summed across the 3 of 9 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 897756

hydromorphone hydrochloride 8 MG Oral Tablet

14,889 Medicaid prescriptions (Q1–Q4 2025) 4% of Hydromorphone prescriptions shown $789,413 gross reimbursement (before rebates) ≈ $53 per prescription (gross)

Summed across the 2 of 27 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 897710

1 ML hydromorphone hydrochloride 1 MG/ML Injection

10,502 Medicaid prescriptions (Q1–Q4 2025) 3% of Hydromorphone prescriptions shown $411,417 gross reimbursement (before rebates) ≈ $39 per prescription (gross)

Summed across the 2 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 897653

1 ML hydromorphone hydrochloride 2 MG/ML Cartridge

8,978 Medicaid prescriptions (Q1–Q4 2025) 2% of Hydromorphone prescriptions shown $668,598 gross reimbursement (before rebates) ≈ $74 per prescription (gross)

Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1724644

hydromorphone hydrochloride 1 MG/ML Oral Solution

2,450 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $154,891 gross reimbursement (before rebates) ≈ $63 per prescription (gross)

Summed across the 3 of 11 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 897657

1 ML hydromorphone hydrochloride 2 MG/ML Prefilled Syringe

1,570 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $68,876 gross reimbursement (before rebates) ≈ $44 per prescription (gross)

Summed across the 2 of 9 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 897757

1 ML hydromorphone hydrochloride 0.2 MG/ML Prefilled Syringe

1,472 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $185,016 gross reimbursement (before rebates) ≈ $126 per prescription (gross)

Summed across the 1 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2277368

50 ML hydromorphone hydrochloride 10 MG/ML Injection

638 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $111,550 gross reimbursement (before rebates) ≈ $175 per prescription (gross)

Summed across the 2 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1724341

24 HR hydromorphone hydrochloride 8 MG Extended Release Oral Tablet

483 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $77,867 gross reimbursement (before rebates) ≈ $161 per prescription (gross)

Summed across the 1 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 902741

5 ML hydromorphone hydrochloride 10 MG/ML Injection

234 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $38,959 gross reimbursement (before rebates) ≈ $166 per prescription (gross)

Summed across the 2 of 6 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1724340

0.5 ML hydromorphone hydrochloride 0.5 MG/ML Prefilled Syringe

202 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $809 gross reimbursement (before rebates) ≈ $4.00 per prescription (gross)

Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2675350

hydromorphone hydrochloride 2 MG/ML Injectable Solution

127 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $1,781 gross reimbursement (before rebates) ≈ $14 per prescription (gross)

Summed across the 1 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 897745

24 HR hydromorphone hydrochloride 12 MG Extended Release Oral Tablet

87 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $26,300 gross reimbursement (before rebates) ≈ $302 per prescription (gross)

Summed across the 1 of 6 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 902729

1 ML hydromorphone hydrochloride 10 MG/ML Injection

51 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $7,520 gross reimbursement (before rebates) ≈ $147 per prescription (gross)

Summed across the 3 of 6 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1724338

24 HR hydromorphone hydrochloride 16 MG Extended Release Oral Tablet

36 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $12,520 gross reimbursement (before rebates) ≈ $348 per prescription (gross)

Summed across the 1 of 6 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 902736

1 ML hydromorphone hydrochloride 4 MG/ML Cartridge

24 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $2 gross reimbursement (before rebates) ≈ $0.06 per prescription (gross)

Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 897758

hydromorphone hydrochloride 3 MG Rectal Suppository

12 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $6,930 gross reimbursement (before rebates) ≈ $578 per prescription (gross)

Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 897749

1 ML hydromorphone hydrochloride 4 MG/ML Injection

12 Medicaid prescriptions (Q1–Q4 2025) <1% of Hydromorphone prescriptions shown $52 gross reimbursement (before rebates) ≈ $4.32 per prescription (gross)

Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 897753

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Hydromorphone, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 45 of 259 listed Hydromorphone NDCs with Medicaid activity.

🔍 Compare Hydromorphone products

A representative set of FDA-listed product records for Hydromorphone — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 200 of 240 products — FDA National Drug Code Directory. See every product, package size and price: browse all 240 Hydromorphone NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Hydromorphone RxCUI 3423 10 dose forms · 32 strengths
  1. Dose form (SCDF) Extended Release Oral Capsule RxCUI 372427 No current FDA listing
    Clinical drug / strength (SCD) 12 HR hydromorphone hydrochloride 2 MG RxCUI 898611 12 HR hydromorphone hydrochloride 4 MG RxCUI 898614 12 HR hydromorphone hydrochloride 8 MG RxCUI 898618
  2. Dose form (SCDF) Injectable Solution RxCUI 370652 In current FDA listings
    Clinical drug / strength (SCD) hydrochloride 2 MG/ML RxCUI 897745
  3. Dose form (SCDF) Oral Capsule RxCUI 385569 No current FDA listing
    Clinical drug / strength (SCD) hydrochloride 1.3 MG RxCUI 898004 hydrochloride 2.6 MG RxCUI 898138
  4. Dose form (SCDF) Oral Solution RxCUI 370653 In current FDA listings
    Clinical drug / strength (SCD) hydrochloride 1 MG/ML RxCUI 897657
  5. Dose form (SCDF) Rectal Suppository RxCUI 370655 In current FDA listings
    Clinical drug / strength (SCD) hydrochloride 3 MG RxCUI 897749

Look up RxCUI 3423 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Dilaudid Exalgo

🏭 Manufacturers & labelers

Hospira, Inc. 26 Fresenius Kabi USA, LLC 26 Hikma Pharmaceuticals USA Inc. 23 Bryant Ranch Prepack 19 Rhodes Pharmaceuticals L.P. 16 Padagis US LLC 14 SpecGx LLC 13 XLCare Pharmaceuticals, Inc. 12 Trigen Laboratories, LLC 12 Camber Pharmaceuticals, Inc. 12 American Health Packaging 8 Rhodes Pharmaceuticals LLC 8 Teva Parenteral Medicines, Inc. 6 Aurolife Pharma, LLC 6 Ascent Pharmaceuticals Inc 4 Ascent Pharmaceuticals, Inc. 4 Veranova, L.P. 3 Lannett Company, Inc. 3 Asclemed Usa Inc. 3 Professional Compounding Centers of America 3 RedPharm Drug, Inc. 2 Purisys LLC 1 Akorn 1 St. Mary's Medical Park Pharmacy 1

…and 14 more on the FDA NDC directory.

RxNorm drug class

Hydromorphone belongs to the Opioid Agonist class.

Pharmacologic class Opioid Agonist
Drug family (ATC) Natural opium alkaloids
How it works Full Opioid Agonists

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective May 14, 2026
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Hydromorphone.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Hydromorphone after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
20
NDC products indexed
240
Distinct labelers/manufacturers represented
38
Linked representative label
Rhodes Pharmaceuticals L.P.
Linked label effective
May 14, 2026
Composite sections available
27
Linked SPL Set ID
37565441-0d95-4743-a695-d7b3326f58a1
Linked SPL Document ID
b786b01b-46f9-4a00-a667-699e813a741b
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 20 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Rhodes Pharmaceuticals L.P. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.