Hydromorphone Withdrawal Side Effects, Timeline & Treatment

Hydromorphone withdrawal is a detoxification process that happens when you quit taking hydromorphone or reduce the amount you usually take. In other words, it’s a combination of physical and mental symptoms that occur when your body clears out hydromorphone from its system. 

Withdrawal symptoms are inevitable if you’ve been taking Dilaudid or other hydromorphone products long enough to become dependent on them. Since they can be uncomfortable and potentially life-threatening, it’s in your best interest to learn as much as possible about hydromorphone withdrawal before quitting the drug.

What Is Hydromorphone?

What Is Hydromorphone?

Hydromorphone is a potent opioid medication used to treat moderate to severe pain that non-opioid painkillers cannot manage. 

Hydromorphone is classified as a Schedule II controlled substance and can only be obtained by prescription due to its high potential for abuse and addiction. In the United States, it is sold under the brand names Dilaudid and Exalgo, but it is also available in its generic form.

Hydromorphone comes in the following formulations:

  • Tablet
  • Extended-release tablet
  • Injectable ampoule
  • Liquid
  • Suppository

Extended-release hydromorphone can provide round-the-clock pain relief, but it should only be prescribed to opioid-tolerant patients, i.e., those who have been taking opioid medication for no less than a week.

As a semi-synthetic opioid, hydromorphone is synthesized in laboratories from morphine. While both of these opioids effectively relieve pain by attaching to opioid receptors and disrupting the transmission of pain signals between the body and the brain, they differ in terms of potency. According to certain studies, hydromorphone is up to 10 times stronger than morphine. 

Besides effectively easing severe pain, hydromorphone may induce euphoric feelings, especially when taken in large doses. Like other opioids, it stimulates the release of dopamine, which can make people feel “high.” Since this dramatically increases the risk of opioid abuse and addiction, you should always take this medication as prescribed by your doctor. 

Common Dilaudid Withdrawal Symptoms 

Dilaudid withdrawal symptoms occur when you stop taking the drug after developing physical dependence or addiction to hydromorphone.

Simply put, even if you take hydromorphone strictly as instructed, you may become dependent, especially when taking it for an extended time. Over time, the body gets used to the usual drug dose and thus no longer produces desired effects. This phenomenon is known as tolerance, and it is the first sign of opioid dependence. 

If you’ve become physically dependent on hydromorphone, you shouldn’t increase your usual dosage without consulting your doctor. Otherwise, it may lead to opioid addiction, a treatable brain condition that makes it very difficult to control opioid use.

Once you develop opioid dependence or addiction and stop taking hydromorphone, your body will begin to clear the drug out from its system, causing withdrawal symptoms. 

Withdrawal symptoms may also occur when patients switch to another opioid. A study on opioid switching found that switching from hydromorphone to alfentanil, a derivative of fentanyl, triggers hydromorphone withdrawal symptoms.

Given that hydromorphone is very potent, its withdrawal symptoms tend to be more severe than those of less potent opioids, such as tramadol.

With that in mind, here are the most common hydromorphone withdrawal symptoms:

  • Anxiety
  • Appetite loss
  • Chills
  • Cravings
  • Diarrhea
  • Fatigue
  • Increased heart rate and blood pressure
  • Irritability
  • Muscle ache
  • Mydriasis (pupil dilation)
  • Nausea
  • Runny nose and watery eyes
  • Sleeplessness
  • Sweating
  • Vomiting

Dilaudid Withdrawal Timeline 

Dilaudid withdrawal timeline depends on how long you’ve been taking hydromorphone, as well as at what doses. That said, here’s what it typically looks like:

The First 12 Hours

The half-life of immediate-release hydromorphone is around 2.5 hours, whereas that of extended-release formulations is 11 hours on average. 

As such, you may start to feel the first hydromorphone withdrawal symptoms, such as anxiety and irritability, within the first 12 hours after the last dose.

Days 1-2

Dilaudid withdrawal symptoms usually peak within the first couple of days. Besides anxiety and agitation, you may experience:

  • Nausea
  • Chills and sweating
  • Muscle aches
  • Runny nose
  • Watery eyes
  • Difficulty sleeping
  • Fever
  • Depression
  • Loss of appetite

Days 3-4

Hydromorphone withdrawal symptoms usually begin to subside within the third and fourth day after taking the last dose. You may still experience some mild withdrawal symptoms, such as nausea and muscle aches.

Days 5-15

Depending on the intensity of use, you may experience some hydromorphone withdrawal symptoms for two weeks and even longer since your last dose. 

The most common late Dilaudid withdrawal symptoms include:

  • Depression
  • Anxiety
  • Agitation
  • Apathy
  • Fatigue
  • Cravings

While late hydromorphone withdrawal symptoms are usually psychological, some people may also experience physical symptoms, such as sleep problems, stomach cramps, diarrhea, and nausea.

How Long Do Dilaudid Withdrawal Symptoms Last?

The duration of Dilaudid withdrawal symptoms depends on various factors, including:

  • Age
  • Metabolic rate
  • Kidney, liver, and other organ health
  • Hydromorphone use (duration, dosage, etc.)

Essentially, the faster your metabolism is and the less hydromorphone you’ve taken, the easier and shorter your Dilaudid withdrawal process should be. 

On average, hydromorphone withdrawal symptoms last 10–14 days. However, in some cases, these symptoms may last longer. Experiencing withdrawal symptoms for weeks, months, or even years after quitting Dilaudid may indicate post-acute withdrawal syndrome (PAWS), a condition primarily characterized by psychological symptoms such as cravings and depression.

Risks, Dangers, and Side Effects of Hydromorphone 

One of the greatest risks of taking hydromorphone is becoming addicted to it. As mentioned above, anyone can develop an addiction to hydromorphone, even those patients who take this medication according to the doctor’s instructions.

Besides that, Dilaudid can cause various side effects, just like any other medication. The most common hydromorphone side effects are:

  • Anxiety
  • Constipation
  • Depression
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Headache
  • Itching
  • Nausea
  • Sleep disturbances
  • Sweating
  • Vomiting

Risks, Dangers, and Side Effects of Hydromorphone -hydromorphone withdrawal

Moreover, the following hydromorphone side effects are considered severe and require medical attention:

  • Swelling
  • Difficulty swallowing
  • Slowed breathing
  • Hallucinations
  • Erectile dysfunction
  • Seizures
  • Fainting
  • Extreme dizziness or drowsiness

If you notice any of the above-mentioned side effects or your side effects aren’t improving, talk to your doctor. To minimize the risk of potentially life-threatening side effects and complications, you should also inform your doctor if you’re taking any of the following medications:

  • Benzodiazepines and other sedatives
  • Muscle relaxants
  • Opioids
  • Herbal medicines (e.g., St. John’s wort)

Also, you should never take hydromorphone with alcohol or drive before you know how this medication affects you. Hydromorphone products may also not be the right choice for you if you have lung disease, kidney problems, asthma, or head injury. 

In other words, inform your doctor about any health problems you have and any medications you’re taking to reduce the risk of serious adverse events, including respiratory depression and death.

How to Manage Dilaudid Withdrawal Symptoms 

As a particularly potent opioid, Dilaudid often causes very uncomfortable and painful withdrawal symptoms. Since Dilaudid withdrawal symptoms are particularly intense when you quit the drug abruptly, tapering off hydromorphone can help reduce their severity.

Hydromorphone withdrawal can also be potentially life-threatening, and it’s not uncommon for people to struggle with suicidal ideation after quitting Dilaudid. Because of this, you should never stop hydromorphone or other opioids without medical supervision. 

Most importantly, quitting hydromorphone without medical care greatly increases the risk of relapse, overdose, and death. In an attempt to soothe the pain and discomfort of Dilaudid withdrawal symptoms, you may accidentally take too much of the drug. Sadly, this isn’t a rare occurrence, as abstinence reduces tolerance to the drug.

Quitting hydromorphone under medical supervision, on the other hand, ensures your safety and maximizes your chances of making a long-term recovery. However, you should carefully consider which hydromorphone withdrawal treatment to choose, as not all are effective, let alone safe.

Rapid detox, for example, may seem like a good option due to its speed, but what many people don’t know is that it is dangerous and ineffective in the long term. While it can help you manage hydromorphone withdrawal symptoms, it doesn’t eliminate addiction and thus often leads to relapse.

If you’re looking for an effective opioid dependence treatment that can help you safely manage Dilaudid withdrawal symptoms and make a lifelong recovery, your best option is Accelerated Neuro-Regulation (ANR).

ANR Opioid Treatment for Hydromorphone Withdrawal 

Accelerated Neuro-Regulation  is a state-of-the-art opioid dependence treatment that has helped over 24,000 people worldwide heal from opioid addiction.

ANR Opioid Treatment for Hydromorphone Withdrawal
The ANR treatment is the only opioid addiction treatment that addresses the root cause of opioid dependence by re-regulating the endorphin-receptor system. Not only does ANR reverse the chemical imbalance caused by opioid use, but it also negates the risk of relapse, cravings, and side effects, helping you make a long-lasting recovery!

Most importantly, the ANR treatment is very safe. Whether you choose to be treated in our center in Brazil, Israel, Switzerland, or the United States, the procedure will be tailored to your individual needs. Moreover, it will be carried out by highly experienced medical staff in an ICU setting of an accredited hospital.

Better yet, the hospital stay for the ANR treatment lasts 36 hours on average, after which you can return to your daily life addiction-free!

To get started with the ANR treatment, contact us to arrange a free, 100% confidential consultation!

Key Takeaways 

Hydromorphone withdrawal is a potentially life-threatening condition that shouldn’t be taken lightly. Under no circumstances should you attempt to quit Dilaudid abruptly or on your own, as this may lead to severe withdrawal symptoms, relapse, overdose, and even death.

While tapering off hydromorphone can reduce the severity of withdrawal symptoms, it doesn’t eliminate them. 

If you’re looking for a way to overcome Dilaudid addiction and manage hydromorphone withdrawal symptoms with minimum discomfort, consider ANR. This modern opioid dependence treatment not only reverses opioid effects on the brain but also eliminates the risk of relapse, clearing the way for long-term recovery! 

Dilaudid Withdrawal FAQ

Some of the main Dilaudid withdrawal symptoms are drug cravings, sweating, anxiety, muscle aches, nausea, and vomiting. Dilaudid may cause more severe withdrawal symptoms than most other opioids, so you shouldn’t quit it without consulting your doctor.

Dilaudid withdrawal timeline varies from one person to another. Hydromorphone withdrawal symptoms usually emerge within the first 12 hours after taking the last dose, peak within 24–48 hours, and subside within 10–14 days.

Yes, hydromorphone is a semi-synthetic opioid derived from morphine. While these two opioids are very similar, hydromorphone may be up to 10 times as strong as morphine.

Dilaudid is prescribed for moderate-to-severe pain management. Since it is very potent and may be habit-forming, it shouldn’t be taken unless non-opioid painkillers are ineffective or cannot be used. 

Yes, hydromorphone is known to have a high potential for addiction and is therefore classified as a Schedule II controlled substance. Although Dilaudid can be used for chronic pain management, prolonged use increases the risk of abuse and addiction.

Yes, you can get addicted to hydromorphone. While taking it according to the doctor’s instructions reduces the risk of addiction, it’s possible to develop opioid use disorder (OUD) even if you take it as prescribed. Long-term use (three months or more) is associated with an increased risk of hydromorphone addiction.

If you want to stop taking hydromorphone, consult your doctor to ensure you do so safely and effectively. Never quit hydromorphone “cold turkey,” as this may lead to severe withdrawal symptoms.

Depending on the formula, dosage, and other factors, Dilaudid can stay in your system anywhere between 10 hours to four days after the last dose. Nonetheless, it could be detected by a hair follicle test for up to three months after you’ve last taken it.  

Naloxone is an opioid antagonist that can be administered to reverse the effects of hydromorphone. It is commonly used to reverse a hydromorphone overdose.

Accelerated Neuro-Regulation (ANR) is an innovative opioid dependence treatment designed to help people overcome opioid addiction safely, quickly, and effectively. By restoring the brain to its normal state, ANR eliminates the risk of relapse and ongoing withdrawal symptoms, which makes it highly effective for treating opioid dependence.

Reclaim your life with the revolutionary ANR treatment.

Dr. Andre Waismann

Dr. Waismann identified the biological roots of opioid dependency, Since then he has successfully treated more than 24,000 patients worldwide that are struggling with opioid addiction.


Throughout his career, he has lectured and educated health professionals in dozens of countries around the world to this day.

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