Dilaudid (hydromorphone) questions! - Pain Management Message Board

conductor · 11-03-2005, 08:15 PM

Dear helpful Pain Management Poster:

What are the available strengths of the regular Dilaudid tablets?

What is Dilaudid HP and what is it used for?

This sustained-release type of Dilaudid...Is it relatively new?

Is there liquid Dilaudid available and does it work well?

Finally, how about the Dilaudid Cough Syrup? Are there that many people who need such a strong narcotic to quell their cough reflex?

I use the generic Dilaudid 8 mg (by Roxane) for BT pain, and I feel like it is getting weaker and weaker as time goes by. I guess this means my tolerance is growing by leaps and bounds. This used to work wonders for me (as did the injections of hydromorphone when the BT pain had gotten out of hand), but it doesn't work all that well now.

Furthermore, I also use Actiq 800 mcg for BT pain, which helps in certain situations.

I use Duragesic 75 mcg (every 48 hours) for my main pain reliever, and I have to give praise where it's due--as long as it's the brand name or the Sandoz generic (the Mylan type really blows). This has really helped the pain I have related to my exceptionally enjoyable Lupus and Lupus Anticoagulant conditions.

Sorry...I have gone on long enough. However, I am interested in everything you can tell me concerning the Dilaudid questions listed above.

Shoreline · 11-04-2005, 12:33 AM

Hey Conductor, Dialaudid or hyrdromorphone comes in 2,4 and 8 mg tablets it also comes in 5mg per ml solution. Dilauid HP is is a potent injectable version of 1mg per ml.
Just a side note, the 8mg tabs cost twice as much as taking 2 4mg tablets if you happen to pay cash. 8mg dilauid tablets are the most potent tablet that any manufacturer makes compared to the gold standard morphine and it's avaialability.

The US version of LA dilaudid "Palladone" was pulled from the market within months after they realized just one drink of alcohol destroyed the time release mechanism and unfortunately there are people that drink on top of their meds. A black box warning not to drink or you may die wouldn't satisfy the DEA. nfortunately there is already a well established IV dilaudid abuse problem, That's why the Contin version was never aproved in the US. The 4's sell for as much as 40 bucks a piece to an IV abuser.
Canada has a little more faith in it's people and Purdue still markets HydrormorphContin up north. Palladone used a different more tamper proof release system but apearently alcohol wasn't considered.

Hope you find an answer, Have you tried combining different LA opiates, Like Kadian, LA morphine or perhaps meth with Duragesic, sometimes one plus one equals more than two when you're covering a broader range of receptors.

As far as tolerance, My first thought would be after taking 800 mics of aqtiq in a single dose even an 8mg dilaudid isn't going to continue to do the trick once the pops become the only med that works. I would definitely say try 12mgs of dilauid before using more Aqtiq daily.

Why not adjust you base dose, it seems kind of backwards to use a BT med 9 times stronger than your base? There ought to be a happy medium somehwere. I think we would all would like the relief of something as strong as Aqtiq, but when there is no stronger med on the market all you can do is continue to increase the dose. Once you reach 1600mcg Aqtiq and that doesn't work, what can you do at home for pain? What is an ER doc going to be willing to give you that's stronger if your doc has given you the most potent med available that's suposed to be reserved for malignant cancer only.

Good luck, Dave

Chaddyfriend · 11-04-2005, 12:50 AM

I just want to throw my 2 cents in about maybe an option for you. I have had such great succes with LA morphine as my base. I take avinza, which is 24hr morphine, but my dr. scribed it at 90mg in the morning and 90mg 12hrs later. maybe u could give this a shot. just tryin to help. good luck. oh yea, dilaudid sucks for me. i took 12mg and didnt do a thing.

Josie115 · 11-04-2005, 04:49 AM

I'm at the cross roads here. Maybe some suggestions can help me figure out the next direction. I am currently on 150 mcg. fentanyl plus my former meds..hydrocodone 7.5 2- twice a day..or as needed... At first, it all seemed to be working. Started this in July..was on hydroc for ever it seemed..tried Avinza..made me too sick to continue beyond 3rd month. Anyway..I'm finding I'm now using the vics again most days of the week..yesterday..only 2 but that was the exception. The pain level..and I've been keeping a log..trying to figure out what I'm doing wrong/right to keep things manageable..here's the Q...I'm using the mylan brand of duragesic. I'll be meeting with my doc and it's a case of should I switch to sandoz (hard time finding it)..or, change bt or, up base of current mylan? I really don't want to go up on it if I don't need to..actually, would like to be pain free and off everything..but..wouldn't we all. Any suggestions? My original and base problem is back problems. My last yr. has been that plus traumatic injury to my shoulder/hand..surgery on the hand..shoulder..just a killer pain. The kind we all know..deep, chronic, wear you down until even breathing seems to be too hard to manage. I will likely need shoulder surgery to resolve that problem..was hoping that it would slowly, over time heal. Still may..hope lives. Any help? Ideas?