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What Factors Affect Dilaudid® Dosage?

By S. Berger
Updated Feb 21, 2024
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Dilaudid® is a brand name that refers to the medication hydromorphone, a potent opioid painkiller. Usually, this drug is taken to relieve moderate to severe pain. The exact Dilaudid® dosage that is taken by an individual depends on several factors. Level of pain, tolerance to opioids, body weight, and other medications taken can all influence which dose can provide the most benefits with the fewest side effects.

Adults taking this medication for pain typically take a Dilaudid® dosage of 2 milligrams (mg) to 4 mg at first, if they have not already been taking opioid drugs on a regular basis. People that have switched to Dilaudid® from another medication must factor in their previous dose to determine an equivalent amount of this drug needed for pain relief. An opioid conversion chart is often used for this purpose. Generally, 8 mg of hydromorphone taken orally is said to be equivalent to 40 mg to 60 mg of oral morphine, for example.

People changing from another medication to hydromorphone typically lower their initial Dilaudid® dosage that is calculated from this chart. This is done in order to account for the strength of this drug, and to minimize side effects. Normally, a dose is reduced by one-third to two-thirds of the calculated dose. An individual that is estimated to require 6 mg of Dilaudid® would therefore take 2 to 4 mg the first few times, until they know how their pain responds to this dosage.

Some people taking Dilaudid® for acute pain, which arises suddenly, may take another long-acting opioid for chronic pain, which is usually constant. Combining opioids can be dangerous, and even fatal in high doses. Therefore, an individual taking an extended-release drug for chronic pain may take a lower Dilaudid® dosage than would be needed without the long-acting medication. Individuals taking depressant medications for sleep or anxiety may also take a lower Dilaudid® dosage for similar reasons.

At times, this drug may be given as an injection, for intravenous (IV) usage. Typically, the IV Dilaudid® dosage that is used is lower than an oral dose. The IV form of this medication is roughly four times as strong as when it is taken by mouth. An individual that normally takes 8 mg of Dilaudid® orally would therefore only take 1.5 mg to 2 mg of this drug by IV. Even lower doses may be used in order to avoid dangerous side effects, particularly in elderly people.

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Discussion Comments
By anon944459 — On Apr 07, 2014

I have been on 6mg of dilaudid a day for two years now. I need to ask my doctor to increase my dosage because the effects are wearing off and I'm afraid to. This medication really helps me and i am afraid there more paranoid and or afraid than they are willing to help me. I wished I knew how to approach this.

By fBoyle — On Jul 20, 2012

@burcinc-- I can't really help you because as far as I know, mg and ml cannot be converted to each other. They're different measurements. So there is no way for me to know if 2mg of the tablets is equivalent to 6ml of the liquid Dilaudid.

You need to call the pharmacy you got the prescription from, or your doctor to clarify. It's best to follow the directions on the bottle unless your doctor specifically told you to take a different dose.

Oh, also make sure to use the measurement spoon the pharmacy gave you. I once made the mistake of using a regular tablespoon for my medicine and ended up taking the wrong dose.

By burcinc — On Jul 20, 2012

My doctor has prescribed me Dilaudid post surgery but I'm a little confused about the dose.

I spent two days in the hospital after the surgery and I was given 2mg every six hours then. But my doctor has not prescribed me tablets, but rather liquid Dilaudid. The directions on the bottle say to take 6ml every six hours. Isn't this too much?

Can anyone help?

By bear78 — On Jul 19, 2012

I use dilaudid for chronic pain and last month, I had the injection at the hospital instead of the pills. I was surprised by how small a dose I was given as an injection and asked the nurse about it.

She told me that the injection is a lot stronger like the article also said. The other reason she mentioned was that the injection works a lot faster than the pills. Since it enters the bloodstream immediately and all at once, it's more effective. That's why a small dose is enough.

I actually think this is really good. I've heard that hydromoprhone can be addictive so I don't want to take it regularly in pill form. I'm thinking of only getting the injection when I really need to now. At least the dose is much less.

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