Hydromorphone - DrugBank

ID Pharmacology Interactions References Trials Economics Properties Spectra Taxonomy

Targets (3)Enzymes (5)

Targets (3)Enzymes (5)Biointeractions (8)

Identification

Name

Hydromorphone

Accession Number

DB00327 (APRD01021)

Type

Small Molecule

Groups

Approved, Illicit

Description

An opioid analgesic derived from morphine and used mainly as an analgesic. It has a shorter duration of action and is more potent than morphine. [PubChem]

Structure

MOL SDF 3D-SDF PDB SMILES InChI View 3D Structure

Synonyms

(-)-(5R)-4,5-Epoxy-3-hydroxy-9alpha-methylmorphinan-6-one

4,5-Epoxy-3-hydroxy-17-methylmorphinan-6-one

4,5alpha-Epoxy-3-hydroxy-17-methyl-6-morphinanone

6-Deoxy-7,8-dihydro-6-oxomorphine

7,8-Dihydromorphinone

Dihydromorfinon

Dihydromorphinone

Dimorphone

Hidromorfona

Hydromorfona

Hydromorphone

Hydromorphonum

Idromorfone

External IDs

IDS-NH-004 / N02AA03 / NSC-19046

Product Ingredients

Ingredient	UNII	CAS	InChI Key	Details
Hydromorphone Hydrochloride	L960UP2KRW	71-68-1	XHILEZUETWRSHC-NRGUFEMZSA-N	Details
Hydromorphone sulfate	75Y990NH3Z	25333-57-7	JBBINZRUTLUBFR-NRGUFEMZSA-N	Details

Approved Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Bar-hydromorphone HCl	Capsule, extended release	6 mg	Oral	Bard Pharmaceuticals (1990) Inc	Not applicable	Not applicable	Canada
Bar-hydromorphone HCl	Capsule, extended release	4.5 mg	Oral	Bard Pharmaceuticals (1990) Inc	Not applicable	Not applicable	Canada
Bar-hydromorphone HCl	Capsule, extended release	18 mg	Oral	Bard Pharmaceuticals (1990) Inc	Not applicable	Not applicable	Canada
Bar-hydromorphone HCl	Capsule, extended release	9 mg	Oral	Bard Pharmaceuticals (1990) Inc	Not applicable	Not applicable	Canada
Bar-hydromorphone HCl	Capsule, extended release	24 mg	Oral	Bard Pharmaceuticals (1990) Inc	Not applicable	Not applicable	Canada
Bar-hydromorphone HCl	Capsule, extended release	3 mg	Oral	Bard Pharmaceuticals (1990) Inc	Not applicable	Not applicable	Canada
Bar-hydromorphone HCl	Capsule, extended release	12 mg	Oral	Bard Pharmaceuticals (1990) Inc	Not applicable	Not applicable	Canada
Bar-hydromorphone HCl	Capsule, extended release	30 mg	Oral	Bard Pharmaceuticals (1990) Inc	Not applicable	Not applicable	Canada
Dilaudid	Injection, solution	1 mg/mL	Intramuscular; Intravenous; Subcutaneous	Fresenius Kabi	2016-12-16	Not applicable	US
Dilaudid	Liquid	1 mg	Oral	Purdue Pharma	1989-12-31	Not applicable	Canada
Dilaudid	Tablet	8 mg/1	Oral	Purdue Pharma LP	1956-01-01	Not applicable	US
Dilaudid	Tablet	4 mg	Oral	Purdue Pharma	1984-12-31	Not applicable	Canada
Dilaudid	Suppository	3 mg	Rectal	Purdue Pharma	1984-12-31	2010-08-05	Canada
Dilaudid	Tablet	4 mg/1	Oral	Cardinal Health	1926-01-01	Not applicable	US
Dilaudid	Tablet	2 mg/1	Oral	Rhodes Pharmaceuticals, L.P.	2017-05-15	Not applicable	US
Dilaudid	Tablet	1 mg	Oral	Purdue Pharma	1986-12-31	Not applicable	Canada
Dilaudid	Tablet	8 mg	Oral	Purdue Pharma	1989-12-31	Not applicable	Canada
Dilaudid	Tablet	2 mg/1	Oral	Purdue Pharma LP	1956-01-01	Not applicable	US
Dilaudid	Solution	5 mg/5mL	Oral	Rhodes Pharmaceuticals, L.P.	2017-05-15	Not applicable	US
Dilaudid	Injection, solution	2 mg/mL	Intramuscular; Intravenous; Subcutaneous	Purdue Pharma LP	1926-01-01	Not applicable	US
Dilaudid	Tablet	4 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	1956-01-01	2016-12-21	US
Dilaudid	Liquid	2 mg	Intramuscular; Intravenous; Subcutaneous	Purdue Pharma	1984-12-31	Not applicable	Canada
Dilaudid	Injection, solution	2 mg/mL	Intramuscular; Intravenous; Subcutaneous	Fresenius Kabi	2016-12-16	Not applicable	US
Dilaudid	Tablet	4 mg/1	Oral	Mckesson Rxpak Inc	1956-01-01	Not applicable	US
Dilaudid	Tablet	4 mg/1	Oral	Rhodes Pharmaceuticals, L.P.	2017-05-15	Not applicable	US
Dilaudid	Tablet	4 mg/1	Oral	Purdue Pharma LP	1956-01-01	Not applicable	US
Dilaudid	Injection, solution	4 mg/mL	Intramuscular; Intravenous; Subcutaneous	Purdue Pharma LP	1926-01-01	Not applicable	US
Dilaudid	Tablet	2 mg/1	Oral	Lake Erie Medical &Surgical Supply Dba Quality Care Products Llc	2011-12-01	Not applicable	US
Dilaudid	Tablet	2 mg	Oral	Purdue Pharma	1984-12-31	Not applicable	Canada
Dilaudid	Injection, solution	4 mg/mL	Intramuscular; Intravenous; Subcutaneous	Fresenius Kabi	2016-12-16	Not applicable	US
Dilaudid	Powder, for solution	250 mg	Intramuscular; Intravenous; Subcutaneous	Purdue Pharma	1994-12-31	2013-06-07	Canada
Dilaudid	Liquid	5 mg/5mL	Oral	Purdue Pharma LP	1956-01-01	Not applicable	US
Dilaudid	Tablet	8 mg/1	Oral	Rhodes Pharmaceuticals, L.P.	2017-05-15	Not applicable	US
Dilaudid	Injection, solution	1 mg/mL	Intramuscular; Intravenous; Subcutaneous	Purdue Pharma LP	1926-01-01	2017-02-01	US
Dilaudid Hp	Liquid	10 mg	Intramuscular; Intravenous; Subcutaneous	Purdue Pharma	1984-12-31	Not applicable	Canada
Dilaudid Hp	Injection, powder, lyophilized, for solution	10 mg/mL	Intramuscular; Intravenous; Subcutaneous	Purdue Pharma LP	1984-01-11	2016-07-01	US
Dilaudid Hp	Injection, solution	10 mg/mL	Intramuscular; Intravenous; Subcutaneous	Purdue Pharma LP	1984-01-11	2016-05-01	US
Dilaudid-HP-plus	Solution	20 mg	Intramuscular; Intravenous; Subcutaneous	Purdue Pharma	1995-12-31	2012-08-02	Canada
Dilaudid-XP	Liquid	50 mg	Intramuscular; Intravenous; Subcutaneous	Purdue Pharma	1995-12-31	2012-08-02	Canada
Exalgo	Tablet, extended release	12 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2011-03-14	Not applicable	US
Exalgo	Tablet, extended release	8 mg/1	Oral	Mallinckrodt	2011-03-14	Not applicable	US
Exalgo	Tablet, extended release	32 mg/1	Oral	Mallinckrodt	2012-08-24	Not applicable	US
Exalgo	Tablet, extended release	8 mg/1	Oral	Physicians Total Care, Inc.	2012-12-31	Not applicable	US
Exalgo	Tablet, extended release	16 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2011-03-14	Not applicable	US
Exalgo	Tablet, extended release	12 mg/1	Oral	Mallinckrodt	2011-03-14	Not applicable	US
Exalgo	Tablet, extended release	16 mg/1	Oral	Physicians Total Care, Inc.	2012-12-31	Not applicable	US
Exalgo	Tablet, extended release	16 mg/1	Oral	Mallinckrodt	2011-03-14	Not applicable	US
Exalgo	Tablet, extended release	8 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2011-03-14	Not applicable	US
Exalgo	Tablet, extended release	8 mg/1	Oral	Stat Rx USA	2011-03-14	Not applicable	US
Hydromorph Contin	Capsule, extended release	4.5 mg	Oral	Purdue Pharma	2011-04-14	Not applicable	Canada
Hydromorph Contin	Capsule, extended release	9.0 mg	Oral	Purdue Pharma	2011-04-14	Not applicable	Canada
Hydromorph Contin-controlled Release Cap - 12mg	Capsule, extended release	12 mg	Oral	Purdue Pharma	1996-12-31	Not applicable	Canada
Hydromorph Contin-controlled Release Cap - 18mg	Capsule, extended release	18 mg	Oral	Purdue Pharma	2001-07-03	Not applicable	Canada
Hydromorph Contin-controlled Release Cap - 24mg	Capsule, extended release	24 mg	Oral	Purdue Pharma	1996-12-31	Not applicable	Canada
Hydromorph Contin-controlled Release Cap - 30mg	Capsule, extended release	30 mg	Oral	Purdue Pharma	1998-02-16	Not applicable	Canada
Hydromorph Contin-controlled Release Cap - 3mg	Capsule, extended release	3 mg	Oral	Purdue Pharma	1995-12-31	Not applicable	Canada
Hydromorph Contin-controlled Release Cap - 6mg	Capsule, extended release	6 mg	Oral	Purdue Pharma	1995-12-31	Not applicable	Canada
Hydromorph.ir - 2mg	Tablet	2 mg	Oral	Purdue Pharma	2002-12-19	2012-08-02	Canada
Hydromorph.ir - 4mg	Tablet	4 mg	Oral	Purdue Pharma	2002-12-19	2012-08-02	Canada
Hydromorph.ir - 8mg	Tablet	8 mg	Oral	Purdue Pharma	2002-12-19	2012-08-02	Canada
Hydromorphone	Tablet	4 mg	Oral	Sorres Pharma Inc	2004-04-06	2014-06-20	Canada
Hydromorphone	Tablet	1 mg	Oral	Sorres Pharma Inc	2004-04-06	2014-06-20	Canada
Hydromorphone	Tablet	2 mg	Oral	Sorres Pharma Inc	2004-04-06	2014-06-20	Canada
Hydromorphone	Tablet	8 mg	Oral	Sorres Pharma Inc	2004-04-06	2014-06-20	Canada
Hydromorphone HCl Tab 2mg USP	Tablet	2 mg	Oral	Roxane Labs, Division Of Boehringer Ingelheim	1992-12-31	2001-07-30	Canada
Hydromorphone HCl Tab 4mg USP	Tablet	4 mg	Oral	Roxane Labs, Division Of Boehringer Ingelheim	1992-12-31	2001-07-30	Canada
Hydromorphone Hp 10	Solution	10 mg	Intramuscular; Intravenous; Subcutaneous	Sandoz Canada Incorporated	1995-12-31	Not applicable	Canada
Hydromorphone Hp 20	Solution	20 mg	Intramuscular; Intravenous; Subcutaneous	Sandoz Canada Incorporated	1995-12-31	Not applicable	Canada
Hydromorphone Hp 50	Solution	50 mg	Intramuscular; Intravenous; Subcutaneous	Sandoz Canada Incorporated	1995-12-31	Not applicable	Canada
Hydromorphone Hp Forte Injection	Solution	100 mg	Intramuscular; Intravenous; Subcutaneous	Sandoz Canada Incorporated	2001-12-10	Not applicable	Canada
Hydromorphone Hydrochloride	Tablet	4 mg/1	Oral	Rhodes Pharmaceuticals, L.P.	2009-11-23	Not applicable	US
Hydromorphone Hydrochloride	Injection, solution	2 mg/mL	Intramuscular; Intravenous; Subcutaneous	Hospira, Inc.	2011-12-01	Not applicable	US
Hydromorphone Hydrochloride	Injection, solution	4 mg/mL	Intramuscular; Intravenous; Subcutaneous	Hospira, Inc.	2011-12-01	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	Rhodes Pharmaceuticals, L.P.	2009-11-23	Not applicable	US
Hydromorphone Hydrochloride	Injection, solution	2 mg/mL	Intramuscular; Intravenous; Subcutaneous	Hospira, Inc.	2011-12-01	Not applicable	US
Hydromorphone Hydrochloride	Tablet	8 mg/1	Oral	Rhodes Pharmaceuticals, L.P.	2009-11-23	Not applicable	US
Hydromorphone Hydrochloride	Injection, solution	4 mg/mL	Intramuscular; Intravenous; Subcutaneous	Hospira, Inc.	2011-12-01	Not applicable	US
Hydromorphone Hydrochloride	Injection, solution	2 mg/mL	Intramuscular; Intravenous; Subcutaneous	Hospira, Inc.	2011-12-01	Not applicable	US
Hydromorphone Hydrochloride	Tablet	8 mg/1	Oral	Stat Rx USA	2009-11-23	Not applicable	US
Hydromorphone Hydrochloride	Tablet	4 mg/1	Oral	bryant ranch prepack	2009-11-23	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	bryant ranch prepack	2009-11-23	Not applicable	US
Hydromorphone Hydrochloride	Injection, solution	1 mg/mL	Intramuscular; Intravenous; Subcutaneous	Hospira, Inc.	2011-12-01	Not applicable	US
Hydromorphone Hydrochloride	Solution	5 mg/5mL	Oral	Rhodes Pharmaceuticals, L.P.	2012-07-20	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	Avera Mc Kennan Hospital	2015-05-28	Not applicable	US
Hydromorphone Hydrochloride	Injection, solution	1 mg/mL	Intramuscular; Intravenous; Subcutaneous	Hospira, Inc.	2011-12-01	Not applicable	US
Hydromorphone Hydrochloride Extended-release	Tablet, extended release	8 mg/1	Oral	Mallinckrodt	2014-06-12	Not applicable	US
Hydromorphone Hydrochloride Extended-release	Tablet, extended release	32 mg/1	Oral	Mallinckrodt	2014-06-12	Not applicable	US
Hydromorphone Hydrochloride Extended-release	Tablet, extended release	12 mg/1	Oral	Mallinckrodt	2014-06-12	Not applicable	US
Hydromorphone Hydrochloride Extended-release	Tablet, extended release	16 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2014-06-12	Not applicable	US
Hydromorphone Hydrochloride Extended-release	Tablet, extended release	16 mg/1	Oral	Mallinckrodt	2014-06-12	Not applicable	US
Hydromorphone Hydrochloride Injection	Solution	2 mg	Intramuscular; Intravenous; Subcutaneous	Sterimax Inc	2017-02-06	Not applicable	Canada
Hydromorphone Hydrochloride Injection Hp 10	Solution	10 mg	Intramuscular; Intravenous; Subcutaneous	Sterimax Inc	2017-02-06	Not applicable	Canada
Hydromorphone Hydrochloride Injection USP	Solution	2 mg	Intramuscular; Intravenous; Subcutaneous	Sandoz Canada Incorporated	1995-12-31	Not applicable	Canada
Hydromorphone Hydrochloride Injection USP Hp 10	Solution	10 mg	Intramuscular; Intravenous; Subcutaneous	Hospira, Inc.	2014-06-11	Not applicable	Canada
Hydromorphone Hydrochloride Sup 3mg	Suppository	3 mg	Rectal	Sandoz Canada Incorporated	1992-12-31	2012-01-23	Canada
Jurnista	Tablet, extended release	8 mg	Oral	Janssen Pharmaceuticals	2010-03-04	Not applicable	Canada
Jurnista	Tablet, extended release	4 mg	Oral	Janssen Pharmaceuticals	2010-03-04	Not applicable	Canada
Jurnista	Tablet, extended release	16 mg	Oral	Janssen Pharmaceuticals	2010-03-04	Not applicable	Canada
Jurnista	Tablet, extended release	32 mg	Oral	Janssen Pharmaceuticals	2010-03-04	Not applicable	Canada
Palladone XL - 12mg	Capsule, extended release	12 mg	Oral	Purdue Pharma	2002-12-19	2005-08-05	Canada
Palladone XL - 16mg	Capsule, extended release	16 mg	Oral	Purdue Pharma	2002-12-19	2005-08-05	Canada
Palladone XL - 24mg	Capsule, extended release	24 mg	Oral	Purdue Pharma	2002-12-19	2005-08-05	Canada
PHL-hydromorphone	Suppository	3 mg	Rectal	Pharmel Inc	Not applicable	Not applicable	Canada
PHL-hydromorphone -syr 1mg/ml	Syrup	1 mg	Oral	Pharmel Inc	Not applicable	Not applicable	Canada
PMS Hydromorphone Sirop 1mg/ml	Syrup	1 mg	Oral	Pharmascience Inc	1991-12-31	Not applicable	Canada
PMS Hydromorphone Suppositoire 3mg	Suppository	3 mg	Rectal	Pharmascience Inc	1991-12-31	Not applicable	Canada
PMS-hydromorphone Tab 1mg	Tablet	1 mg	Oral	Pharmascience Inc	1991-12-31	Not applicable	Canada
PMS-hydromorphone Tab 2mg	Tablet	2 mg	Oral	Pharmascience Inc	1991-12-31	Not applicable	Canada
PMS-hydromorphone Tab 4mg	Tablet	4 mg	Oral	Pharmascience Inc	1991-12-31	Not applicable	Canada
PMS-hydromorphone Tab 8mg	Tablet	8 mg	Oral	Pharmascience Inc	1991-12-31	Not applicable	Canada
Teva-hydromorphone	Tablet	2 mg	Oral	Teva	2011-11-16	Not applicable	Canada
Teva-hydromorphone	Tablet	4 mg	Oral	Teva	2011-11-16	Not applicable	Canada
Teva-hydromorphone	Tablet	1 mg	Oral	Teva	2011-11-16	Not applicable	Canada
Teva-hydromorphone	Tablet	8 mg	Oral	Teva	2011-11-16	Not applicable	Canada

Approved Generic Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Apo-hydromorphone	Tablet	4 mg	Oral	Apotex Corporation	2012-12-18	Not applicable	Canada
Apo-hydromorphone	Tablet	1 mg	Oral	Apotex Corporation	2012-12-18	Not applicable	Canada
Apo-hydromorphone	Tablet	8 mg	Oral	Apotex Corporation	2012-12-18	Not applicable	Canada
Apo-hydromorphone	Tablet	2 mg	Oral	Apotex Corporation	2012-12-18	Not applicable	Canada
Hydromorphone Hydrochloride	Tablet, extended release	8 mg/1	Oral	Trigen Laboratories, Inc.	2016-09-15	Not applicable	US
Hydromorphone Hydrochloride	Tablet	8 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2010-04-26	2017-02-03	US
Hydromorphone Hydrochloride	Tablet	4 mg/1	Oral	Stat Rx USA	2007-09-19	Not applicable	US
Hydromorphone Hydrochloride	Tablet	8 mg/1	Oral	Lannett Company, Inc.	2009-12-09	Not applicable	US
Hydromorphone Hydrochloride	Tablet	8 mg/1	Oral	Mallinckrodt	2009-05-14	Not applicable	US
Hydromorphone Hydrochloride	Tablet, extended release	32 mg/1	Oral	Actavis Pharma Company	2016-10-10	Not applicable	US
Hydromorphone Hydrochloride	Tablet	8 mg/1	Oral	bryant ranch prepack	2009-07-29	Not applicable	US
Hydromorphone Hydrochloride	Tablet, extended release	8 mg/1	Oral	Paddock Laboratories, Inc.	2015-05-22	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	Stat Rx USA	2009-05-14	Not applicable	US
Hydromorphone Hydrochloride	Tablet, extended release	32 mg/1	Oral	Trigen Laboratories, Inc.	2016-09-15	Not applicable	US
Hydromorphone Hydrochloride	Tablet	8 mg/1	Oral	H.J. Harkins Company	2009-12-09	Not applicable	US
Hydromorphone Hydrochloride	Tablet	4 mg/1	Oral	Lake Erie Medical &Surgical Supply Dba Quality Care Products Llc	2011-11-29	2016-12-31	US
Hydromorphone Hydrochloride	Tablet, film coated, extended release	12 mg/1	Oral	Actavis Pharma Company	2014-05-21	Not applicable	US
Hydromorphone Hydrochloride	Tablet	8 mg/1	Oral	Aurolife Pharma, LLC	2016-05-17	Not applicable	US
Hydromorphone Hydrochloride	Tablet	4 mg/1	Oral	Lannett Company, Inc.	2009-12-09	Not applicable	US
Hydromorphone Hydrochloride	Tablet	8 mg/1	Oral	Amerincan Health Packaging	2014-08-14	Not applicable	US
Hydromorphone Hydrochloride	Tablet	8 mg/1	Oral	West Ward Pharmaceutical	2009-07-29	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	Mallinckrodt	2009-05-14	Not applicable	US
Hydromorphone Hydrochloride	Tablet, film coated	8 mg/1	Oral	Physicians Total Care, Inc.	2002-02-06	Not applicable	US
Hydromorphone Hydrochloride	Injection, solution	10 mg/mL	Intramuscular; Intravenous; Subcutaneous	Teva Parenteral Medicines, Inc.	2011-01-18	Not applicable	US
Hydromorphone Hydrochloride	Tablet	4 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2009-12-09	Not applicable	US
Hydromorphone Hydrochloride	Tablet, extended release	12 mg/1	Oral	Trigen Laboratories, Inc.	2016-09-15	Not applicable	US
Hydromorphone Hydrochloride	Tablet	8 mg/1	Oral	TAGI Pharma, Inc.	2012-03-09	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	Stat Rx USA	2007-09-19	Not applicable	US
Hydromorphone Hydrochloride	Tablet, film coated, extended release	8 mg/1	Oral	Actavis Pharma Company	2014-05-21	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	Aurolife Pharma, LLC	2016-05-17	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2009-05-14	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	Amerincan Health Packaging	2013-07-17	Not applicable	US
Hydromorphone Hydrochloride	Tablet, extended release	12 mg/1	Oral	Paddock Laboratories, Inc.	2015-05-22	Not applicable	US
Hydromorphone Hydrochloride	Injection	10 mg/mL	Parenteral	Akorn	2010-05-15	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	Mc Kesson Packaging Services A Buisness Unit Of Mc Kesson Corporation	2009-12-09	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	H.J. Harkins Company	2009-12-09	Not applicable	US
Hydromorphone Hydrochloride	Injection, solution	10 mg/mL	Intramuscular; Intravenous; Subcutaneous	Hospira, Inc.	2008-06-17	Not applicable	US
Hydromorphone Hydrochloride	Solution	1 mg/mL	Oral	West Ward Pharmaceutical	2012-03-01	Not applicable	US
Hydromorphone Hydrochloride	Tablet	4 mg/1	Oral	Mallinckrodt	2009-05-14	Not applicable	US
Hydromorphone Hydrochloride	Tablet, film coated	4 mg/1	Oral	Physicians Total Care, Inc.	2004-01-07	Not applicable	US
Hydromorphone Hydrochloride	Injection, solution	10 mg/mL	Intramuscular; Intravenous; Subcutaneous	Teva Parenteral Medicines, Inc.	2011-01-18	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2009-12-09	Not applicable	US
Hydromorphone Hydrochloride	Tablet, extended release	16 mg/1	Oral	Paddock Laboratories, Inc.	2015-05-22	Not applicable	US
Hydromorphone Hydrochloride	Tablet, extended release	16 mg/1	Oral	Trigen Laboratories, Inc.	2016-09-15	Not applicable	US
Hydromorphone Hydrochloride	Tablet	4 mg/1	Oral	H.J. Harkins Company	2009-12-09	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	Pd Rx Pharmaceuticals, Inc.	2009-12-09	Not applicable	US
Hydromorphone Hydrochloride	Tablet, film coated, extended release	16 mg/1	Oral	Actavis Pharma Company	2014-05-21	Not applicable	US
Hydromorphone Hydrochloride	Tablet	4 mg/1	Oral	Aurolife Pharma, LLC	2016-05-17	Not applicable	US
Hydromorphone Hydrochloride	Tablet	2 mg/1	Oral	Lannett Company, Inc.	2009-12-09	Not applicable	US
Hydromorphone Hydrochloride	Tablet	4 mg/1	Oral	Amerincan Health Packaging	2013-07-17	Not applicable	US
Hydromorphone Hydrochloride	Injection, solution	10 mg/mL	Intramuscular; Intravenous; Subcutaneous	Teva Parenteral Medicines, Inc.	2011-01-18	Not applicable	US
Hydromorphone Hydrochloride	Tablet	8 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2009-12-09	Not applicable	US
Hydromorphone Hydrochloride	Tablet	4 mg/1	Oral	West Ward Pharmaceutical	2009-07-29	Not applicable	US
Hydromorphone Hydrochloride	Tablet	4 mg/1	Oral	Mc Kesson Packaging Services A Buisness Unit Of Mc Kesson Corporation	2009-12-09	Not applicable	US
Hydromorphone Hydrochloride	Tablet, film coated	2 mg/1	Oral	Physicians Total Care, Inc.	2004-09-20	Not applicable	US
Hyrdomorphone Hydrochloride	Tablet	8 mg/1	Oral	Precision Dose, Inc.	2014-02-17	Not applicable	US

Approved Over the Counter Products

Not Available

Unapproved/Other Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Hydromorphone HCl	Injection, solution	.4 mg/mL	Intravenous	Cantrell Drug Company	2014-08-13	Not applicable	US
Hydromorphone HCl	Injection, solution	.2 mg/mL	Intravenous	Cantrell Drug Company	2010-08-23	Not applicable	US
Hydromorphone HCl	Injection, solution	1 mg/mL	Intravenous	Cantrell Drug Company	2011-06-30	Not applicable	US
Hydromorphone HCl	Injection, solution	2 mg/mL	Intravenous	Cantrell Drug Company	2014-08-13	Not applicable	US
Hydromorphone HCl	Injection, solution	.1 mg/mL	Intravenous	Cantrell Drug Company	2014-08-21	Not applicable	US
Hydromorphone HCl	Injection, solution	10 mg/mL	Intravenous	Cantrell Drug Company	2014-08-13	Not applicable	US
Hydromorphone HCl	Injection, solution	.5 mg/mL	Intramuscular; Intravenous; Subcutaneous	Cantrell Drug Company	2012-01-18	Not applicable	US
Hydromorphone Hydrochloride	Suppository	3 mg/1	Rectal	Paddock Laboratories, Inc.	1996-01-31	Not applicable	US
Hydromorphone Hydrochloride	Injection	2 mg/mL	Intramuscular; Intravenous; Subcutaneous	West Ward Pharmaceutical	1972-01-01	Not applicable	US
Hydromorphone Hydrochloride	Injection	2 mg/mL	Intramuscular; Intravenous; Subcutaneous	West Ward Pharmaceutical	1972-01-01	Not applicable	US

International Brands

Name	Company
Palladone	Not Available

Brand mixtures

Not Available

Categories

UNII

Q812464R06

CAS number

466-99-9

Weight

Average: 285.3377
Monoisotopic: 285.136493479

Chemical Formula

C₁₇H₁₉NO₃

InChI Key

WVLOADHCBXTIJK-YNHQPCIGSA-N

InChI

InChI=1S/C17H19NO3/c1-18-7-6-17-10-3-5-13(20)16(17)21-15-12(19)4-2-9(14(15)17)8-11(10)18/h2,4,10-11,16,19H,3,5-8H2,1H3/t10-,11+,16-,17-/m0/s1

IUPAC Name

(1S,5R,13R,17R)-10-hydroxy-4-methyl-12-oxa-4-azapentacyclo[9.6.1.0¹,¹³.0⁵,¹⁷.0⁷,¹⁸]octadeca-7(18),8,10-trien-14-one

SMILES

[H][C@@]12OC3=C(O)C=CC4=C3[C@@]11CCN(C)[C@]([H])(C4)[C@]1([H])CCC2=O

Pharmacology

Indication

For the relief of moderate to severe pain such as that due to surgery, cancer, trauma/injury, or burns.

Structured Indications

Pharmacodynamics

Hydromorphone is a hydrogenated ketone derivative of morphine that acts as a narcotic analgesic. It has a shorter duration of action than morphine. Hydromorphone is approximately 8 times more potent on a milligram basis than morphine. In addition, hydromorphone is better absorbed orally than is morphine. In clinical settings, Hydromorphone exerts its principal pharmacological effect on the central nervous system and gastrointestinal tract. Its primary actions of therapeutic value are analgesia and sedation. Hydromorphone appears to increase the patient's tolerance for pain and to decrease discomfort, although the presence of the pain itself may still be recognized. In addition to analgesia, alterations in mood, euphoria and dysphoria, and drowsiness commonly occur. Opioids also produce respiratory depression by direct action on brain stem respiratory centers.

Mechanism of action

Hydromorphone is a narcotic analgesic; its principal therapeutic effect is relief of pain. Hydromorphone interacts predominantly with the opioid mu-receptors. These mu-binding sites are discretely distributed in the human brain, with high densities in the posterior amygdala, hypothalamus, thalamus, nucleus caudatus, putamen, and certain cortical areas. They are also found on the terminal axons of primary afferents within laminae I and II (substantia gelatinosa) of the spinal cord and in the spinal nucleus of the trigeminal nerve. In clinical settings, Hydromorphone exerts its principal pharmacological effect on the central nervous system and gastrointestinal tract. Hydromorphone also binds with kappa-receptors which are thought to mediate spinal analgesia, miosis and sedation.

Target	Kind	Pharmacological action	Actions	Organism	UniProt ID
Mu-type opioid receptor	Protein	yes	agonist	Human	P35372	details
Delta-type opioid receptor	Protein	yes	partial agonist	Human	P41143	details
Kappa-type opioid receptor	Protein	yes	agonist	Human	P41145	details

Absorption

Better absorbed orally than morphine

Volume of distribution

Not Available

Protein binding

20%

Metabolism

Primarily hepatic. After absorption hydromorphone is metabolized by the liver to the glucuronide conjugate which is then excreted in the urine. Hydromorphone is metabolized to the major metabolites hydromorphone-3-glucuronide, hydromorphone-3-glucoside and dihydroisomorphine-6-glucuronide.

Substrate	Enzymes	Product
Hydromorphone	Prostaglandin G/H synthase 1	Dihydromorphine	Details
Hydromorphone	Prostaglandin G/H synthase 1	Dihydroisomorphine	Details
Hydromorphone	Cytochrome P450 3A4 Cytochrome P450 2C9 Cytochrome P450 2D6	Norhydromorphone	Details
Hydromorphone	UDP-glucuronosyltransferase 1-9	Hydromorphone 3-beta-O-glucuronide	Details
Hydromorphone	Not Available	Dihydroisomorphine-6-glucuronide	Details
Hydromorphone	Not Available	Hydromorphone-3-glucoside	Details
Hydromorphone	Not Available	Hydromorphone-3-glucuronide	Details
Hydromorphone	Not Available	Hydromorphone-3-sulphate	Details
Dihydromorphine	UDP-glucuronosyltransferase	Dihydromorphine-3-glucuronide	Details

Route of elimination

Only a small amount of the hydromorphone dose is excreted unchanged in the urine. Most of the dose is excreted as hydromorphone-3-glucuronide along with minor amounts of 6-hydroxy reduction metabolites.

Half life

2.6 hours (oral); 18.6 hours for sustained release Palladone

Clearance

1.96 L/min

Toxicity

Hydromorphone is a schedule II narcotic which can lead to physical dependence or addiction. High doses lead to respiratory depression, nausea, and vomiting. Overdoses lead to extreme somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, and sometimes bradycardia and hypotension. In severe overdosage, apnea, circulatory collapse, cardiac arrest and death may occur.

Affected organisms

Humans and other mammals

Pathways

Not Available

Pharmacogenomic Effects/ADRs

Not Available

Interactions

Drug Interactions

Drug	Interaction	Drug group
2,5-Dimethoxy-4-ethylamphetamine	2,5-Dimethoxy-4-ethylamphetamine may increase the analgesic activities of Hydromorphone.	Experimental, Illicit
3,4-Methylenedioxyamphetamine	3,4-Methylenedioxyamphetamine may increase the analgesic activities of Hydromorphone.	Experimental, Illicit
3,4-Methylenedioxymethamphetamine	3,4-Methylenedioxymethamphetamine may increase the analgesic activities of Hydromorphone.	Experimental, Illicit
4-Bromo-2,5-dimethoxyamphetamine	4-Bromo-2,5-dimethoxyamphetamine may increase the analgesic activities of Hydromorphone.	Experimental, Illicit
7-Nitroindazole	The risk or severity of adverse effects can be increased when Hydromorphone is combined with 7-Nitroindazole.	Experimental
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline	The risk or severity of adverse effects can be increased when 7,8-DICHLORO-1,2,3,4-TETRAHYDROISOQUINOLINE is combined with Hydromorphone.	Experimental
Abiraterone	The serum concentration of Hydromorphone can be increased when it is combined with Abiraterone.	Approved
Acepromazine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Acepromazine.	Approved, Vet Approved
Aceprometazine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Aceprometazine.	Approved
Acetazolamide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Acetazolamide.	Approved, Vet Approved
Aclidinium	The risk or severity of adverse effects can be increased when Aclidinium is combined with Hydromorphone.	Approved
Adipiplon	The risk or severity of adverse effects can be increased when Hydromorphone is combined with adipiplon.	Investigational
Agomelatine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Agomelatine.	Approved, Investigational
Alfaxalone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Alfaxalone.	Vet Approved
Alfentanil	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Alfentanil.	Approved, Illicit
Alimemazine	Alimemazine may increase the hypotensive activities of Hydromorphone.	Approved, Vet Approved
Allopregnanolone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Sage 547.	Investigational
Alphacetylmethadol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Alphacetylmethadol.	Experimental, Illicit
Alprazolam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Alprazolam.	Approved, Illicit, Investigational
Alvimopan	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Alvimopan.	Approved
Amiloride	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Amiloride.	Approved
Amiodarone	The metabolism of Hydromorphone can be decreased when combined with Amiodarone.	Approved, Investigational
Amisulpride	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Amisulpride.	Approved, Investigational
Amitriptyline	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Amitriptyline.	Approved
Ammonium chloride	Ammonium chloride may increase the excretion rate of Hydromorphone which could result in a lower serum level and potentially a reduction in efficacy.	Approved, Vet Approved
Amobarbital	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Amobarbital.	Approved, Illicit
Amoxapine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Amoxapine.	Approved
Amperozide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Amperozide.	Experimental
Amphetamine	Amphetamine may increase the analgesic activities of Hydromorphone.	Approved, Illicit
Anisotropine Methylbromide	The risk or severity of adverse effects can be increased when Anisotropine Methylbromide is combined with Hydromorphone.	Approved
Aprepitant	The serum concentration of Hydromorphone can be increased when it is combined with Aprepitant.	Approved, Investigational
Aripiprazole	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Aripiprazole.	Approved, Investigational
Artemether	The metabolism of Hydromorphone can be decreased when combined with Artemether.	Approved
Articaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Articaine.	Approved
Asenapine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Asenapine.	Approved
Atazanavir	The metabolism of Hydromorphone can be decreased when combined with Atazanavir.	Approved, Investigational
Atomoxetine	The metabolism of Hydromorphone can be decreased when combined with Atomoxetine.	Approved
Atracurium besylate	The risk or severity of adverse effects can be increased when Atracurium besylate is combined with Hydromorphone.	Approved
Atropine	The risk or severity of adverse effects can be increased when Atropine is combined with Hydromorphone.	Approved, Vet Approved
Azelastine	Hydromorphone may increase the central nervous system depressant (CNS depressant) activities of Azelastine.	Approved
Azelastine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Azelastine.	Approved
Azosemide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Azosemide.	Investigational
Baclofen	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Baclofen.	Approved
Barbital	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Barbital.	Illicit
Benactyzine	The risk or severity of adverse effects can be increased when Benactyzine is combined with Hydromorphone.	Withdrawn
Bendroflumethiazide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Bendroflumethiazide.	Approved
Benmoxin	The risk or severity of adverse effects can be increased when Benmoxin is combined with Hydromorphone.	Withdrawn
Benperidol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Benperidol.	Investigational
Benzatropine	The risk or severity of adverse effects can be increased when Benzatropine is combined with Hydromorphone.	Approved
Benzocaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Benzocaine.	Approved
Benzphetamine	Benzphetamine may increase the analgesic activities of Hydromorphone.	Approved, Illicit
Benzyl alcohol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Benzyl alcohol.	Approved
Betaxolol	The metabolism of Hydromorphone can be decreased when combined with Betaxolol.	Approved
Bexarotene	The serum concentration of Hydromorphone can be decreased when it is combined with Bexarotene.	Approved, Investigational
Biperiden	The risk or severity of adverse effects can be increased when Biperiden is combined with Hydromorphone.	Approved
BL-1020	BL-1020 may increase the hypotensive activities of Hydromorphone.	Investigational
Boceprevir	The metabolism of Hydromorphone can be decreased when combined with Boceprevir.	Approved, Investigational
Bortezomib	The metabolism of Hydromorphone can be decreased when combined with Bortezomib.	Approved, Investigational
Bosentan	The serum concentration of Hydromorphone can be decreased when it is combined with Bosentan.	Approved, Investigational
Brexpiprazole	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Brexpiprazole.	Approved
Brimonidine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Brimonidine.	Approved
Brimonidine	Brimonidine may increase the central nervous system depressant (CNS depressant) activities of Hydromorphone.	Approved
Bromazepam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Bromazepam.	Approved, Illicit
Brompheniramine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Brompheniramine.	Approved
Brotizolam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Brotizolam.	Approved, Withdrawn
Bumetanide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Bumetanide.	Approved
Bupivacaine	The risk or severity of adverse effects can be increased when Bupivacaine is combined with Hydromorphone.	Approved, Investigational
Buprenorphine	Hydromorphone may increase the central nervous system depressant (CNS depressant) activities of Buprenorphine.	Approved, Illicit, Investigational, Vet Approved
Bupropion	The metabolism of Hydromorphone can be decreased when combined with Bupropion.	Approved
Buspirone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Buspirone.	Approved, Investigational
Butabarbital	The risk or severity of adverse effects can be increased when Butabarbital is combined with Hydromorphone.	Approved, Illicit
Butalbital	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Butalbital.	Approved, Illicit
Butethal	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Butethal.	Approved, Illicit
Butorphanol	Butorphanol may decrease the analgesic activities of Hydromorphone.	Approved, Illicit, Vet Approved
Canrenoic acid	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Canrenoic acid.	Approved, Withdrawn
Canrenone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Canrenone.	Investigational
Capecitabine	The metabolism of Hydromorphone can be decreased when combined with Capecitabine.	Approved, Investigational
Carbamazepine	The metabolism of Hydromorphone can be increased when combined with Carbamazepine.	Approved, Investigational
Carbinoxamine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Carbinoxamine.	Approved
Carfentanil	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Carfentanil.	Illicit, Vet Approved
Carisoprodol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Carisoprodol.	Approved
Caroxazone	The risk or severity of adverse effects can be increased when Caroxazone is combined with Hydromorphone.	Withdrawn
Celecoxib	The metabolism of Hydromorphone can be decreased when combined with Celecoxib.	Approved, Investigational
Ceritinib	The serum concentration of Hydromorphone can be increased when it is combined with Ceritinib.	Approved
Cetirizine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Cetirizine.	Approved
Chloral hydrate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Chloral hydrate.	Approved, Illicit, Vet Approved
Chlordiazepoxide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Chlordiazepoxide.	Approved, Illicit
Chlormezanone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Chlormezanone.	Approved, Withdrawn
Chloroprocaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Chloroprocaine.	Approved
Chloroquine	The metabolism of Hydromorphone can be decreased when combined with Chloroquine.	Approved, Vet Approved
Chlorothiazide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Chlorothiazide.	Approved, Vet Approved
Chlorphenamine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Chlorphenamine.	Approved
Chlorphenoxamine	The risk or severity of adverse effects can be increased when Chlorphenoxamine is combined with Hydromorphone.	Withdrawn
Chlorphentermine	Chlorphentermine may increase the analgesic activities of Hydromorphone.	Illicit, Withdrawn
Chlorpromazine	The metabolism of Hydromorphone can be decreased when combined with Chlorpromazine.	Approved, Vet Approved
Chlorprothixene	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Chlorprothixene.	Approved, Withdrawn
Chlorthalidone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Chlorthalidone.	Approved
Chlorzoxazone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Chlorzoxazone.	Approved
Cholecalciferol	The metabolism of Hydromorphone can be decreased when combined with Cholecalciferol.	Approved, Nutraceutical
Cicletanine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Cicletanine.	Investigational
Cimetidine	The metabolism of Hydromorphone can be decreased when combined with Cimetidine.	Approved
Cinacalcet	The metabolism of Hydromorphone can be decreased when combined with Cinacalcet.	Approved
Cinchocaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Cinchocaine.	Approved, Vet Approved
Citalopram	The metabolism of Hydromorphone can be decreased when combined with Citalopram.	Approved
Clarithromycin	The metabolism of Hydromorphone can be decreased when combined with Clarithromycin.	Approved
Clemastine	The metabolism of Hydromorphone can be decreased when combined with Clemastine.	Approved
Clidinium	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Clidinium.	Approved
Clobazam	The metabolism of Hydromorphone can be decreased when combined with Clobazam.	Approved, Illicit
Clomipramine	The metabolism of Hydromorphone can be decreased when combined with Clomipramine.	Approved, Vet Approved
Clonazepam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Clonazepam.	Approved, Illicit
Clonidine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Clonidine.	Approved
Clorazepate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Clorazepate.	Approved, Illicit
Clotrimazole	The metabolism of Hydromorphone can be decreased when combined with Clotrimazole.	Approved, Vet Approved
Clozapine	The metabolism of Hydromorphone can be decreased when combined with Clozapine.	Approved
Cobicistat	The serum concentration of Hydromorphone can be increased when it is combined with Cobicistat.	Approved
Cocaine	The metabolism of Hydromorphone can be decreased when combined with Cocaine.	Approved, Illicit
Codeine	The risk or severity of adverse effects can be increased when Codeine is combined with Hydromorphone.	Approved, Illicit
Conivaptan	The serum concentration of Hydromorphone can be increased when it is combined with Conivaptan.	Approved, Investigational
Crizotinib	The metabolism of Hydromorphone can be decreased when combined with Crizotinib.	Approved
Cyclizine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Cyclizine.	Approved
Cyclobenzaprine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Cyclobenzaprine.	Approved
Cyclopentolate	The risk or severity of adverse effects can be increased when Cyclopentolate is combined with Hydromorphone.	Approved
Cyclosporine	The metabolism of Hydromorphone can be decreased when combined with Cyclosporine.	Approved, Investigational, Vet Approved
Cyclothiazide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Cyclothiazide.	Approved
Cyproheptadine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Cyproheptadine.	Approved
Dabrafenib	The serum concentration of Hydromorphone can be decreased when it is combined with Dabrafenib.	Approved
Dantrolene	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Dantrolene.	Approved
Dapiprazole	The risk or severity of adverse effects can be increased when Dapiprazole is combined with Hydromorphone.	Approved
Dapoxetine	Hydromorphone may increase the serotonergic activities of Dapoxetine.	Investigational
Darifenacin	The metabolism of Hydromorphone can be decreased when combined with Darifenacin.	Approved, Investigational
Darunavir	The serum concentration of Hydromorphone can be increased when it is combined with Darunavir.	Approved
Dasatinib	The serum concentration of Hydromorphone can be increased when it is combined with Dasatinib.	Approved, Investigational
Deferasirox	The serum concentration of Hydromorphone can be decreased when it is combined with Deferasirox.	Approved, Investigational
Delavirdine	The metabolism of Hydromorphone can be decreased when combined with Delavirdine.	Approved
Deramciclane	The risk or severity of adverse effects can be increased when Hydromorphone is combined with deramciclane.	Investigational
Desflurane	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Desflurane.	Approved
Desipramine	The metabolism of Hydromorphone can be decreased when combined with Desipramine.	Approved
Desloratadine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Desloratadine.	Approved, Investigational
Desmopressin	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Desmopressin.	Approved
Desvenlafaxine	Hydromorphone may increase the serotonergic activities of Desvenlafaxine.	Approved
Dexamethasone	The serum concentration of Hydromorphone can be decreased when it is combined with Dexamethasone.	Approved, Investigational, Vet Approved
Dexbrompheniramine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Dexbrompheniramine.	Approved
Dexetimide	The risk or severity of adverse effects can be increased when Dexetimide is combined with Hydromorphone.	Withdrawn
Dexmedetomidine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Dexmedetomidine.	Approved, Vet Approved
Dextroamphetamine	Dextroamphetamine may increase the analgesic activities of Hydromorphone.	Approved, Illicit
Dextromoramide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Dextromoramide.	Experimental, Illicit
Dextropropoxyphene	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Dextropropoxyphene.	Approved, Illicit, Withdrawn
Dezocine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Dezocine.	Approved
Diazepam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Diazepam.	Approved, Illicit, Vet Approved
Dicyclomine	The risk or severity of adverse effects can be increased when Dicyclomine is combined with Hydromorphone.	Approved
Diethylpropion	Diethylpropion may increase the analgesic activities of Hydromorphone.	Approved, Illicit
Difenoxin	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Difenoxin.	Approved, Illicit
Dihydrocodeine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Dihydrocodeine.	Approved, Illicit
Dihydroergotamine	The metabolism of Hydromorphone can be decreased when combined with Dihydroergotamine.	Approved
Dihydroetorphine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Dihydroetorphine.	Experimental, Illicit
Dihydromorphine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Dihydromorphine.	Experimental, Illicit
Diltiazem	The metabolism of Hydromorphone can be decreased when combined with Diltiazem.	Approved
Dimenhydrinate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Dimenhydrinate.	Approved
Diphenhydramine	The metabolism of Hydromorphone can be decreased when combined with Diphenhydramine.	Approved
Diphenoxylate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Diphenoxylate.	Approved, Illicit
Doxepin	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Doxepin.	Approved
Doxycycline	The metabolism of Hydromorphone can be decreased when combined with Doxycycline.	Approved, Investigational, Vet Approved
Doxylamine	Doxylamine may increase the central nervous system depressant (CNS depressant) activities of Hydromorphone.	Approved, Vet Approved
Dronabinol	Dronabinol may increase the central nervous system depressant (CNS depressant) activities of Hydromorphone.	Approved, Illicit
Dronedarone	The metabolism of Hydromorphone can be decreased when combined with Dronedarone.	Approved
Droperidol	Droperidol may increase the central nervous system depressant (CNS depressant) activities of Hydromorphone.	Approved, Vet Approved
Drospirenone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Drospirenone.	Approved
Drotebanol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Drotebanol.	Experimental, Illicit
Duloxetine	The metabolism of Hydromorphone can be decreased when combined with Duloxetine.	Approved
Dyclonine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Dyclonine.	Approved
Ecgonine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ecgonine.	Experimental, Illicit
Ecopipam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ecopipam.	Investigational
Efavirenz	The serum concentration of Hydromorphone can be decreased when it is combined with Efavirenz.	Approved, Investigational
Efonidipine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Efonidipine.	Approved
Eliglustat	The metabolism of Hydromorphone can be decreased when combined with Eliglustat.	Approved
Eltanolone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Pregnanolone.	Investigational
Eluxadoline	Hydromorphone may increase the constipating activities of Eluxadoline.	Approved
Enflurane	The risk or severity of adverse effects can be increased when Enflurane is combined with Hydromorphone.	Approved, Vet Approved
Entacapone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Entacapone.	Approved, Investigational
Enzalutamide	The serum concentration of Hydromorphone can be decreased when it is combined with Enzalutamide.	Approved
Eplerenone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Eplerenone.	Approved
Erythromycin	The metabolism of Hydromorphone can be decreased when combined with Erythromycin.	Approved, Vet Approved
Escitalopram	Hydromorphone may increase the serotonergic activities of Escitalopram.	Approved, Investigational
Eslicarbazepine acetate	The serum concentration of Hydromorphone can be decreased when it is combined with Eslicarbazepine acetate.	Approved
Estazolam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Estazolam.	Approved, Illicit
Eszopiclone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Eszopiclone.	Approved
Etacrynic acid	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Etacrynic acid.	Approved
Ethanol	Hydromorphone may increase the central nervous system depressant (CNS depressant) activities of Ethanol.	Approved
Ethchlorvynol	The risk or severity of adverse effects can be increased when Ethchlorvynol is combined with Hydromorphone.	Approved, Illicit, Withdrawn
Ethopropazine	The risk or severity of adverse effects can be increased when Ethopropazine is combined with Hydromorphone.	Approved
Ethosuximide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ethosuximide.	Approved
Ethotoin	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ethotoin.	Approved
Ethoxzolamide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ethoxzolamide.	Withdrawn
Ethyl carbamate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ethyl carbamate.	Withdrawn
Ethyl loflazepate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ethyl loflazepate.	Approved, Illicit
Ethylmorphine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ethylmorphine.	Approved, Illicit
Etidocaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Etidocaine.	Approved
Etifoxine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Etifoxine.	Withdrawn
Etizolam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Etizolam.	Approved
Etomidate	The risk or severity of adverse effects can be increased when Etomidate is combined with Hydromorphone.	Approved
Etoperidone	Hydromorphone may increase the serotonergic activities of Etoperidone.	Approved
Etorphine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Etorphine.	Illicit, Vet Approved
Etravirine	The serum concentration of Hydromorphone can be decreased when it is combined with Etravirine.	Approved
Ezogabine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ezogabine.	Approved
Felbamate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Felbamate.	Approved
Fencamfamine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Fencamfamine.	Approved, Illicit, Withdrawn
Fentanyl	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Fentanyl.	Approved, Illicit, Investigational, Vet Approved
Fesoterodine	The risk or severity of adverse effects can be increased when Fesoterodine is combined with Hydromorphone.	Approved
Fexofenadine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Fexofenadine.	Approved
Flibanserin	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Flibanserin.	Approved
Floxuridine	The metabolism of Hydromorphone can be decreased when combined with Floxuridine.	Approved
Fluconazole	The metabolism of Hydromorphone can be decreased when combined with Fluconazole.	Approved
Fludiazepam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Fludiazepam.	Approved, Illicit
Flunarizine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Flunarizine.	Approved
Flunitrazepam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Flunitrazepam.	Approved, Illicit
Fluorouracil	The metabolism of Hydromorphone can be decreased when combined with Fluorouracil.	Approved
Fluoxetine	The metabolism of Hydromorphone can be decreased when combined with Fluoxetine.	Approved, Vet Approved
Flupentixol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Flupentixol.	Approved, Withdrawn
Fluphenazine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Fluphenazine.	Approved
Flurazepam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Flurazepam.	Approved, Illicit
Fluspirilene	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Fluspirilene.	Approved
Fluticasone propionate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Fluticasone Propionate.	Approved
Fluvastatin	The metabolism of Hydromorphone can be decreased when combined with Fluvastatin.	Approved
Fluvoxamine	The metabolism of Hydromorphone can be decreased when combined with Fluvoxamine.	Approved, Investigational
Fosamprenavir	The metabolism of Hydromorphone can be decreased when combined with Fosamprenavir.	Approved
Fosaprepitant	The serum concentration of Hydromorphone can be increased when it is combined with Fosaprepitant.	Approved
Fosphenytoin	The metabolism of Hydromorphone can be increased when combined with Fosphenytoin.	Approved
Fospropofol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Fospropofol.	Approved, Illicit
Furazolidone	The risk or severity of adverse effects can be increased when Furazolidone is combined with Hydromorphone.	Approved, Vet Approved
Furosemide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Furosemide.	Approved, Vet Approved
Fusidic Acid	The serum concentration of Hydromorphone can be increased when it is combined with Fusidic Acid.	Approved
Gabapentin	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Gabapentin.	Approved, Investigational
Gabapentin Enacarbil	The risk or severity of adverse effects can be increased when Hydromorphone is combined with gabapentin enacarbil.	Approved
Gallamine Triethiodide	The risk or severity of adverse effects can be increased when Gallamine Triethiodide is combined with Hydromorphone.	Approved
Gamma Hydroxybutyric Acid	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Gamma Hydroxybutyric Acid.	Approved, Illicit
Gemfibrozil	The metabolism of Hydromorphone can be decreased when combined with Gemfibrozil.	Approved
Gepirone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Gepirone.	Investigational
Glutethimide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Glutethimide.	Approved, Illicit
Glycopyrronium	The risk or severity of adverse effects can be increased when Glycopyrronium is combined with Hydromorphone.	Approved, Investigational, Vet Approved
Guanfacine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Guanfacine.	Approved, Investigational
Halazepam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Halazepam.	Approved, Illicit, Withdrawn
Haloperidol	The metabolism of Hydromorphone can be decreased when combined with Haloperidol.	Approved
Halothane	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Halothane.	Approved, Vet Approved
Heroin	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Heroin.	Approved, Illicit
Hexamethonium	The risk or severity of adverse effects can be increased when Hexamethonium is combined with Hydromorphone.	Experimental
Hexobarbital	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Hexobarbital.	Approved
Hydracarbazine	The risk or severity of adverse effects can be increased when Hydracarbazine is combined with Hydromorphone.	Experimental
Hydrochlorothiazide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Hydrochlorothiazide.	Approved, Vet Approved
Hydrocodone	Hydromorphone may increase the central nervous system depressant (CNS depressant) activities of Hydrocodone.	Approved, Illicit
Hydroflumethiazide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Hydroflumethiazide.	Approved
Hydroxyamphetamine	Hydroxyamphetamine hydrobromide may increase the analgesic activities of Hydromorphone.	Approved
Hydroxyzine	Hydroxyzine may increase the central nervous system depressant (CNS depressant) activities of Hydromorphone.	Approved
Hyoscyamine	The risk or severity of adverse effects can be increased when Hyoscyamine is combined with Hydromorphone.	Approved
Idelalisib	The serum concentration of Hydromorphone can be increased when it is combined with Idelalisib.	Approved
Iloperidone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Iloperidone.	Approved
Imatinib	The metabolism of Hydromorphone can be decreased when combined with Imatinib.	Approved
Imipramine	The metabolism of Hydromorphone can be decreased when combined with Imipramine.	Approved
Indalpine	Hydromorphone may increase the serotonergic activities of Indalpine.	Investigational, Withdrawn
Indapamide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Indapamide.	Approved
Indinavir	The metabolism of Hydromorphone can be decreased when combined with Indinavir.	Approved
Ipratropium bromide	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Hydromorphone.	Approved
Iproclozide	The risk or severity of adverse effects can be increased when Iproclozide is combined with Hydromorphone.	Withdrawn
Iproniazid	The risk or severity of adverse effects can be increased when Iproniazid is combined with Hydromorphone.	Withdrawn
Irbesartan	The metabolism of Hydromorphone can be decreased when combined with Irbesartan.	Approved, Investigational
Isavuconazonium	The metabolism of Hydromorphone can be decreased when combined with Isavuconazonium.	Approved, Investigational
Isocarboxazid	The risk or severity of adverse effects can be increased when Isocarboxazid is combined with Hydromorphone.	Approved
Isoflurane	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Isoflurane.	Approved, Vet Approved
Isoniazid	The metabolism of Hydromorphone can be decreased when combined with Isoniazid.	Approved
Isradipine	The metabolism of Hydromorphone can be decreased when combined with Isradipine.	Approved
Itraconazole	The metabolism of Hydromorphone can be decreased when combined with Itraconazole.	Approved, Investigational
Ivacaftor	The serum concentration of Hydromorphone can be increased when it is combined with Ivacaftor.	Approved
Ketamine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ketamine.	Approved, Vet Approved
Ketazolam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ketazolam.	Approved
Ketobemidone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ketobemidone.	Approved
Ketoconazole	The metabolism of Hydromorphone can be decreased when combined with Ketoconazole.	Approved, Investigational
Lamotrigine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Lamotrigine.	Approved, Investigational
Leflunomide	The metabolism of Hydromorphone can be decreased when combined with Leflunomide.	Approved, Investigational
Levetiracetam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Levetiracetam.	Approved, Investigational
Levobupivacaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Levobupivacaine.	Approved
Levocabastine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Levocabastine.	Approved
Levocetirizine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Levocetirizine.	Approved
Levodopa	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Levodopa.	Approved
Levomethadyl Acetate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Levomethadyl Acetate.	Approved
Levomilnacipran	Hydromorphone may increase the serotonergic activities of Levomilnacipran.	Approved
Levorphanol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Levorphanol.	Approved
Lidocaine	The risk or severity of adverse effects can be increased when Lidocaine is combined with Hydromorphone.	Approved, Vet Approved
Lisdexamfetamine	Lisdexamfetamine may increase the analgesic activities of Hydromorphone.	Approved, Investigational
Lithium	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Lithium.	Approved
Lofentanil	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Lofentanil.	Illicit
Lopinavir	The metabolism of Hydromorphone can be decreased when combined with Lopinavir.	Approved
Loratadine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Loratadine.	Approved
Lorazepam	The risk or severity of adverse effects can be increased when Lorazepam is combined with Hydromorphone.	Approved
Lorcaserin	The metabolism of Hydromorphone can be decreased when combined with Lorcaserin.	Approved
Losartan	The metabolism of Hydromorphone can be decreased when combined with Losartan.	Approved
Lovastatin	The metabolism of Hydromorphone can be decreased when combined with Lovastatin.	Approved, Investigational
Loxapine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Loxapine.	Approved
Luliconazole	The serum concentration of Hydromorphone can be increased when it is combined with Luliconazole.	Approved
Lumacaftor	The serum concentration of Hydromorphone can be decreased when it is combined with Lumacaftor.	Approved
Lumefantrine	The metabolism of Hydromorphone can be decreased when combined with Lumefantrine.	Approved
Lurasidone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Lurasidone.	Approved
Magnesium Sulfate	Magnesium Sulfate may increase the central nervous system depressant (CNS depressant) activities of Hydromorphone.	Approved, Vet Approved
Mannitol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Mannitol.	Approved, Investigational
Maprotiline	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Maprotiline.	Approved
Mebanazine	The risk or severity of adverse effects can be increased when Mebanazine is combined with Hydromorphone.	Withdrawn
Mecamylamine	The risk or severity of adverse effects can be increased when Mecamylamine is combined with Hydromorphone.	Approved
Meclizine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Meclizine.	Approved
Melatonin	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Melatonin.	Approved, Nutraceutical, Vet Approved
Melperone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Melperone.	Approved
Mephedrone	Mephedrone may increase the analgesic activities of Hydromorphone.	Investigational
Mephentermine	Mephentermine may increase the analgesic activities of Hydromorphone.	Approved
Mepivacaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Mepivacaine.	Approved, Vet Approved
Meprobamate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Meprobamate.	Approved, Illicit
Mersalyl	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Mersalyl.	Approved
Mesoridazine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Mesoridazine.	Approved
Metaxalone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Metaxalone.	Approved
Methadone	The metabolism of Hydromorphone can be decreased when combined with Methadone.	Approved
Methadyl Acetate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Methadyl Acetate.	Approved, Illicit
Methamphetamine	Methamphetamine may increase the analgesic activities of Hydromorphone.	Approved, Illicit
Methantheline	The risk or severity of adverse effects can be increased when Methantheline is combined with Hydromorphone.	Approved
Methapyrilene	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Methapyrilene.	Withdrawn
Methaqualone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Methaqualone.	Illicit, Withdrawn
Methazolamide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Methazolamide.	Approved
Methocarbamol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Methocarbamol.	Approved, Vet Approved
Methohexital	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Methohexital.	Approved
Methotrimeprazine	Hydromorphone may increase the central nervous system depressant (CNS depressant) activities of Methotrimeprazine.	Approved
Methoxyflurane	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Methoxyflurane.	Approved, Vet Approved
Methsuximide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Methsuximide.	Approved
Methyclothiazide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Methyclothiazide.	Approved
Methylecgonine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with ECGONINE METHYL ESTER.	Experimental
Methylene blue	The risk or severity of adverse effects can be increased when Methylene blue is combined with Hydromorphone.	Investigational
Methylphenobarbital	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Methylphenobarbital.	Approved
Metixene	The risk or severity of adverse effects can be increased when Metixene is combined with Hydromorphone.	Approved
Metolazone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Metolazone.	Approved
Metoprolol	The metabolism of Hydromorphone can be decreased when combined with Metoprolol.	Approved, Investigational
Metyrosine	Hydromorphone may increase the sedative activities of Metyrosine.	Approved
Midazolam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Midazolam.	Approved, Illicit
Mifepristone	The serum concentration of Hydromorphone can be increased when it is combined with Mifepristone.	Approved, Investigational
Milnacipran	Hydromorphone may increase the serotonergic activities of Milnacipran.	Approved
Minaprine	The risk or severity of adverse effects can be increased when Minaprine is combined with Hydromorphone.	Approved
Minocycline	Minocycline may increase the central nervous system depressant (CNS depressant) activities of Hydromorphone.	Approved, Investigational
Mirabegron	The metabolism of Hydromorphone can be decreased when combined with Mirabegron.	Approved
Mirtazapine	Hydromorphone may increase the central nervous system depressant (CNS depressant) activities of Mirtazapine.	Approved
Mitotane	The serum concentration of Hydromorphone can be decreased when it is combined with Mitotane.	Approved
MMDA	MMDA may increase the analgesic activities of Hydromorphone.	Experimental, Illicit
Moclobemide	The risk or severity of adverse effects can be increased when Moclobemide is combined with Hydromorphone.	Approved
Modafinil	The serum concentration of Hydromorphone can be decreased when it is combined with Modafinil.	Approved, Investigational
Molindone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Molindone.	Approved
Moricizine	Moricizine may increase the hypotensive activities of Hydromorphone.	Approved, Withdrawn
Morphine	The risk or severity of adverse effects can be increased when Morphine is combined with Hydromorphone.	Approved, Investigational
Nabilone	Nabilone may increase the central nervous system depressant (CNS depressant) activities of Hydromorphone.	Approved, Investigational
Nafcillin	The serum concentration of Hydromorphone can be decreased when it is combined with Nafcillin.	Approved
Nalbuphine	Nalbuphine may decrease the analgesic activities of Hydromorphone.	Approved
Naltrexone	The therapeutic efficacy of Hydromorphone can be decreased when used in combination with Naltrexone.	Approved, Investigational, Vet Approved
Nefazodone	The metabolism of Hydromorphone can be decreased when combined with Nefazodone.	Approved, Withdrawn
Nelfinavir	The metabolism of Hydromorphone can be decreased when combined with Nelfinavir.	Approved
Netupitant	The serum concentration of Hydromorphone can be increased when it is combined with Netupitant.	Approved
Nevirapine	The metabolism of Hydromorphone can be increased when combined with Nevirapine.	Approved
Nialamide	The risk or severity of adverse effects can be increased when Nialamide is combined with Hydromorphone.	Withdrawn
Nicardipine	The metabolism of Hydromorphone can be decreased when combined with Nicardipine.	Approved
Nilotinib	The metabolism of Hydromorphone can be decreased when combined with Nilotinib.	Approved, Investigational
Nitrazepam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Nitrazepam.	Approved
Nitrous oxide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Nitrous oxide.	Approved, Vet Approved
Norflurane	The risk or severity of adverse effects can be increased when Hydromorphone is combined with 1,1,1,2 Tetrafluoroethane.	Investigational
Normethadone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Normethadone.	Approved, Illicit
Nortriptyline	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Nortriptyline.	Approved
Octamoxin	The risk or severity of adverse effects can be increased when Octamoxin is combined with Hydromorphone.	Withdrawn
Olanzapine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Olanzapine.	Approved, Investigational
Olaparib	The metabolism of Hydromorphone can be decreased when combined with Olaparib.	Approved
Olopatadine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Olopatadine.	Approved
Omeprazole	The metabolism of Hydromorphone can be decreased when combined with Omeprazole.	Approved, Investigational, Vet Approved
Ondansetron	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ondansetron.	Approved
Opium	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Opium.	Approved, Illicit
Orphenadrine	Hydromorphone may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine.	Approved
Osanetant	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Osanetant.	Investigational
Osimertinib	The serum concentration of Hydromorphone can be increased when it is combined with Osimertinib.	Approved
Oxazepam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Oxazepam.	Approved
Oxethazaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Oxetacaine.	Investigational
Oxprenolol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Oxprenolol.	Approved
Oxybuprocaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Oxybuprocaine.	Approved
Oxybutynin	The risk or severity of adverse effects can be increased when Oxybutynin is combined with Hydromorphone.	Approved, Investigational
Oxycodone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Oxycodone.	Approved, Illicit, Investigational
Oxymorphone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Oxymorphone.	Approved, Investigational, Vet Approved
Oxyphenonium	The risk or severity of adverse effects can be increased when Oxyphenonium is combined with Hydromorphone.	Approved
Palbociclib	The serum concentration of Hydromorphone can be increased when it is combined with Palbociclib.	Approved
Paliperidone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Paliperidone.	Approved
Pancuronium	The risk or severity of adverse effects can be increased when Pancuronium is combined with Hydromorphone.	Approved
Panobinostat	The serum concentration of Hydromorphone can be increased when it is combined with Panobinostat.	Approved, Investigational
Paraldehyde	Hydromorphone may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde.	Approved
Pargyline	The risk or severity of adverse effects can be increased when Pargyline is combined with Hydromorphone.	Approved
Paroxetine	The metabolism of Hydromorphone can be decreased when combined with Paroxetine.	Approved, Investigational
Peginterferon alfa-2b	The serum concentration of Hydromorphone can be decreased when it is combined with Peginterferon alfa-2b.	Approved
Pegvisomant	The therapeutic efficacy of Pegvisomant can be decreased when used in combination with Hydromorphone.	Approved
Pentazocine	Pentazocine may decrease the analgesic activities of Hydromorphone.	Approved, Vet Approved
Pentobarbital	The metabolism of Hydromorphone can be increased when combined with Pentobarbital.	Approved, Vet Approved
Pentolinium	The risk or severity of adverse effects can be increased when Pentolinium is combined with Hydromorphone.	Approved
Perampanel	Perampanel may increase the central nervous system depressant (CNS depressant) activities of Hydromorphone.	Approved
Perazine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Perazine.	Investigational
Perospirone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Perospirone.	Approved
Perphenazine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Perphenazine.	Approved
Pethidine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Pethidine.	Approved
Phenelzine	The risk or severity of adverse effects can be increased when Phenelzine is combined with Hydromorphone.	Approved
Pheniprazine	The risk or severity of adverse effects can be increased when Pheniprazine is combined with Hydromorphone.	Withdrawn
Phenobarbital	The metabolism of Hydromorphone can be increased when combined with Phenobarbital.	Approved
Phenoxypropazine	The risk or severity of adverse effects can be increased when Phenoxypropazine is combined with Hydromorphone.	Withdrawn
Phentermine	Phentermine may increase the analgesic activities of Hydromorphone.	Approved, Illicit
Phenytoin	The metabolism of Hydromorphone can be increased when combined with Phenytoin.	Approved, Vet Approved
Pimozide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Pimozide.	Approved
Pipamperone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Pipamperone.	Approved
Pipecuronium	The risk or severity of adverse effects can be increased when Pipecuronium is combined with Hydromorphone.	Approved
Pipotiazine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Pipotiazine.	Approved
Pirenzepine	The risk or severity of adverse effects can be increased when Pirenzepine is combined with Hydromorphone.	Approved
Piretanide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Piretanide.	Experimental
Piritramide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Piritramide.	Investigational
Pirlindole	The risk or severity of adverse effects can be increased when Pirlindole is combined with Hydromorphone.	Approved
Pivhydrazine	The risk or severity of adverse effects can be increased when Pivhydrazine is combined with Hydromorphone.	Withdrawn
Polythiazide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Polythiazide.	Approved
Pomalidomide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Pomalidomide.	Approved
Posaconazole	The metabolism of Hydromorphone can be decreased when combined with Posaconazole.	Approved, Investigational, Vet Approved
Potassium	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Potassium.	Approved
Potassium Citrate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Potassium Citrate.	Approved, Vet Approved
Pramipexole	Hydromorphone may increase the sedative activities of Pramipexole.	Approved, Investigational
Pramocaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Pramocaine.	Approved
Prazepam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Prazepam.	Approved, Illicit
Pregabalin	The risk or severity of adverse effects can be increased when Pregabalin is combined with Hydromorphone.	Approved, Illicit, Investigational
Prilocaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Prilocaine.	Approved
Primidone	The metabolism of Hydromorphone can be increased when combined with Primidone.	Approved, Vet Approved
Procaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Procaine.	Approved, Investigational, Vet Approved
Prochlorperazine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Prochlorperazine.	Approved, Vet Approved
Procyclidine	The risk or severity of adverse effects can be increased when Procyclidine is combined with Hydromorphone.	Approved
Promazine	The metabolism of Hydromorphone can be decreased when combined with Promazine.	Approved, Vet Approved
Promethazine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Promethazine.	Approved
Propantheline	The risk or severity of adverse effects can be increased when Propantheline is combined with Hydromorphone.	Approved
Proparacaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Proparacaine.	Approved, Vet Approved
Propiverine	The risk or severity of adverse effects can be increased when Propiverine is combined with Hydromorphone.	Investigational
Propofol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Propofol.	Approved, Investigational, Vet Approved
Propoxycaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Propoxycaine.	Approved
Protriptyline	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Protriptyline.	Approved
Pseudoephedrine	Pseudoephedrine may increase the analgesic activities of Hydromorphone.	Approved
Pyrimethamine	The metabolism of Hydromorphone can be decreased when combined with Pyrimethamine.	Approved, Vet Approved
Quazepam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Quazepam.	Approved, Illicit
Quetiapine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Quetiapine.	Approved
Quinethazone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Quinethazone.	Approved
Quinidine	The metabolism of Hydromorphone can be decreased when combined with Quinidine.	Approved
Quinine	The metabolism of Hydromorphone can be decreased when combined with Quinine.	Approved
Raclopride	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Raclopride.	Investigational
Ramelteon	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ramelteon.	Approved, Investigational
Ramosetron	Hydromorphone may increase the constipating activities of Ramosetron.	Approved
Ranolazine	The metabolism of Hydromorphone can be decreased when combined with Ranolazine.	Approved, Investigational
Rasagiline	The risk or severity of adverse effects can be increased when Rasagiline is combined with Hydromorphone.	Approved
Remifentanil	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Remifentanil.	Approved
Remoxipride	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Remoxipride.	Approved, Withdrawn
Reserpine	The risk or severity of adverse effects can be increased when Reserpine is combined with Hydromorphone.	Approved
Rifabutin	The metabolism of Hydromorphone can be increased when combined with Rifabutin.	Approved
Rifampicin	The metabolism of Hydromorphone can be increased when combined with Rifampicin.	Approved
Rifapentine	The metabolism of Hydromorphone can be increased when combined with Rifapentine.	Approved
Risperidone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Risperidone.	Approved, Investigational
Ritanserin	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ritanserin.	Investigational
Ritobegron	Ritobegron may increase the analgesic activities of Hydromorphone.	Investigational
Ritonavir	The metabolism of Hydromorphone can be decreased when combined with Ritonavir.	Approved, Investigational
Rolapitant	The metabolism of Hydromorphone can be decreased when combined with Rolapitant.	Approved
Rolofylline	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Rolofylline.	Investigational
Ropinirole	Hydromorphone may increase the sedative activities of Ropinirole.	Approved, Investigational
Ropivacaine	The risk or severity of adverse effects can be increased when Ropivacaine is combined with Hydromorphone.	Approved
Rotigotine	Hydromorphone may increase the sedative activities of Rotigotine.	Approved
Rufinamide	The risk or severity of adverse effects can be increased when Rufinamide is combined with Hydromorphone.	Approved
Safrazine	The risk or severity of adverse effects can be increased when Safrazine is combined with Hydromorphone.	Withdrawn
Saquinavir	The metabolism of Hydromorphone can be decreased when combined with Saquinavir.	Approved, Investigational
Scopolamine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Scopolamine.	Approved
Scopolamine butylbromide	The risk or severity of adverse effects can be increased when Scopolamine butylbromide is combined with Hydromorphone.	Approved, Vet Approved
Secobarbital	The metabolism of Hydromorphone can be increased when combined with Secobarbital.	Approved, Vet Approved
Selegiline	The risk or severity of adverse effects can be increased when Selegiline is combined with Hydromorphone.	Approved, Investigational, Vet Approved
Sepranolone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Uc1010.	Investigational
Sertindole	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Sertindole.	Approved, Withdrawn
Sertraline	The metabolism of Hydromorphone can be decreased when combined with Sertraline.	Approved
Sevoflurane	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Sevoflurane.	Approved, Vet Approved
Sildenafil	The metabolism of Hydromorphone can be decreased when combined with Sildenafil.	Approved, Investigational
Siltuximab	The serum concentration of Hydromorphone can be decreased when it is combined with Siltuximab.	Approved
Simeprevir	The serum concentration of Hydromorphone can be increased when it is combined with Simeprevir.	Approved
Sodium oxybate	Sodium oxybate may increase the central nervous system depressant (CNS depressant) activities of Hydromorphone.	Approved
Solifenacin	The risk or severity of adverse effects can be increased when Solifenacin is combined with Hydromorphone.	Approved
Sorafenib	The metabolism of Hydromorphone can be decreased when combined with Sorafenib.	Approved, Investigational
Spironolactone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Spironolactone.	Approved
St. John's Wort	The serum concentration of Hydromorphone can be decreased when it is combined with St. John's Wort.	Nutraceutical
Stiripentol	The serum concentration of Hydromorphone can be increased when it is combined with Stiripentol.	Approved
Succinylcholine	Succinylcholine may increase the bradycardic activities of Hydromorphone.	Approved
Sufentanil	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Sufentanil.	Approved, Investigational
Sulfadiazine	The metabolism of Hydromorphone can be decreased when combined with Sulfadiazine.	Approved, Vet Approved
Sulfamethoxazole	The metabolism of Hydromorphone can be decreased when combined with Sulfamethoxazole.	Approved
Sulfisoxazole	The metabolism of Hydromorphone can be decreased when combined with Sulfisoxazole.	Approved, Vet Approved
Sulpiride	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Sulpiride.	Approved
Suvorexant	Hydromorphone may increase the central nervous system depressant (CNS depressant) activities of Suvorexant.	Approved
Tandospirone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Tandospirone.	Investigational
Tapentadol	Tapentadol may increase the central nervous system depressant (CNS depressant) activities of Hydromorphone.	Approved
Tasimelteon	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Tasimelteon.	Approved
Telaprevir	The metabolism of Hydromorphone can be decreased when combined with Telaprevir.	Withdrawn
Telithromycin	The metabolism of Hydromorphone can be decreased when combined with Telithromycin.	Approved
Temazepam	The risk or severity of adverse effects can be increased when Temazepam is combined with Hydromorphone.	Approved
Terbinafine	The metabolism of Hydromorphone can be decreased when combined with Terbinafine.	Approved, Investigational, Vet Approved
Tetrabenazine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Tetrabenazine.	Approved
Tetracaine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Tetracaine.	Approved, Vet Approved
Tetrodotoxin	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Tetrodotoxin.	Investigational
Thalidomide	Hydromorphone may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.	Approved, Investigational, Withdrawn
Theobromine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Theobromine.	Approved
Thiamylal	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Thiamylal.	Approved, Vet Approved
Thiethylperazine	Thiethylperazine may increase the hypotensive activities of Hydromorphone.	Withdrawn
Thiopental	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Thiopental.	Approved, Vet Approved
Thioridazine	The metabolism of Hydromorphone can be decreased when combined with Thioridazine.	Withdrawn
Thiothixene	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Thiothixene.	Approved
Tiagabine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Tiagabine.	Approved
Tiapride	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Tiapride.	Approved, Investigational
Ticagrelor	The metabolism of Hydromorphone can be decreased when combined with Ticagrelor.	Approved
Ticlopidine	The metabolism of Hydromorphone can be decreased when combined with Ticlopidine.	Approved
Ticrynafen	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ticrynafen.	Withdrawn
Tiotropium	The risk or severity of adverse effects can be increased when Tiotropium is combined with Hydromorphone.	Approved
Tipranavir	The metabolism of Hydromorphone can be decreased when combined with Tipranavir.	Approved, Investigational
Tizanidine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Tizanidine.	Approved
Tocilizumab	The serum concentration of Hydromorphone can be decreased when it is combined with Tocilizumab.	Approved
Tolbutamide	The metabolism of Hydromorphone can be decreased when combined with Tolbutamide.	Approved
Tolcapone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Tolcapone.	Approved, Withdrawn
Toloxatone	The risk or severity of adverse effects can be increased when Toloxatone is combined with Hydromorphone.	Approved
Tolterodine	The risk or severity of adverse effects can be increased when Tolterodine is combined with Hydromorphone.	Approved, Investigational
Tolvaptan	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Tolvaptan.	Approved
Topiramate	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Topiramate.	Approved
Torasemide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Torasemide.	Approved
Tramadol	The risk or severity of adverse effects can be increased when Tramadol is combined with Hydromorphone.	Approved, Investigational
Trans-2-Phenylcyclopropylamine	The risk or severity of adverse effects can be increased when Trans-2-Phenylcyclopropylamine is combined with Hydromorphone.	Experimental
Tranylcypromine	The risk or severity of adverse effects can be increased when Tranylcypromine is combined with Hydromorphone.	Approved
Trazodone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Trazodone.	Approved, Investigational
Triamterene	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Triamterene.	Approved
Triazolam	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Triazolam.	Approved
Trichlormethiazide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Trichlormethiazide.	Approved, Vet Approved
Trifluoperazine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Trifluoperazine.	Approved
Triflupromazine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Triflupromazine.	Approved, Vet Approved
Trihexyphenidyl	The risk or severity of adverse effects can be increased when Trihexyphenidyl is combined with Hydromorphone.	Approved
Trimethaphan	The risk or severity of adverse effects can be increased when Trimethaphan is combined with Hydromorphone.	Approved
Trimethoprim	The metabolism of Hydromorphone can be decreased when combined with Trimethoprim.	Approved, Vet Approved
Trimipramine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Trimipramine.	Approved
Triprolidine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Triprolidine.	Approved
Tropicamide	The risk or severity of adverse effects can be increased when Tropicamide is combined with Hydromorphone.	Approved
Trospium	The risk or severity of adverse effects can be increased when Trospium is combined with Hydromorphone.	Approved
Tubocurarine	The risk or severity of adverse effects can be increased when Tubocurarine is combined with Hydromorphone.	Approved
Ularitide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ularitide.	Investigational
Umeclidinium	The risk or severity of adverse effects can be increased when Umeclidinium is combined with Hydromorphone.	Approved
Valproic Acid	The risk or severity of adverse effects can be increased when Valproic Acid is combined with Hydromorphone.	Approved, Investigational
Valsartan	The metabolism of Hydromorphone can be decreased when combined with Valsartan.	Approved, Investigational
Vecuronium	The risk or severity of adverse effects can be increased when Vecuronium is combined with Hydromorphone.	Approved
Venlafaxine	The metabolism of Hydromorphone can be decreased when combined with Venlafaxine.	Approved
Verapamil	The metabolism of Hydromorphone can be decreased when combined with Verapamil.	Approved
Vigabatrin	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Vigabatrin.	Approved
Voriconazole	The metabolism of Hydromorphone can be decreased when combined with Voriconazole.	Approved, Investigational
Vortioxetine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Vortioxetine.	Approved
Zafirlukast	The metabolism of Hydromorphone can be decreased when combined with Zafirlukast.	Approved, Investigational
Zaleplon	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Zaleplon.	Approved, Illicit, Investigational
Ziconotide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ziconotide.	Approved
Zimelidine	Hydromorphone may increase the serotonergic activities of Zimelidine.	Withdrawn
Ziprasidone	The metabolism of Hydromorphone can be decreased when combined with Ziprasidone.	Approved
Zolpidem	Hydromorphone may increase the central nervous system depressant (CNS depressant) activities of Zolpidem.	Approved
Zonisamide	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Zonisamide.	Approved, Investigational
Zopiclone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Zopiclone.	Approved
Zotepine	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Zotepine.	Approved
Zuclopenthixol	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Zuclopenthixol.	Approved, Investigational

Food Interactions

Take without regard to meals. Avoid alcohol.

References

Synthesis Reference

Anne M. Hailes, Christopher E. French, Neil C. Bruce, "Morphinone reductase for the preparation of hydromorphone and hydrocodone." U.S. Patent US5571685, issued November, 1990.

US5571685

General References

Coda BA, Rudy AC, Archer SM, Wermeling DP: Pharmacokinetics and bioavailability of single-dose intranasal hydromorphone hydrochloride in healthy volunteers. Anesth Analg. 2003 Jul;97(1):117-23, table of contents. [PubMed:12818953 ]
Vallner JJ, Stewart JT, Kotzan JA, Kirsten EB, Honigberg IL: Pharmacokinetics and bioavailability of hydromorphone following intravenous and oral administration to human subjects. J Clin Pharmacol. 1981 Apr;21(4):152-6. [PubMed:6165742 ]

External Links

Resource	Link
Human Metabolome Database (HMDB)	HMDB14472
KEGG Compound	C07042
PubChem Compound	5284570
PubChem Substance	46508700
ChemSpider	4447624
BindingDB	50241341
ChEBI	5790
ChEMBL	CHEMBL398707
Therapeutic Targets Database	DAP000472
PharmGKB	PA449918
Drug Product Database	20280
RxList	http://www.rxlist.com/cgi/generic/hydromorphone.htm
Drugs.com	http://www.drugs.com/cdi/hydromorphone.html
PDRhealth	http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/dil1137.shtml
Wikipedia	Hydromorphone

ATC Codes

N02AA03 — Hydromorphone

N02AG04 — Hydromorphone and antispasmodics

AHFS Codes

28:08.08

PDB Entries

Not Available

FDA label

Download (78.9 KB)

MSDS

Download (48.3 KB)

Clinical Trials

Phase	Status	Purpose	Conditions	Count
0	Recruiting	Treatment	Pain	1
1	Completed	Not Available	Healthy Volunteers	1
1	Completed	Not Available	Heroin Dependence / Opioid-Related Disorders	1
1	Completed	Treatment	Healthy Volunteers	1
1	Completed	Treatment	Pain	1
1	Recruiting	Treatment	Addictions / Opioid Dependence / Pain	1
1	Recruiting	Treatment	Opioid-Related Disorders / Pain, Chronic	1
1, 2	Completed	Treatment	Opioid Abuse / Opioid Addiction / Stimulant Abuse / Stimulant Addiction	1
1, 2	Terminated	Treatment	Wound Healing	1
2	Active Not Recruiting	Treatment	Adenotonsillitis / Tonsillitis	1
2	Completed	Not Available	Heroin Dependence / Opioid-Related Disorders	1
2	Completed	Treatment	Labour Pain	1
2	Completed	Treatment	Opiate Dependence	1
2	Completed	Treatment	Opioid Use Disorders	1
2	Completed	Treatment	Postoperative pain	1
2	Recruiting	Treatment	Cesarean Section / Pain	1
2	Recruiting	Treatment	Pain	1
2	Withdrawn	Treatment	Hb-SS Disease With Vasoocclusive Pain / Hemoglobin SS Disease With Crisis / Hemoglobin SS Disease With Vasoocclusive Crisis / Other Sickle Cell Disease With Vaso-Occlusive Pain / Sickle Cell Disorders	1
2, 3	Completed	Supportive Care	Chronic Obstructive Pulmonary Disease (COPD)	1
3	Active Not Recruiting	Treatment	Pain, Chronic	1
3	Completed	Supportive Care	Malignant Neoplasm of Prostate / Pain	1
3	Completed	Treatment	Heroin Dependence / Opioid Dependence	1
3	Completed	Treatment	Pain	2
3	Completed	Treatment	Pain, Acute	1
3	Not Yet Recruiting	Treatment	Diseases of Liver	1
3	Recruiting	Supportive Care	Breast - Female	1
3	Recruiting	Supportive Care	Intraoperative Complications / Malignant Female Reproductive System Neoplasm / Pain	1
3	Recruiting	Supportive Care	Management of Chronic Pain	1
3	Recruiting	Treatment	Pain, Chronic	1
3	Terminated	Treatment	Back Pain / Lumbar Spine Fusion / Pain	1
3	Terminated	Treatment	Chronic Non-Malignant Pain	1
3	Terminated	Treatment	Fracture Bone / Pain, Acute / Trauma, Multiple	1
3	Unknown Status	Supportive Care	Cancers / Pain	1
3	Unknown Status	Treatment	Breakthrough Cancer Pain	1
3	Withdrawn	Treatment	Mucositis	1
4	Active Not Recruiting	Treatment	Acute Postoperative Pain / Chronic Persistent Surgical Pain / Hydromorphone Use / Patients Satisfaction	1
4	Active Not Recruiting	Treatment	Nausea	1
4	Active Not Recruiting	Treatment	Postoperative pain	1
4	Completed	Basic Science	Healthy Volunteers	1
4	Completed	Supportive Care	Sickle Cell Disorders	1
4	Completed	Treatment	Acute Postoperative Pain	1
4	Completed	Treatment	Analgesia, Obstetrical / Cesarean Section	1
4	Completed	Treatment	Labour Pain	1
4	Completed	Treatment	Low Back Pain (LBP)	1
4	Completed	Treatment	Migraines	1
4	Completed	Treatment	Narcotic Use / Nausea / Occasional Constipation / Pain	1
4	Completed	Treatment	Pain	1
4	Completed	Treatment	Pain, Acute	2
4	Completed	Treatment	Pain, Cancer	1
4	Completed	Treatment	Pain, Neuropathic	1
4	Completed	Treatment	Post Operative Pain	1
4	Completed	Treatment	Postoperative pain	2
4	Not Yet Recruiting	Treatment	Analgesics, Opioid / Anti-Inflammatory Agents, Non-Steroidal / Child/Adolescent Problems / Emergency Service, Hospital / Fentanyl / Ibuprofen / Pain, Acute	1
4	Not Yet Recruiting	Treatment	Body Weight Changes / Postoperative Hemorrhages / Postoperative pain / Prophylaxis against postoperative nausea and vomiting	1
4	Not Yet Recruiting	Treatment	Pain, Acute / Postoperative pain / Surgery, Colorectal	1
4	Not Yet Recruiting	Treatment	Postoperative pain	1
4	Recruiting	Prevention	Pain / Rotator Cuff Injury	1
4	Recruiting	Supportive Care	Advanced Cancers / Pain	1
4	Recruiting	Supportive Care	Colon Diverticulosis / Colonic Neoplasms / Constipation Drug Induced / Diverticulitis, Colonic / Ileus / Ileus paralytic / Ileus; Mechanical / Malignant Neoplasm of Colon / Occasional Constipation / Postoperative pain / Rectum Cancer / Rectum Neoplasm	1
4	Recruiting	Treatment	Analgesia, Obstetrical	1
4	Recruiting	Treatment	Breakthrough Pain / Pain, Chronic / Pain, Intractable	1
4	Recruiting	Treatment	Fusion of Spine, Lumbar Region	1
4	Recruiting	Treatment	Pain	1
4	Recruiting	Treatment	Pain, Acute	2
4	Recruiting	Treatment	Pectus Excavatum	1
4	Recruiting	Treatment	Unilateral Knee Arthroplasty	1
4	Terminated	Treatment	Pain	1
4	Unknown Status	Not Available	Adults / Healthy Volunteers / Humans / Parturient	1
4	Unknown Status	Treatment	Acute Severe Pain	1
4	Unknown Status	Treatment	Pain	4
4	Unknown Status	Treatment	Pain, Acute	1
Not Available	Active Not Recruiting	Treatment	Rib Fractures	1
Not Available	Completed	Not Available	Breakthrough Cancer Pain / Pain, Cancer / Pain, Neuropathic / Tumors	1
Not Available	Completed	Not Available	Cancer, Ovarian / Cervical Cancers / Endometrial Cancers / Fallopian Tube Cancer / Pain / Perioperative/Postoperative Complications / Sarcomas	1
Not Available	Completed	Supportive Care	Pain Measurement / Visual Analog Pain Scale	1
Not Available	Completed	Treatment	Cancer, Breast	1
Not Available	Completed	Treatment	Low Back Pain (LBP)	1
Not Available	Completed	Treatment	Opioid-Related Disorders	1
Not Available	Completed	Treatment	Post Operative Pain	1
Not Available	Completed	Treatment	Lumbar epidural anesthesia	1
Not Available	Enrolling by Invitation	Basic Science	Healthy Volunteers	1
Not Available	Not Yet Recruiting	Prevention	Caudal epidural block therapy / Postoperative pain / Surgery, Cardiac	1
Not Available	Not Yet Recruiting	Treatment	Lumbar Spinal Instability / Lumbar Spine Degeneration / Spinal Stenosis of Lumbar Region	1
Not Available	Recruiting	Not Available	Acute Bacterial Exacerbation of Chronic Bronchitis (ABECB) / Acute Bacterial Sinusitis (ABS) / Acute Decompensated Heart Failure (ADHF) / Acute Pyelonephritis / Adenovirus / Adjunct to general anesthesia therapy / Adrenal Insufficiency / Airway Swelling / Anaesthesia therapy / Anxiolysis / Arterial Hypotension / Autism, Early Infantile / Autistic Disorder / Bartonellosis / Benzodiazepine Withdrawal / Benzodiazepines / Bipolar Disorder (BD) / Bloodstream Infections / Bone and Joint Infections / Brain Swelling / Bronchospasm / Brucellosis / Cardiac Arrest / Central Nervous System Infections / Cholera / Chronic Bacterial Prostatitis / Community Acquired Pneumonia (CAP) / Complicated Urinary Tract Infections / Convulsions / Cyanide Poisoning / Cytomegalovirus Retinitis / Drug hypersensitivity reaction / Early-onset Schizophrenia Spectrum Disorders / Edema / Epilepsies / Feeling Anxious / Flu caused by Influenza / Gastroparesis / GYNAECOLOGICAL INFECTION / Headaches / Herpes Simplex Virus / Hospital-acquired bacterial pneumonia / Hypercholesterolaemia / Hyperlipidemias / Hypertensive / Infantile Hemangiomas / Infection NOS / Inflammatory Conditions / Inflammatory Reaction / Influenza Treatment or Prophylaxis / Inhalational Anthrax (Post-Exposure) / Intra-Abdominal Infections / Life-threatening Fungal Infections / Lower Respiratory Tract Infection (LRTI) / Meningitis, Bacterial / Migraines / Muscle Spasms / Nausea / Opioid Addiction / Pain / Plague / Pneumonia / Prophylaxis / Psittacosis / Q Fever / Reflux / Relapsing Fever / Rocky Mountain Spotted Fever / Schizophrenic Disorders / Sedation therapy / Seizures / Sepsis / Skeletal Muscle Spasms / Skin and Subcutaneous Tissue Bacterial Infections / Skin Structures and Soft Tissue Infections / Stable Angina (SA) / Thromboprophylaxis / Thrombosis / Trachoma / Treatment-resistant Schizophrenia / Tularemia / Typhus Fever / Uncomplicated Skin and Skin Structure Infections / Uncomplicated Urinary Tract Infections / Urinary Tract Infections (UTIs) / Vomiting / Withdrawal	1
Not Available	Recruiting	Prevention	Postoperative pain	1
Not Available	Recruiting	Prevention	Pregnancy	1
Not Available	Recruiting	Prevention	Prophylaxis against postoperative nausea and vomiting	1
Not Available	Recruiting	Treatment	Analgesia, Obstetrical / Obstetric Surgical Procedures	1
Not Available	Recruiting	Treatment	Conditions Requiring Colorectal Surgery	1
Not Available	Recruiting	Treatment	Nausea / Pain	1
Not Available	Recruiting	Treatment	Pain / Post Operative Nausea and Vomiting (PONV)	1
Not Available	Terminated	Supportive Care	Pain / Respiratory Depression	1
Not Available	Terminated	Treatment	Laparoscopic Colorectal Resection	1
Not Available	Unknown Status	Treatment	Pain	1
Not Available	Withdrawn	Treatment	Pain / Ventilatory Depression	1

Pharmacoeconomics

Manufacturers

Purdue pharma lp
Purdue pharmaceutical products lp
Akorn inc
Barr laboratories inc
Hospira inc
Watson laboratories inc
Roxane laboratories inc
Mallinckrodt inc
Actavis totowa llc
Kv pharmaceutical co
Lannett holdings inc
Tyco healthcare mallinckrodt

Packagers

Dosage forms

Form	Route	Strength
Capsule, extended release	Oral	9 mg
Liquid	Intramuscular; Intravenous; Subcutaneous	2 mg
Liquid	Oral	1 mg
Liquid	Oral	5 mg/5mL
Powder, for solution	Intramuscular; Intravenous; Subcutaneous	250 mg
Tablet	Oral	4 mg/1
Injection, powder, lyophilized, for solution	Intramuscular; Intravenous; Subcutaneous	10 mg/mL
Injection, solution	Intramuscular; Intravenous; Subcutaneous	10 mg/mL
Liquid	Intramuscular; Intravenous; Subcutaneous	10 mg
Liquid	Intramuscular; Intravenous; Subcutaneous	50 mg
Capsule, extended release	Oral	4.5 mg
Capsule, extended release	Oral	9.0 mg
Capsule, extended release	Oral	12 mg
Capsule, extended release	Oral	18 mg
Capsule, extended release	Oral	24 mg
Capsule, extended release	Oral	30 mg
Capsule, extended release	Oral	3 mg
Capsule, extended release	Oral	6 mg
Injection, solution	Intramuscular; Intravenous; Subcutaneous	.5 mg/mL
Injection, solution	Intravenous	.1 mg/mL
Injection, solution	Intravenous	.2 mg/mL
Injection, solution	Intravenous	.4 mg/mL
Injection, solution	Intravenous	1 mg/mL
Injection, solution	Intravenous	10 mg/mL
Injection, solution	Intravenous	2 mg/mL
Solution	Intramuscular; Intravenous; Subcutaneous	10 mg
Solution	Intramuscular; Intravenous; Subcutaneous	20 mg
Solution	Intramuscular; Intravenous; Subcutaneous	50 mg
Solution	Intramuscular; Intravenous; Subcutaneous	100 mg
Injection	Intramuscular; Intravenous; Subcutaneous	2 mg/mL
Injection	Parenteral	10 mg/mL
Injection, solution	Intramuscular; Intravenous; Subcutaneous	1 mg/mL
Injection, solution	Intramuscular; Intravenous; Subcutaneous	2 mg/mL
Injection, solution	Intramuscular; Intravenous; Subcutaneous	4 mg/mL
Solution	Oral	1 mg/mL
Solution	Oral	5 mg/5mL
Suppository	Rectal	3 mg/1
Tablet	Oral	2 mg/1
Tablet	Oral	8 mg/1
Tablet, film coated	Oral	2 mg/1
Tablet, film coated	Oral	4 mg/1
Tablet, film coated	Oral	8 mg/1
Tablet, film coated, extended release	Oral	12 mg/1
Tablet, film coated, extended release	Oral	16 mg/1
Tablet, film coated, extended release	Oral	8 mg/1
Tablet, extended release	Oral	12 mg/1
Tablet, extended release	Oral	16 mg/1
Tablet, extended release	Oral	32 mg/1
Tablet, extended release	Oral	8 mg/1
Solution	Intramuscular; Intravenous; Subcutaneous	2 mg
Tablet, extended release	Oral	16 mg
Tablet, extended release	Oral	32 mg
Tablet, extended release	Oral	4 mg
Tablet, extended release	Oral	8 mg
Capsule, extended release	Oral	16 mg
Syrup	Oral	1 mg
Suppository	Rectal	3 mg
Tablet	Oral	1 mg
Tablet	Oral	2 mg
Tablet	Oral	4 mg
Tablet	Oral	8 mg

Prices

Unit description	Cost	Unit
Hydromorphone hcl powder	166.25USD	g
Dilaudid-hp 250 mg vial	114.8USD	vial
Dilaudid Sterile Powder 250 mg/vial	78.99USD	vial
HYDROmorphone HCl 6 3 mg Suppository Box	54.92USD	box
Hydromorphone Hp 50 50 mg/ml	13.78USD	ml
Dilaudid-Xp 50 mg/ml	11.82USD	ml
Hydromorphone 3 mg suppository	11.11USD	suppository
Dilaudid-Hp-Plus 20 mg/ml	5.08USD	ml
Hydromorphone Hp 20 20 mg/ml	4.72USD	ml
Hydromorph Contin 30 mg Controlled-Release Capsule	4.21USD	capsule
Hydromorph Contin 24 mg Controlled-Release Capsule	3.52USD	capsule
Dilaudid-Hp 10 mg/ml	3.14USD	ml
Hydromorphone Hp 10 mg/ml	2.92USD	ml
Hydromorph Contin 18 mg Controlled-Release Capsule	2.75USD	capsule
Hydromorphone 10 mg/ml ampul	2.58USD	ml
Pms-Hydromorphone 3 mg Suppository	2.42USD	suppository
Dilaudid 4 mg/ml ampul	2.2USD	ml
Dilaudid 8 mg tablet	2.19USD	tablet
HYDROmorphone HCl 4 mg/ml Solution 1ml Cartridge	2.07USD	cartridge
Hydromorph Contin 12 mg Controlled-Release Capsule	1.91USD	capsule
Dilaudid 2 mg/ml ampul	1.81USD	ml
Dilaudid 1 mg/ml ampul	1.64USD	ml
Hydromorphone hcl 8 mg tablet	1.4USD	tablet
Dilaudid 4 mg tablet	1.36USD	tablet
Hydromorphone 8 mg tablet	1.32USD	tablet
Dilaudid 2 mg/ml	1.28USD	ml
Hydromorphone 2 mg/ml	1.19USD	ml
Hydromorph Contin 6 mg Controlled-Release Capsule	1.1USD	capsule
Hydromorphone-ns 0.4 mg/ml	1.08USD	ml
Hydromorphone-ns 0.3 mg/ ml	1.05USD	ml
Hydromorphone 2 mg/ml vial	1.02USD	ml
Hydromorphone-ns 25 mg/25 ml	1.01USD	ml
Dilaudid 2 mg tablet	1.0USD	tablet
Hydromorphone-ns 2.5 mg/25 ml	0.96USD	ml
HYDROmorphone HCl 4 mg tablet	0.8USD	tablet
HYDROmorphone HCl 2 mg tablet	0.77USD	tablet
Hydromorph Contin 3 mg Controlled-Release Capsule	0.73USD	capsule
Hydromorphone 4 mg tablet	0.72USD	tablet
Dilaudid 8 mg Tablet	0.55USD	tablet
Hydromorphone-ns 0.2 mg/ml	0.49USD	ml
Hydromorphone 2 mg tablet	0.37USD	tablet
Pms-Hydromorphone 8 mg Tablet	0.37USD	tablet
Dilaudid 4 mg Tablet	0.35USD	tablet
Dilaudid-5 1 mg/ml liquid	0.33USD	ml
Hydromorphone-ns 5.5 mg/55 ml	0.33USD	ml
Dilaudid 2 mg Tablet	0.23USD	tablet
Pms-Hydromorphone 4 mg Tablet	0.23USD	tablet
Dilaudid 1 mg Tablet	0.16USD	tablet
Pms-Hydromorphone 2 mg Tablet	0.15USD	tablet
Pms-Hydromorphone 1 mg Tablet	0.1USD	tablet
Dilaudid 1 mg/ml Liquid	0.09USD	ml
Pms-Hydromorphone 1 mg/ml Liquid	0.07USD	ml

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.

Patents

Patent Number	Pediatric Extension	Approved	Expires (estimated)
US5968551	No	1994-12-24	2011-12-24	US
US6589960	No	2000-11-09	2020-11-09	US

Properties

State

Solid

Experimental Properties

Property	Value	Source
melting point (°C)	266.5 °C	PhysProp
logP	0.9	Not Available

Predicted Properties

Property	Value	Source
Water Solubility	4.39 mg/mL	ALOGPS
logP	1.69	ALOGPS
logP	1.62	ChemAxon
logS	-1.8	ALOGPS
pKa (Strongest Acidic)	10.11	ChemAxon
pKa (Strongest Basic)	8.59	ChemAxon
Physiological Charge	1	ChemAxon
Hydrogen Acceptor Count	4	ChemAxon
Hydrogen Donor Count	1	ChemAxon
Polar Surface Area	49.77 Å²	ChemAxon
Rotatable Bond Count	0	ChemAxon
Refractivity	78.26 m³·mol^-1	ChemAxon
Polarizability	30.02 Å³	ChemAxon
Number of Rings	5	ChemAxon
Bioavailability	1	ChemAxon
Rule of Five	Yes	ChemAxon
Ghose Filter	Yes	ChemAxon
Veber's Rule	No	ChemAxon
MDDR-like Rule	No	ChemAxon

Predicted ADMET features

Property	Value	Probability
Human Intestinal Absorption	+	1.0
Blood Brain Barrier	+	0.9931
Caco-2 permeable	+	0.8647
P-glycoprotein substrate	Substrate	0.8174
P-glycoprotein inhibitor I	Non-inhibitor	0.8497
P-glycoprotein inhibitor II	Non-inhibitor	0.9641
Renal organic cation transporter	Inhibitor	0.6374
CYP450 2C9 substrate	Non-substrate	0.7925
CYP450 2D6 substrate	Substrate	0.8618
CYP450 3A4 substrate	Substrate	0.7571
CYP450 1A2 substrate	Non-inhibitor	0.6918
CYP450 2C9 inhibitor	Non-inhibitor	0.9539
CYP450 2D6 inhibitor	Non-inhibitor	0.5197
CYP450 2C19 inhibitor	Non-inhibitor	0.8088
CYP450 3A4 inhibitor	Non-inhibitor	0.8177
CYP450 inhibitory promiscuity	Low CYP Inhibitory Promiscuity	0.9413
Ames test	Non AMES toxic	0.7214
Carcinogenicity	Non-carcinogens	0.9554
Biodegradation	Not ready biodegradable	0.9815
Rat acute toxicity	2.9191 LD50, mol/kg	Not applicable
hERG inhibition (predictor I)	Weak inhibitor	0.8906
hERG inhibition (predictor II)	Non-inhibitor	0.8992

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )

Spectra

Mass Spec (NIST)

Not Available

Spectra

Spectrum Type	Description	Splash Key
Predicted LC-MS/MS	Predicted LC-MS/MS Spectrum - 10V, Positive	Not Available
Predicted LC-MS/MS	Predicted LC-MS/MS Spectrum - 20V, Positive	Not Available
Predicted LC-MS/MS	Predicted LC-MS/MS Spectrum - 40V, Positive	Not Available
Predicted LC-MS/MS	Predicted LC-MS/MS Spectrum - 10V, Negative	Not Available
Predicted LC-MS/MS	Predicted LC-MS/MS Spectrum - 20V, Negative	Not Available
Predicted LC-MS/MS	Predicted LC-MS/MS Spectrum - 40V, Negative	Not Available
MS	Mass Spectrum (Electron Ionization)	splash10-002r-6960000000-9f3d9b17d56e032d76c5	View in MoNA

Taxonomy

Description

This compound belongs to the class of organic compounds known as morphinans. These are polycyclic compounds with a four-ring skeleton with three condensed six-member rings forming a partially hydrogenated phenanthrene moiety, one of which is aromatic while the two others are alicyclic.

Kingdom

Organic compounds

Super Class

Alkaloids and derivatives

Class

Morphinans

Sub Class

Not Available

Direct Parent

Morphinans

Alternative Parents

Phenanthrenes and derivatives / Isoquinolones and derivatives / Tetralins / Coumarans / Aralkylamines / Alkyl aryl ethers / 1-hydroxy-2-unsubstituted benzenoids / Piperidines / Trialkylamines / Ketones

Substituents

Morphinan / Phenanthrene / Isoquinolone / Tetralin / Coumaran / Alkyl aryl ether / 1-hydroxy-2-unsubstituted benzenoid / Aralkylamine / Piperidine / Benzenoid

Molecular Framework

Aromatic heteropolycyclic compounds

External Descriptors

morphinane alkaloid, organic heteropentacyclic compound (CHEBI:5790 )

Targets

Details

1. Mu-type opioid receptor

Kind: Protein
Organism: Human
Pharmacological action: yes
Actions: agonist

General Function:: Voltage-gated calcium channel activity
Specific Function:: Receptor for endogenous opioids such as beta-endorphin and endomorphin. Receptor for natural and synthetic opioids including morphine, heroin, DAMGO, fentanyl, etorphine, buprenorphin and methadone. Agonist binding to the receptor induces coupling to an inactive GDP-bound heterotrimeric G-protein complex and subsequent exchange of GDP for GTP in the G-protein alpha subunit leading to dissociati...
Gene Name:: OPRM1
Uniprot ID:: P35372
Molecular Weight:: 44778.855 Da

References

Quigley C: Hydromorphone for acute and chronic pain. Cochrane Database Syst Rev. 2002;(1):CD003447. [PubMed:11869661 ]
Inturrisi CE: Clinical pharmacology of opioids for pain. Clin J Pain. 2002 Jul-Aug;18(4 Suppl):S3-13. [PubMed:12479250 ]
Sarhill N, Walsh D, Nelson KA: Hydromorphone: pharmacology and clinical applications in cancer patients. Support Care Cancer. 2001 Mar;9(2):84-96. [PubMed:11305075 ]
Kumar P, Sunkaraneni S, Sirohi S, Dighe SV, Walker EA, Yoburn BC: Hydromorphone efficacy and treatment protocol impact on tolerance and mu-opioid receptor regulation. Eur J Pharmacol. 2008 Nov 12;597(1-3):39-45. doi: 10.1016/j.ejphar.2008.08.025. Epub 2008 Aug 30. [PubMed:18789923 ]

Details

2. Delta-type opioid receptor

Kind: Protein
Organism: Human
Pharmacological action: yes
Actions: partial agonist

General Function:: Opioid receptor activity
Specific Function:: G-protein coupled receptor that functions as receptor for endogenous enkephalins and for a subset of other opioids. Ligand binding causes a conformation change that triggers signaling via guanine nucleotide-binding proteins (G proteins) and modulates the activity of down-stream effectors, such as adenylate cyclase. Signaling leads to the inhibition of adenylate cyclase activity. Inhibits neurot...
Gene Name:: OPRD1
Uniprot ID:: P41143
Molecular Weight:: 40368.235 Da

References

Fang X, Larson DL, Portoghese PS: 7-spirobenzocyclohexyl derivatives of naltrexone, oxymorphone, and hydromorphone as selective opioid receptor ligands. J Med Chem. 1997 Sep 12;40(19):3064-70. [PubMed:9301669 ]
Hennies HH, Friderichs E, Schneider J: Receptor binding, analgesic and antitussive potency of tramadol and other selected opioids. Arzneimittelforschung. 1988 Jul;38(7):877-80. [PubMed:2849950 ]
Jiang Q, Sebastian A, Archer S, Bidlack JM: 5 beta-Methyl-14 beta-(p-nitrocinnamoylamino)-7,8-dihydromorphinone and its corresponding N-cyclopropylmethyl analog, N-cyclopropylmethylnor-5 beta-methyl-14 beta-(p-nitrocinnamoylamino)- 7,8-dihydromorphinone: mu-selective irreversible opioid antagonists. J Pharmacol Exp Ther. 1994 Mar;268(3):1107-13. [PubMed:7511163 ]
Guay DR: Use of oral oxymorphone in the elderly. Consult Pharm. 2007 May;22(5):417-30. [PubMed:17658959 ]
Hartvig P, Neil A, Terenius L, Antoni G, Rimland A, Ulin J, Langstrom B: Brain and plasma kinetics of the opioid 11C-hydromorphone in two macaque species. Pharmacol Toxicol. 1989 Sep;65(3):214-6. [PubMed:2478994 ]
Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352 ]

Details

3. Kappa-type opioid receptor

Kind: Protein
Organism: Human
Pharmacological action: yes
Actions: agonist

General Function:: Opioid receptor activity
Specific Function:: G-protein coupled opioid receptor that functions as receptor for endogenous alpha-neoendorphins and dynorphins, but has low affinity for beta-endorphins. Also functions as receptor for various synthetic opioids and for the psychoactive diterpene salvinorin A. Ligand binding causes a conformation change that triggers signaling via guanine nucleotide-binding proteins (G proteins) and modulates th...
Gene Name:: OPRK1
Uniprot ID:: P41145
Molecular Weight:: 42644.665 Da

References

Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284 ]
Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423 ]
Gharagozlou P, Hashemi E, DeLorey TM, Clark JD, Lameh J: Pharmacological profiles of opioid ligands at kappa opioid receptors. BMC Pharmacol. 2006 Jan 25;6:3. [PubMed:16433932 ]

Enzymes

Details

1. Cytochrome P450 3A4

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: substrate

General Function:: Vitamin d3 25-hydroxylase activity
Specific Function:: Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation reactions (e.g. caffeine 8-oxidation, omeprazole sulphoxidation, midazolam 1'-hydroxylation and midazolam 4-hydroxylation) of structurally unrelated compounds, including steroids, fatty acids, and xenobiot...
Gene Name:: CYP3A4
Uniprot ID:: P08684
Molecular Weight:: 57342.67 Da

References

Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. [PubMed:19515014 ]
Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]

Details

2. Cytochrome P450 2C9

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: substrate

General Function:: Steroid hydroxylase activity
Specific Function:: Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics. This enzyme contributes to the wide pharmacokinetics variability of the metabolism of drugs such as S-warfarin, diclofenac, phenyto...
Gene Name:: CYP2C9
Uniprot ID:: P11712
Molecular Weight:: 55627.365 Da

References

Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. [PubMed:19515014 ]
Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]

Details

3. Cytochrome P450 2D6

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: substrate

General Function:: Steroid hydroxylase activity
Specific Function:: Responsible for the metabolism of many drugs and environmental chemicals that it oxidizes. It is involved in the metabolism of drugs such as antiarrhythmics, adrenoceptor antagonists, and tricyclic antidepressants.
Gene Name:: CYP2D6
Uniprot ID:: P10635
Molecular Weight:: 55768.94 Da

References

Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. [PubMed:19515014 ]
Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]

Details

4. Prostaglandin G/H synthase 1

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: substrate

General Function:: Prostaglandin-endoperoxide synthase activity
Specific Function:: Converts arachidonate to prostaglandin H2 (PGH2), a committed step in prostanoid synthesis. Involved in the constitutive production of prostanoids in particular in the stomach and platelets. In gastric epithelial cells, it is a key step in the generation of prostaglandins, such as prostaglandin E2 (PGE2), which plays an important role in cytoprotection. In platelets, it is involved in the gener...
Gene Name:: PTGS1
Uniprot ID:: P23219
Molecular Weight:: 68685.82 Da

References

Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. [PubMed:19515014 ]

Details

5. UDP-glucuronosyltransferase 1-9

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: substrate

General Function:: Retinoic acid binding
Specific Function:: UDPGT is of major importance in the conjugation and subsequent elimination of potentially toxic xenobiotics and endogenous compounds. This isoform has specificity for phenols. Isoform 2 lacks transferase activity but acts as a negative regulator of isoform 1.
Gene Name:: UGT1A9
Uniprot ID:: O60656
Molecular Weight:: 59940.495 Da

References

Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. [PubMed:19515014 ]

Drug created on June 13, 2005 07:24 / Updated on July 22, 2017 18:04

Get DrugBank to go!

Structure for DB00327 (Hydromorphone)

Targets

References

References

References

Enzymes

References

References

References

References

References