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Pain Management Message Board


Pain Management Board Index


Re: Delaudid???
Jul 12, 2006
Hi Misti, Ozzy is correct about Dilaudid or generic hydromorphone, but sttrength isn't just determined by by comparison to one drug or another, the number of mgs is really the key factor. Hydrocodone is almost as strong as morphine, but not vailable in a pur e form without tylenol, so the amount you can take is limited by the recomended max dose of tylenol you can take.

There are conversion charts called equianelgesic charts, meaning equal relief converting the right number of mgs to the right number of mgs of another med. All drugs are compared to morphine in strength. Morphine is the gold standard to which others are compared. Hydrocodone converts about .8:1 meaning 8 mgs of hydro would be equal to 10 mgs of morphine. Dilaudid converts about 1:8 to morphine, meaning 1 mg of dilaudid is equal to about 8 mgs of morphine.

If your used to taking 2 10 mg norco, or 20 mgs of hydrocodone at one time, 2 mgs of dilaudid really isn't significantly stronger, but you can take more dilaudid than hydro because there isn't a ceiling created by the amount of tylenol in dilaudid because they don't use apap in it. So the dose of dilaudid and how much Hydro you were used to taking is what really makes the difference.

Drugs also act differently when delivered in different forms, a shot in muscle "IM" is about 3 times stronger than it's oral version, IV meds injected directly into a vein is 3 times stronger than recieving the drug IM or 6 times stronger than orally.

Every back surgery I have had I was given IV dilauid through an V pump, IF I had a choice I wold choose IV dilaudid for post surgery pain, But when it comes to oral meds, I never found oral dilaudid to be anywhere near as effective as an IV drip of the same med. Different drugs have different half lifes or duration and oral dilauid has a fairly short half life. OxyCodone the opiate in Percocet or OxyContin isn't as stong as dilauid when you compare it mg to mg, but it does have a longer half life and is available in higher mg strengths. I prefer oxy codone because it lasts longer and I can compensate for strength by takng more mgs. Everyone reponds to meds differently so my experience with oral dilaudid may not be the same as yours, I hactually have dilaudid in my pmplanted pump and because it's a continous flow the duration really isn't an issue. So it really comes down to how maqny mgs, how it's delivered, How many mgs of the previous drug you were taking and your individualk response.

If you find your not getting relief from your present dose, or it doesn't last 4 hours or the way it's prescribed, consult your doc before you take it upon yourself o afjjust the timing or dose you take. ecause you not used to taking strong high dose meds, an extra pill could kill you depending on the strenght. It does come in different strengths, 2,4 and 8 mg tablets. So there is quite a difference in the strength between 2mgs and 8 mgs, something 4 times stronger than what your used to taking is enough to kill most people that aren't tolerant to the drug, so never just decide to take another pill or increase any med without consulting your doc. It's the fastest way to end up being discharged with no doc and no meds if you don't kill yourself in the process of self medicating.

The goal of pain management is not to eliminate all pain, it's to make the pain tolerable. Even with an implanted pump delivering dilaudid directly to my spine, at best I get 50% relief and some days it's more like 10%. IF they increased the dose to try and obtain greater relief, it would leave me impaired with even greater side effects like constipaion, nausea, urinary retention, sweating, and if you feel shor5t of breath while taking any opiate call your doc asap. I'm not going to die anytime soon so I'm not ready to live the next 30 years as a zombie that can't walk a straight line, pee without a cath or keep their eyes open during a conversation.

I would expect greater side effects going from Norco to dilaudid like constipation and if you unable to urinate due to the new med, report that to your doc asap. Other side efects like drowsiness, vomitting and hot flashes tend to deminish with time as you become used to the new med.Another thing to be aware of, is you will become physically dependent on opiates even quicker taking stronger meds. Stoping Norco 4 weeks post op would be a breeze compared to discontinuing dilaudid after 4 weeks of continued use. That's probably the greratest price you pay for pain relief and the greatest reason to be compliant with the way your doc prescribes your meds.

Good luck , Dave
Re: Delaudid???
Jul 10, 2009
[QUOTE=Shoreline;2454361]Hi Misti, Ozzy is correct about Dilaudid or generic hydromorphone, but sttrength isn't just determined by by comparison to one drug or another, the number of mgs is really the key factor. Hydrocodone is almost as strong as morphine, but not vailable in a pur e form without tylenol, so the amount you can take is limited by the recomended max dose of tylenol you can take.

There are conversion charts called equianelgesic charts, meaning equal relief converting the right number of mgs to the right number of mgs of another med. All drugs are compared to morphine in strength. Morphine is the gold standard to which others are compared. Hydrocodone converts about .8:1 meaning 8 mgs of hydro would be equal to 10 mgs of morphine. Dilaudid converts about 1:8 to morphine, meaning 1 mg of dilaudid is equal to about 8 mgs of morphine.

If your used to taking 2 10 mg norco, or 20 mgs of hydrocodone at one time, 2 mgs of dilaudid really isn't significantly stronger, but you can take more dilaudid than hydro because there isn't a ceiling created by the amount of tylenol in dilaudid because they don't use apap in it. So the dose of dilaudid and how much Hydro you were used to taking is what really makes the difference.

Drugs also act differently when delivered in different forms, a shot in muscle "IM" is about 3 times stronger than it's oral version, IV meds injected directly into a vein is 3 times stronger than recieving the drug IM or 6 times stronger than orally.

Every back surgery I have had I was given IV dilauid through an V pump, IF I had a choice I wold choose IV dilaudid for post surgery pain, But when it comes to oral meds, I never found oral dilaudid to be anywhere near as effective as an IV drip of the same med. Different drugs have different half lifes or duration and oral dilauid has a fairly short half life. OxyCodone the opiate in Percocet or OxyContin isn't as stong as dilauid when you compare it mg to mg, but it does have a longer half life and is available in higher mg strengths. I prefer oxy codone because it lasts longer and I can compensate for strength by takng more mgs. Everyone reponds to meds differently so my experience with oral dilaudid may not be the same as yours, I hactually have dilaudid in my pmplanted pump and because it's a continous flow the duration really isn't an issue. So it really comes down to how maqny mgs, how it's delivered, How many mgs of the previous drug you were taking and your individualk response.

If you find your not getting relief from your present dose, or it doesn't last 4 hours or the way it's prescribed, consult your doc before you take it upon yourself o afjjust the timing or dose you take. ecause you not used to taking strong high dose meds, an extra pill could kill you depending on the strenght. It does come in different strengths, 2,4 and 8 mg tablets. So there is quite a difference in the strength between 2mgs and 8 mgs, something 4 times stronger than what your used to taking is enough to kill most people that aren't tolerant to the drug, so never just decide to take another pill or increase any med without consulting your doc. It's the fastest way to end up being discharged with no doc and no meds if you don't kill yourself in the process of self medicating.

The goal of pain management is not to eliminate all pain, it's to make the pain tolerable. Even with an implanted pump delivering dilaudid directly to my spine, at best I get 50% relief and some days it's more like 10%. IF they increased the dose to try and obtain greater relief, it would leave me impaired with even greater side effects like constipaion, nausea, urinary retention, sweating, and if you feel shor5t of breath while taking any opiate call your doc asap. I'm not going to die anytime soon so I'm not ready to live the next 30 years as a zombie that can't walk a straight line, pee without a cath or keep their eyes open during a conversation.

I would expect greater side effects going from Norco to dilaudid like constipation and if you unable to urinate due to the new med, report that to your doc asap. Other side efects like drowsiness, vomitting and hot flashes tend to deminish with time as you become used to the new med.Another thing to be aware of, is you will become physically dependent on opiates even quicker taking stronger meds. Stoping Norco 4 weeks post op would be a breeze compared to discontinuing dilaudid after 4 weeks of continued use. That's probably the greratest price you pay for pain relief and the greatest reason to be compliant with the way your doc prescribes your meds.

Good luck , Dave[/QUOTE]





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