Dilaudid (hydromorphone hydrochloride)

DILAUDID is a narcotic analgesic; its principal therapeutic effect is relief of pain. The precise mechanism of action of DILAUDID and other opiates is not known, although it is believed to relate to the existence of opiate receptors in the central nervous system. There is no intrinsic limit to the analgesic effect of DILAUDID; like morphine, adequate doses will relieve even the most severe pain. Clinically, however, dosage limitations are imposed by the adverse effects, primarily respiratory depression, nausea, and vomiting, which can result from high doses.

DILAUDID has diverse additional actions. It may produce drowsiness, changes in mood and mental clouding, depress the respiratory center and the cough center, stimulate the vomiting center, produce pinpoint constriction of the pupil, enhance parasympathetic activity, elevate cere- brospinal fluid pressure, increase biliary pressure, produce transient hyperglycemia.

Generally, the analgesic action of parenterally administered DILAUDID is apparent within 15 minutes and usually remains in effect for more than five hours. The onset of action of oral DILAUDID is somewhat slower, with measurable analgesia occurring within 30 minutes.
In human plasma the half-life of a DILAUDID 4 mg tablet is 2.6 hours. In a random crossover study in six subjects, 4 mg of oral DILAUDID produced a mean concentration/ time curve similar to that of 2 mg DILAUDID I.V., after the first hour.


WARNINGS

Respiratory Depression: DILAUDID produces dose-related respiratory depression by acting directly on brain stem respiratory centers. DILAUDID also affects centers that control respiratory rhythm, and may produce irregular and periodic breathing.

Head Injury and Increased Intracranial Pressure: The respiratory depressant effects of narcotics and their capacity to elevate cerebra-spinal fluid pressure may be markedly exaggerated in the presence of head injury, other intracranial lesions or a preexisting increase in intracranial pressure. Furthermore, narcotics produce effects which may obscure the clinical course of patients with head injuries.

Acute Abdominal Conditions: The administration of narcotics may obscure the diagnosis or clinical course of patients with acute abdominal conditions.


PRECAUTIONS

Special Risk Patients: DILAUDID should be used with caution in elderly or debilitated patients and those with impaired renal or hepatic function, hypothyroidism, Addison's disease, prostatic hypertrophy or urethral stricture. As with any narcotic analgesic agent, the usual precautions should be observed and the possibility of respiratory depression should be kept in mind.

Cough Reflex: DILAUDID suppresses the cough reflex; as with all narcotics, caution should be exercised when DILAUDID is used postoperatively and in patients with pulmonary disease.

Usage in Ambulatory Patients: Narcotics may impair the mental and or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery; patients should be cautioned accordingly.

drug Interactions: Patients receiving other narcotic analgesics, general anesthetics, phenothiazines, tranquilizers, sedative-hypnotics, tricyclic antidepressants or other CNS depressants (including alcohol) concomitantly with DILAUDID may exhibit an additive CNS depression. When such combined therapy is contemplated, the dose of one or both agents should be reduced.

Parenteral Administration: The parenteral form of DILAUDID may be given intravenously, but the injection should be given very slowly. Rapid intravenous injection of narcotic analgesics increases the possibility of side effects such as hypotension and respiratory depression.

Pregnancy: Pregnancy Category C. DILAUDID has been shown to be teratogenic in hamsters when given in doses 600 times the human dose. There are no adequate and well-controlled studies in pregnant women. DILAUDID should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nonteratogenic effects: Babies born to mothers who have been taking opioids regularly prior to delivery will be physically dependent. The withdrawal signs include irritability and excessive crying, tremors, hyperactive reflexea, increased respiratory rate, increased stools, sneezing, yawning, vomiting, and fever. The intensity of the syndrome does not always correlate with the duration of maternal opioid use or dose. There is no consensus on the best method of managing withdrawal. Chlorpromazine 0.7 to 1.0 mg/kg q.h. phenobarbital 2 mg/kg q.h. and paregoric 2 to 4 drops/kg q4h, have been used to treat withdrawal symptoms in infants. The duration ot therapy is 4 to 28 days, with the dosages decreased as tolerated.

Labor and Delivery: As with all narcotics, administration of DILAUDID to the mother shortly before delivery may result in some degree of respiratory depression in the newborn, especially if higher doses are used.

Nursing Mothers: it is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from DILAUDID, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Pediatric Use: Safety and effectiveness in children have not been established.

This forum is not to discuss suppliers. This thread is to discuss Dilaudid and not the companies offering it.

Thanks for your support

I am curious as to if you can even function in any capacity while on dilaudid. How does it compare with fentanyl and demerol in pain relief and effects.

Painstaking -

I use 250Mcg of Duragesic (2 100s and 1 50), and when I have breakthrough pain I use 4mg or 8mg Dilaudid tablets.

As far as functioning, it's hard to function without! Granted, I've been using it for some time, but I find 2mg of Dilaudid gives the same pain relief as 2 10/325 Hydrocodone.

Just my experience
T

So probably comparable to percocet 10 then, didn't figure that. I wonder if it would be more suited for my migraines. I have recently been swayed to believe out of the narcotic analgesics, Demerol is one of the better ones to treat migraines that are of the more severe kind.

Painstaking

Personally, I find Dilaudid to be more functional than hydrocodone, morphine or fentanyl, and about equal with oxycodone. Drowsiness is the primary side effect, instead of an actual 'high' that fentanyl, morphine and hydrocodone gives me. You should certainly try it if you have difficulties with the side effects of any of the other narcotic analgesics, as everyone will react differently with the side effects.

This medication was prescribed for me because Tylox (5mg oxycodone) did nothing, I mean NOTHING, to relieve pain. I took 150mg of oxy (30 pills) within 40 hours - didn't even care about the amount of tylenol. Surgeon said "Dilaudid 4mg should help". It saved me from going back to the hospital.

For me the side effects were much more gentle than either hydrocodone or oxycodone. No nausea, no dizzy feelings. Just great pain relief and a sense that everything was going to be alright.

Now I see why some think of oxy and hydro as mere candy when compared to this gentle giant of a pain killer.

I have been taking dilaudid 4mg for 6 months my doctor prescribes me 90 every twenty days. I have severe back injuries 2 bulging discs a torn disc and 3 compression fractures and after taking it this long it does nothing for pain I more just have to have it to feel normal and not have withdrawls, I wish I would have never taken it, the physical pain of my injuries are easier to deal with than the pain of not having the dilaudid.

Wow, and here I wish I had a sympathetic enough doctor to prescribe me any dilaudid. I know it is a hardcore drug and shouldnt be used long term but for those real ainful moments I hear it is the best.

IT IS the real deal WITH BILL MCNEIL. If morphine is the gold standard of pain killers, hydromorph is the diamond. You can have your oxy, your fent, your black tar, but for my back and feet, I'll take a pretty yellow number 4 any day of the week. I'm talkin legit pain killin folks, but anyway you slice it, or dice it, it's the shizzel. And b4 ya goin runnin down to tha street to buy some, yes, it's even worse than morph to come off of, SO BE VERY CAREFUL. You don't wanna be caught short on this stuff. Be safe, be very safe, J

This is definately the king of the mountain when it comes to pain medicine. Shouldn't be given outside of a hospital settings unless extremely needed. I see it used quite frequently in the ER to treat very painful things such as kidney stones.

Definatley agree with Jason. But oxymorphone out does dialaudid in my opinion. Of course, they only make it in suppositories now, because it was so abused in the past. That being said, I recently heard that they are trying to get FDA approval for a time released pill, which would be the same as Oxycontin is to oxycodone. Now that would be a painkiller!

They already came out w/Palladone, er for hm. But they recalled it for some reason. In any case, be careful. J (I've never had oxymor., but I'm sure it's effective)

Would diludid be in the same catagory as Demerol? I was given that after I had some knee surgery, and within 15 minutes after I took it, I was out COLD for about 12 hours. I cant imagine taking that as a pain reliever on a regular basis, but I am asking because I really dont know.

Dilaudid is very powerfull (~10X morphine) molar:molar, parentally, and even more so orally. Fine effects of hydromorphone are that it:

1) Lacks almost all of the nasty side effects of morphine, and to some degree, even H.

2) Is almost completely lacking in euphoria compaared to many narcotics which also have greater side effects (yes, hydrocodone and oxycodone produce much more euphoria than hydromorphone). But produces more euphoria than methadone.

3) Can cause a unique physical rush akin to H injection (momentary tightening feeling some equate with orgasm).

Oxymorphone is more potent, gram per gram. Part of the reason Dilaudid has such a reputation is that the tablets classically are relatively pure, so injection method is relatively easy. The thing about Dilaudid, is it is very powerful, and has very few if any side fx. The powerful sublime effect is for the true gourmets.

Yes, Dils are known as the creme de la creme. Downside is they are short acting.

Can a dentist prescribe Dilaudid or Fentanyl for severe mouth pain or would it be a waste to ask?

has ayone here considered that dilaudid is easily made from hydrocodone in 95% yeild in one step by refluxing in 48% hydrobromic acid for 15 minutes. I read a lot of complaints about the pharmacuetical beaurocracy, why not circumvent these establishments with pragmatic chemistry?

Dihydrocodeinone(hydrocodone) can be demethylated with 48%aq HBr to yield hydromorphone
J. Org. Chem. 3, 204 (1938)
9g Ethyldihydrocodeinone in 45ml 48% HBr, reflux 14 min, dilute with 100ml water and basify with NaOH. Wash with ether to remove non-phenolic material, add excess ammonium chloride and extract with 4000ml diethyl ether [in at least two dozen portions], evaporate the ether and recrystallize from alcohol to give 8.4g ethyldihydromorphone
48%aq HBr to demethylate the methoxy ether on about a half-dozen alkyl dihydrocodeinone derivatives via a 20-30 min. reflux.
"All yields are over 95%"

I obtained the article it is verbatim what is said here.
In the case of 7-substituted analouges the alpha-beta orientation affects it's lability towards acids as to it's decomp. to phenantherenes, hydrocodone is not 7-substituted so this is irrelevant.
a modification to this procedure would be to use other solvents (methylene chloride is good), and to lower th PH with colid CO2 as opposed to ammonium chloride (this is trivial though.

Informative post.

the same thing can be done with dihydrocodeine (HBr demethylation)
this version uses 10% HBR in acetic acid.
I think this is because you will get SN2 reaction of the 6-hydroxy group. in the case of the hydrocodone no SN2 because it is ketonic, so in the case of dihydrocodeine the acid conc. has to be diminished and the solvent non-aqueous (as the formation of +H3O ions will impedede the HBr from doing it's job.)I can't find the reference on that one though.
dihydromorphine is 2X morphine.

there are 4,000 known synthetic opiods, (not all are controlled either)
a book called "opiod anagelsics" by casy and parfait is excellent reading they provide many references in this book as to synthesis and pharmacology.

Nowadays, no way. Especially Fentanyl, I have never heard of any dentist, oral surgeon or endodontist prescribing that. Hydrocodone of darvocet seen to be standard practice nowadays.

While I applaud your interesting knowledge and reference of chemical processing which is intriguing to me, this is not www.ClandestineDrugMakers.com, it's simply DrugBuyers.com. You may be posting on the wrong forum altogether here buddy. Pretty interesting though.

it does have withdrawals from what I 've heard. but no first-hand experience.

I've found that if taken properly, and I do mean exactly how it's prescribed by a compassionate Doctor, I had very little if any WDs. It's a med usually scripted for short periods of time just so you don't get hooked on it.

However, I've been scripted #150 8mg for before and after a surgery. There was a long wait for surgery and they added in about how much I would need during recovery. They were ample in their judgement as I still have 20 or 30 of them left.

So you see, I did not go off with this med and take it like candy. It's a med you want to really use seldomly. I didn't abuse the med, therefore I personally had 0 WDs. I think in the US 8mg is the highest dosage in pill form, but I'm not sure. Also, if you take this med for more than 5 days straight, then you will go through WDs, the more days after 5 you are on this med the longer the WDs will last. So if you aren't careful and you just take this for long periods on a regular basis 2 or 3 times a day you will definitely go thru WDs.

I personally took as little as humanly possible for the shortest possible amount of time, never to exceed a couple of days. So it's a very short term med in my opinion. I would not want this as my main pain reliever, after a month even on a smaller 4mg dose you will WD hardcore. It won't be pretty and you'll probably wish you were dead.

This is a serious drug IMO that should REALLY be careful with. Take it for a day or two and you'll have no WDs and it should effectively wipe out your pain.

If taken for longer periods I wish you all the best, but don't say we didn't warn you.

My doc scripts a few each month to prevent a trip to ER...about 25 a month. I only take them when I need them. I usually use them each and every month, and get refills every two months.

I truly believe too, that you have to respect his med.

Hmmmm... my doctor will prescibe these over anything else (because of the "purity"). I get the 4mgs.. Personally, they do very little for me. I'd rather have hydro! The WD sounds scary but I think any WD would be!

4mgs does little for me too, but 8mg is perfect for me when this type of pain killer is warranted. Although, they don't work as well for headaches as Demerol. I rather think that is a choice med for bad headaches. So that's as sparing as I get. This med isn't to fool with.

I agree that they are nothing to mess with, I have NO trouble going back to oxycodone and taking the dilaudid's just as prescribed; when I need to avoid a trip to the ER.
I have killer HA's due to brain surgery/neck surgery. They are a last resort.
They are the last line b/t med for me before I head to hospital.

This is one of a couple of meds that they regularly use with PCA (patient controlled analgesia) pumps. I had it after abdominal surgery and lemme tell ya, if you're on a basal infusion of 0.4 mg/hr., with 0.2 mg available every 10 min and 4 mg available every 4-6 hr for breakthru,... you can build up an insane tolerance.

As far as WDs, they are awful. My surgeon had to consult a pain mgt doctor prior to discharge because my total daily dose was the highest she'd ever seen. They converted me over to oxycontins at discharge, but tapered me immediately. Talk about feeling awful. The dysphoria is incredible... Crying spells, feeling like you could never possibly be happy again. It sucks.

As others have said: Use sparingly. As far as IV dilaudid compared with other IV pain relief, I'd say that dilaudid packs the biggest punch, but seems to have the shortest half-life of any of them. After a shot of a fairly high dose, severe pain goes away for about 45 minutes and then you either 1) fall asleep (if you're lucky) or 2) hurt again and have to wait 4-6 hrs for your next dose.

That's what they shot me up with after I busted my shoulder up. I practically fell out of the chair. The nurse had to help me over to the bed.

After I regained my composure I asked the nurse I she had a "to go" pack of the stuff. She laughed, and said, "No."

I was given this right after my accident and did not like the effects of this. I felt like I had no control over Wendy and then became nervous and started havinf panic attacks because I was affraid I was dying. Not a good feeling.

If 4mg instant-release hydromorphone is equivalent to 2 x 10/325 hydrocodone or a 10mg Percocet, it does not sound very strong to me. My OxyContin hardly holds me at all; and I can not get anything stronger prescibed.
It appears to work better when combined with 2mg alprazolam and 700mg carisoprodol.
I would like to try 8mg hydromorphone tablets, but they are not available here, where only 1.3 and 2.6mg dosages are on the market as PALLADONE i/r. I think you can get Palladone SR in an 8mg dose, but that means crushing up and all sorts to get the hydromorph into the system quickly.
CC

Oxycodone is much more potent orally than Dilaudid. Now IV Dilaudid is probably more potent than the oxy but everyone's opinion will differ. -ck

Oral hydromorphone has a very low bioavailability and is definitely fairly weak. However, ignoring the specifics regarding the route of administration, dilaudid feels much cleaner than oxycodone to me, with much less nausea and itchiness while keeping me much more lucid. But, if taken any way other than orally, hydromorphone is without a doubt more effective.

I'm prescribed hydromorphone for infrequent use to deal with kidney stones. The pain is intense and comes on quite rapidly, and pills usually just don't cut it.

I realize there is a negative sigma associated with this, but an MD friend of my father's actually suggested that I crush up the pills and insufflate them. Now, I do not even dare using pain meds recreationally lest they become less effective and I have to suffer even more pain, but in a moment of desperation I actually followed his advice.

Let me tell you, if the pain really is that bad, it's worth it. The pills are far more effective and begin working in about 5 minutes rather than one hour, which is a lifesaver when you're dealing with a kidney stone. I know some people will look on this and think it's only something junkies do, but it's actually made my problem infinitely more bearable.

Basically, for strictly oral usage, oxycodone is the way to go. For any other route, Dilaudid seems to me like the obvious choice.

You certainly can't wait for oral medication when you have renal colic - possibly the worst pain a human can suffer. You need IMMEDIATE relief, and I believe doctors should train patients to either inject themselves, giving them one injection to keep for an emergency, or do something like you mention. I wonder if Stadol, being a nasal spray, would be effective?

I was seriously injured in a high impact collision (caused by a 22 year old, uninsured driver). Blew my right pelvic socket wide open and I ended up "dead" for a few minutes trying to hold down the brake pedal. It's called bumper override. I was in an SUV. She was in a sedan. Bigger doesn't mean safer. Turns out the FTC has standards for all passenter vehicles; but, there are no standards for SUV's or light trucks. Her vehicle went up under mine and she put the impact of her 2700 pound of her vehicle along with the full cargo load I was carrying in my lap. There was a school bus in front of me (not kidding). If there is only one bit of anything left in me, it's that I did not hit that bus. I saw her coming. Was at a stoplight. There was absolutely nothing I could do. The settlement didn't even cover the medical expenses. Never figured I'd be totally disabled at 41 years old. Now that I'm done whining (as I'm quite sure there are so many of you who suffered and have suffered more than me, let me get to the good part...I've had every kind of surgery and procedure imaginable. Been to every kind of specialist possible. I have what's called ankylosing spondylitis and adhesive arachnoiditis (listed under the Social Security Diagnostic Disorders under M.I.N.E (medical improvement not expected). I have intractible pain, which causes my blood pressure to soar. My internal systems suffer as a result. I've been to ER's where they pump me full of morphine and demerol (which make me want to tear at my flesh due to side effects). I also get treated like a drug addict when the very last thing I want is what they give me. In October 07 I withstood the rigors of a psych evaluation and several interviews with a pain psychologist at one of this country's most reknowned medical facilities (university affiliated). I was told I qualified for implantation of a Spinal Cord Stimulator - both physically and psychologically. I was nearly giddy with joy.

I just found out that Medicare won't pay for it. You know why? I've never been on opioid therapy. They would (understandably) prefer to pay $5.00/bottle for a prescription than $20,000.00 for an electronic surgical implant - but there is no doctor that will prescribe on a regular basis. In addition, I don't drive and walk only with the aid of several orthotic devices and braces, so getting to doctor's visits every two weeks (for monitoring) is a challenge in and of itself. If there are any pain veterans out there, who are kind-spirited, I've asked God and now I'm asking you to help me. Most people who suffer from my physical conditions are on some sort of opiods - oxycotten (sp?), mophiene sulfate, etc. Problem is my allergies. I'm on several different meds, but nothing for pain. Now the pain is literally killing me. My blood pressure (due to pain) soars. I've been a member for awhile, but never ordered anything for pain because I kept holding on and holding out for the Spinal Cord Stimulator. I read everything (b/c at times I can't move anything but my eyeballs. Some of your responses are so technical and advanced, I feel stupid. Living on SSI is not what it's made out to be...I was a teacher. I love children.The pain is literally killing me. I want to live to see my grandchildren. I've run out of options. What works for severe, chronic, intractible pain (feels like I've been sheared in half) that works for people prone to allergies and who live on (not by choice) a limited budget? Blessings, Crista

cristas,

Sorry to hear about all that. I'm surprised that with your apparent allergic reactions, the doctors haven't tried various synthetic opioids, which is usually the case when patients are allergic.

Your pain sounds quite unrelenting, and two obvious choices to me would be fentanyl and methadone.

Fentanyl is probably more desirable than methadone and generally has less side effects than other opioids, and although it is quite fast-acting, patches are available which slowly release the drug over up to a period of 3 days.

Methadone, while carrying a bit more risk as far as side-effects go, is also great for chronic pain as it is very long-lasting and is *extremely* cheap. Also, methadone is particularly good (possibly even the best) among the opioids for controlling neuropathic pain, which I believe (although I'm not 100% sure) is the kind of pain that usually results from arachnoiditis.

These drugs are unfortunately not really available online and can be difficult to get from doctors even with the most legitimate of problems. All I can say is if your doctor isn't willing to let you try these, look for one who will. It's really heartbreaking to hear about stories like yours. I'm fortunate here in Canada that my family and I have always had access to the care we required. My prayers go out to you

From what I understood in the movie, "Drugstore Cowboy" dilaudid is pharmaceutical grade heroin. I'd say your state of well-being is slightly better than it would be with two 10/325s, but that's just my opinion.

These chemical names can be confusing, especially when thrown around in movies like Drugstore Cowboy.
Pharmaceutical grade heroin is diamorphine. Dilaudid is hydromorphone. They are not the same.
However, hydromorphone is sometimes referred to as diamorphone which can easily be confused with diamorphine.
One example of the two drugs' pharmacokinetics is the estimate that hydromorphone (IV on a mg to mg basis) is five times more potent than heroin/diamorphine.
Easy to get the names mixed up but important differences do exist.

they do say that dilaudid is like pharmaceutical grade heroin in the movie. although thats not true at all. people seem to say that about any opiate addicts inject. "hillbilly heroin" ring a bell?

but yeah, they found a small bottle of pure hydromophone (I'm guessing, it was powdered, although the bottle did say dilaudid).

I can only hope that people don't acquire their definitive pharmaceutical information from movies like Drugstore Cowboy.
But I'm afraid that many do.

oh definetly, usually the people making the movies do little research to figure out if what they are portraying is real.

the only movie I've seen having to do with opiates that was the closest to real life would be Trainspotting (except I never seen a baby on the ceiling). but requiem and man with the golden arm, drugstore cowboy, basketball diaries, I see a bunch of holes in.

If you look it up, T's and blues were a sought after drug combo in the 70's and 80's when and if heroin was scarce. That part of the movie was (kinda) true. But they did mix up the "blues" part. But more realistic than seeing "Nurse Jackie" snorting some red beads in the bathroom. And possibly more realistic than having a show about a known drug addict running a whole department in a teaching hospital in NJ.

http://www.wikidoc.org/index.php/Oxymorphone

http://www.time.com/time/magazine/article/0,9171,954843,00.html

DeeRock,

Even Trainspotting is fairly unrealistic. I know its for the sake of the movie, but the way Renton goes in and out of addiction seemingly at will isn't too close to the mark.

how does renton go in and out of addiction seemingly?

he never actually quits until the end of the movie.

the first time, he locked himself in a room, and had valium, which makes it somewhat easier and he still burst out the door within' minutes of closing it. then he was doing methadone, and OD'd when he did heroin ontop of it. the only time he wasn't on drugs (and he was still smoking hash) and he seemed fine is when him and sickboy were shooting at the dog in the park with the BB gun, and that was like day 1 with no opiates which really isn't that bad.

so, let me know what part you're talking about where he goes from being in and out of addiction seamlessly.

xxx off topic deleted xxx

I had a Dilaudid pump after major surgery. Thank God it put me out for the first few days. After that, I noticed the pain relief is short lived. It did make me less aware of my surroundings which was merciful. The PILLS though, don't work anything like the IV. I got those in the hospital when they removed me from the pump and they offered comparatively little relief. It is less nauseating than Morphine and seems to be the hospital's preferred pain drug (the one I went to).

Oh I hate morphine. That stuff makes me so sick nausous. Then they have to give me reglan or something comperable to that. For the most part I just tell them I cant take it. That happened to me when I was on MScontin even in a low dose it made me sick......dilaudid shots in the ER for short term works ok never had it in pill form though.

I get hydromorphone 8s for BT pain. At my level of CP, they are fairly mild, yet do work. There are a couple of other ways to use dilaudid pills, but this Board generally does not
prefer these kinds of discussions. Watch Intervention, and you can sometimes see dilaudid being abused. I take as directed by my doc-- the HM pills come in 2, 4 and 8 mgs. in the States. Overseas (some parts of Europe) there is an ER formulation called Jurnista. I believe it might be in trials for approval in USA; not sure. It has a very difficult to defeat time release mechanism called "TimerX."

Since this old thread has been resurrected, and I just saw the old movie Drugstore Cowboy- I believe the "blues" they refer to in the movie was Numorphan, which was IR oxymorphone. That drug is back currently under the name Opana, and comes in 5 and 10 mg. IR, and 10, 20, 30, 40 mgs ER strengths. It's very expensive, w/o very good insurance. Generic dilaudid, on the other hand is less than a dollar a pill. Hope this info helps a little... I did like seeing William Burroughs in the "Cowboy" film- that scene at the end was priceless when he sweeps aside all the lesser prescription bottles on the bed, saying "that stuff is for squares!" Then he picks up the dilaudid bottle and says something like "this stuff is the real deal..." Pretty clever - Burroughs loved dilaudid in real life- Just read his famous book- "Junky."

No, the "blues" were pyribenzamine. "T" was Talwin. Heroin substitute. No, was not a narcotic.

U could be right, O & W...there is so much urban myth that floats around about that old movie. Maybe some thought it was numorphan, because it was a blue pill available in those times...talwin- got that in a hospital once for a pre-surgical procedure.

Great sig quote, btw! Chicago's public art comes to mind- some of the Calder pieces downtown, maybe?

Oh, good guess! Old movie? "Gone With the Wind" was an old movie LOL.

<Mexican accent on>
I don't need no stinkin movie to know this stuff.
/<Mexican accent off>

I have suffered chronic migraine headaches for over 25 years. I am 45 years old now. I was also in a severe rear end collision that did neck and back damage. After years of trying preventive meds and every therapy you can think of down to bio feedback I have finally found a great pain management doctor.

After taking Percocet 10/325s for several years I built a tolerance which is really scary as I didn't want to have to take more than I was due to the tylenol in it. My new doctor has put me on Oxycodone 30mg instant release. I never knew there was such a medication. It is basically 30mg of Percocet with NO tylenol in it!!!

So far, except for extreme attacks this works really well!!! You can take it every four hours and can even cut them in half to get 15mg is 30 is too much or not quite enough.

As I was spending sometimes up to 12 hours in extreme pain and vomiting in the waiting room at the emergency room, because as we all know, migraine sufferers are usually labeled "drug seekers" at the ER, so we seem to wait longer than others!!! They usually give me 2mg dilaudid and 4.4mg Zofran IV for the pain. It is very effective and relief starts almost immediately. You can also get the same dosage intra muscular. The main difference being this.....IV treatment relief is almost immediate but doesn't last as long. IM treatment takes appx. 30 - 45 min to get relief but lasts much longer.

To avoid such long waits I actually have a prescription for 2 shots of dilaudid that I can inject myself every month. I inject in the thigh as trust me, the hip is really hard to reach.

I am so grateful that I have finally found a pain management doctor that treats me with respect. He is very diligent as well. If I obtain controlled substances from ANY other he will IMMEDIATELY release me and stop treating me.

As far as dilaudid pills....someone posted earlier that dilaudid was only available in IV. Not true, it is available in 2, 4 and 8 mg tablets as well as suppositories. I don't find the pills to be very effective but the suppositories can help if the pain isn't out of control.

Again, I only use dilaudid for the worst pain!!! I control the milder with the Oxycodone. My doctor has told me that if I find I have to increase he will put me on a low dose Oxycontin and use the oxycodone for break through pain.

He has also explained to me the difference in dependency and addiction. I am definitely dependent on my medication as I have chronic daily pain and have to take it daily. Addiction is when you take more and more than your prescribed dose for the "high" that you get from it.

As far as withdrawal, I was treated some years ago with Hydrocodone (Lortab, Vicodin) and can tell you that coming off hydrocodone was much worse than coming off of oxycodone. Coming off hydrocodone gave me severe diarrhea, muscle cramps and just a feeling of crawling out of my skin. Oxycodone on the other hand gave me a little stomach problems and a sense of drab just no energy.

I am hoping that menopause will bring some relief as my severe migraines seem to be hormonal. Who would have ever thought that a woman would pray for menopause!!!

Hope this info has been at least a little bit helpful.

i feel you on the migraines, i get the absolute worse, they seem to last about24 to 48 hours start to finish but most opiates intensify , a little opiate and a good benzo tend to help mine, sometimes i can go to sleep and wake with it eased. i hate vomiting and that is instant as soon as my headache comes on, dark room, very still, no noise or motion... hate them!

my daughter gets horrible migraines.......I can tell when she has one even tho its hard for her to express her pain but she turns white as a ghost, she cant have any light....any noise...and the 1st sign of it is her running to the bathroom and profuse vomiting. I feel so bad cuz with her disabilities its hard for her to explain it but she used to get the hydro's and then her neurologist retired and a DO dr took over and cut her off.

Cold turkey! I was mad....so now I just give her some of my pain stuff when it gets that bad...its usually worse in the summer time cuz she cant handle staying in the heat for x amount of time. Ive only had a few of them in my lifetime so I know how bad she feels. It really pissed me off when they cut her cold turkey after 11yrs! I know its cuz the DEA cracking down.

But I have been told that there are certan opiates that causes the rebound thing.

Mosts pain meds cause a rebound because they wear off in 4-6 hours. Methadone is one drug I can think of that doesn't because it lasts longer than 12 hours.

Did you mean hydrocodone instead of hydromorphone?

Ohhhhh yes hydro's LOL sorry I didnt read the thread clearly so I guess its my turn to be off topic! I get methadone 10mgs x3 daily and you right they dont cause rebound issues.....OH boy I feel stupid now LOL

Ive never tried dilaudid except for post surgical procedures......

Thanks for pointing out my screw-up! It was late when I posted that so maybe I was delerious! LOL J/K anyway thanks again and sorry for posting on the wrong thread

DO should have tapered her instead of cold turkey! migraines tricky to treat especially if frequent. a medication called toradol can be helpful.

I had that when i was injured very badly i doubt u will find it on any legitimate site.

This is not a thread about trying to find it, but a thread to discuss the medication itself.