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Oxycodone Vs. Hydromorphone (Dilaudid)

There are a variety of painkillers that are now available on the market that can effectively control pain in different clinical conditions. Certain clinical conditions however are accompanied by severe pain that cannot be controlled by over the counter medication. In such cases, stronger painkillers such as narcotic drugs must be given to relieve the pain. Oxycodone and hydrocodone are two such painkillers that are commonly used in clinical practice.

In this article, we shall briefly review these and compare and contrast their actions.


Oxycodone is a narcotic analgesic that acts on the opioid receptors and exerts its painkilling effects. It is extremely potent but unfortunately carries with it a strong potential for abuse.


Hydromorphone hydrochloride, also called Dilaudid, is also a narcotic agent closely related to morphine. As an opioid analgesic it is a powerful painkiller and is used in a variety of clinical situations.

Similarities and differences

There does not appear to be a great deal of difference between oxycodone and hydromorphone. There is however a difference in the equivalent potency when it comes to dosing the drug. In simple terms, this means that the same dose of hydromorphone does not have the same effect as an equivalent dose of oxycodone. In fact, 1 mg of hydromorphone is equivalent to 2.67 mg of oxycodone. This means that hydromorphone is nearly 2.5 times stronger than oxycodone.

When compared to morphine, hydromorphone is 5 times more potent, while oxycodone is only 1.5 times more potent.

The way the two drugs are derived is also different. Hydromorphone is derived directly from morphine and bears a striking resemblance to it. On the other hand, oxycodone is derived from thebain, and is structurally different to morphine despite it being considered an opiate drug.

In patients who have impaired kidney function, hydromorphone is preferred as it is less toxic to the kidneys.

With regards to its similarities, there appear to be a fair few. The indications for usage are the same, and for many it is prescribed to manage pain. The unfortunate recreational use still exists, though it appears to be more with oxycodone than with hydromorphone. Both hydromorphone and oxycodone can be administered to the patient as an oral tablet or in the form of an injection under the skin (called subcutaneous route).

A great deal of care must be taken when changing medication from oxycodone to hydromorphone. It is strongly recommended that any changes to narcotic medications are made by doctors or trained professionals with experience in prescribing pain medication. This is because patients may find that they switch to the wrong dose, and as a result can suffer from distressing pain is the dose is too small. On the contrary, there are also chances of overdose. The symptoms of overdose of oxycodone and hydromorphone are similar and include drowsiness, breathing difficulty, coma and even death in some cases.

Hydromorphone and oxycodone are narcotic analgesics with variable potencies. They must be used on prescription only and when given in the right dose can have a powerful analgesic effect.

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I am having difficulties with taking oxycodone/oxytocin due to side effects... Thus looking at chemical makeup & structure in each. I thankyou very much for you putting this type of education/information on line. I am intending on sharing this with Dr's I am seeing as well because I recently switched for one mo to dilaudid & then back on oxys again & this has allowed me to really see the diff in the NARLY or Edgy side effects I have compared to the oxycodone.... Also have discovered dome people do NOT metabolize certain types of opiates correctly & there is a way to test for it thru blood & it involves missing an enzyme that is called CYP450. There seem to be 3 types & as most things can be searched.... If ur having issues w/some types of opiates! Again... thanku...

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