Hydromorphone: pharmacology and clinical applications in cancer patients

Hydromorphone is a more potent opioid analgesic than morphine and is used f or moderate to severe pain. It can be administered by injection, by infusio n, by mouth, and rectally. Oral bioavailability is low. The kidney excretes hydromorphone and its metabolites. Some metabolites may have greater analg esic activity than hydromorphone itself but are unlikely to Contribute to t he pharmacological activity of hydromorphone. With the exception of pruritu s, sedation and nausea and vomiting, which may occur less after hydromorpho ne than after morphine,the side-effects of these drugs are similar. On a mi lligram basis hydromorphone is five times as potent as morphine when given by the oral route, and 8.5 times as potent as morphine when given intraveno usly.