According to the Center for Disease Control and Prevention (CDC), synthetic opioids such as hydromorphone hydrochloride were involved in over 20,000 deaths in 2016. That’s nearly one-third of the 64,000 overdose deaths that occurred that year. A noticeable percentage of these fatalities were due to errors made in the clinical setting. The majority of hospital overdose cases happen the day following major surgery. Nationwide protocols focusing on accurately assessing patient respiratory depression and converting dose quantities from oral to intravenous routes are now in effect to cut down on hospital errors.

The three most prominent signs of hydromorphone hydrochloride overdose are pinpoint pupils, respiratory depression, and decreased level of consciousness.

Outside of the clinical setting, illicit hydromorphone use can lead to lethal overdose when mixed with substances that depress the central nervous system.

Muscle relaxants, first-generation antihistamines, MAO inhibitor antidepressants, other opioid pain relievers, benzodiazepines, barbiturates, hypnotics, sedatives, and beta-blockers should be avoided. Disclose to your doctor if you’re taking any of these medications before being administered hydromorphone hydrochloride.

Do not drink alcohol while taking hydromorphone hydrochloride. Alcohol interferes with the body’s ability to metabolize hydromorphone hydrochloride and can lead to toxic plasma levels of the drug.

Hydromorphone Hydrochloride Signs, Symptoms, and Side Effects
Hydromorphone hydrochloride is a highly addictive semi-synthetic opioid and analgesic painkiller. It’s considered to be five to eight times more powerful than morphine. Hydromorphone is most commonly administered via IV drip in a hospital setting as a fast-acting pain treatment.
Hydromorphone hydrochloride is a hydrogenated ketone derived from morphine. Hydromorphone was designed to be used intravenously due to its high solubility in water compared to traditional morphine. Hydromorphone hydrochloride has poor oral bioavailability.

Common side effects of hydromorphone overdose include respiratory depression, decreased consciousness, pinpoint pupils even in complete darkness, urinary retention, circulatory depression, and bronchospasm. Other potential side effects of hydromorphone hydrochloride use include dizziness, lightheadedness, nausea, vomiting, itching, poor coordination, sedation, somnolence, headache, and excessive perspiration.

Beginning in the late 1990s and continuing through the first two decades of the 2000s, North America has been in the grips of a major opioid epidemic. As of 2016, drug overdoses are the leading cause of death for Americans under the age of 50. Psychological or physical reliance on opioids often develops when patients are introduced to the drug in a hospital setting.

Physicians are advised to exercise caution when prescribing and administering hydromorphone hydrochloride due to the addictive nature of the drug and its high overdose rates. When administered intravenously, initial doses must be limited to between 0.1 mg and 0.3 mg before reassessing the patient for pain and respiratory depression.

Measures are in effect in several states to keep close tabs on the distribution of schedule II controlled substances. Emergency room staff are trained to look for signs of drug-seeking behavior in individuals complaining of pain.

Hydromorphone Hydrochloride Signs, Symptoms, and Side Effects
The longer-term use of opioids like hydromorphone hydrochloride can lead to several complications. In cases of prolonged high-dosage use, patients can experience neurotoxicity. This can manifest through a range of complications including tremors, agitation, myoclonus, and cognitive dysfunction. Heavy chronic use can also lead to a temporary hormone imbalance known as hypogonadism.

If you or someone you know is suffering from substance use disorder, The Recovery Village is here to help. There is a well-trained team standing by 24/7 that can be reached toll-free at 855-548-9825 or online at We can help you overcome your addiction today and help you get started on the path to living a drug-free life.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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