What is the difference between hydromorphone and hydrocodone

Is cannabis an answer to entering the land of sleep? If medications aren't easing your pain you may be looking to alternative remedies for relief. Essential oils are a natural way to relieve pain. Treating pain with hot and cold can be extremely effective for a number of different conditions and injuries. The tricky part is knowing which…. Everything from stress to the flu to certain chronic illnesses can cause body aches.

Here's a look at what may be causing your symptoms. Health Conditions Discover Plan Connect. Hydromorphone vs. Morphine: How Are They Different? Drug features. Hydromorphone Morphine What are brand names for this drug?

Cost, availability, and insurance. Side effects. Both drugs Hydromorphone Morphine dizziness depression Same common side effects as for both drugs drowsiness elevated mood nausea itchiness vomiting flushing reddening and warming of your skin lightheadedness dry mouth sweating constipation.

Drug interactions. Use with other medical conditions. Methadone can be swallowed or injected. After all, it has a similar chemical structure to that of morphine and heroin. In addition, it can make users feel euphoric and sedated. Since methadone is used to treat opioid use disorders, some may believe that the drug is safe. Unfortunately, this is not the case. When methadone is abused, users are at risk of overdose and other adverse health reactions. Methadone should only be used under careful professional supervision.

Next on the list of the strongest opioids is Oxycodone. Oxycodone is sold under the brand names Percocet, Roxicodone, and Oxycontin. It is one of the most common opioids that is prescribed to treat moderate to severe pain. Despite the fact that it is prescribed often, it still has a high potential for abuse due to its calming and sedating side effects. Morphine is derived naturally from the poppy plant.

Even though it is not synthetic, it is still potent. The potency of morphine is similar to the potency of Oxycodone. It is usually prescribed in the place of other opioids if they are ineffective at treating pain. Morphine can be swallowed or injected, although injection is preferred among people who abuse it due to the near-instantaneous effects it can produce. Hydrocodone is similar in potency to morphine and oxycodone. It is, by far, the most commonly prescribed opioid medication in the United States.

The degree of pain relief is the same. Both morphine and hydromorphone are used to treat moderate to severe pain. Morphine is often the first medication used.

For some patients, however, hydromorphone may be a better first choice. People who are older may have less trouble with side effects such as sleepiness or confusion with hydromorphone. People whose kidneys are not fully functioning may also do better with hydromorphone, because it is removed from the body by the liver not the kidneys.

A physician takes these factors into account when deciding which medication to use. Usually when people have become adjusted to a short-acting medication, they are switched to the slow-release form. Both forms typically take effect within half an hour. However, Otton and colleagues 5 failed to find a significant difference between hydrocodone concentrations in UMs versus PMs, although a significant difference between the hydromorphone concentration was observed 13 , Few studies have used urine data to compare and differentiate between PMs and UMs 16 , However, the results of the current study show that it is possible to use urine data to differentiate between PMs and UMs.

Each point on the graph is the percentage of subjects in this category. The frequency count of these two populations was done using the same computational control of the bin size, i.

Therefore, the percentage of subjects below the lower limit of quantitation is divided by the total population at that specific concentration of hydromorphone. The tail of the sigmoid plot is not the extension of the data where hydrocodone was detectable. This study shows that urine drug specimens taken from the same patient at different times have considerable variability. Although inter-subject variability has been primarily attributed to the inter-subject pharmacogenetic differences of the enzyme CYPD6, these data indicate that other variables such as dose amount, the time of the last dose, drug-drug interactions, circadian time, and fed or fasted state contribute to the observed variability between subjects.

The level of variation in the inter-subject population was two times greater than the intra-subject population.

One explanation of the observed variation between patients is interferences of hydrocodone metabolism by co-medications. These data provide an estimate of the MR expected when hydrocodone is administered. If the MR values fall outside of this range, it is important to discuss with the patient which external factors are responsible. The major limitations of this study are that it is retrospective and no data were collected with regard to dose, collection time after last dose, age, gender or ethnicity In addition to the variability in dosing regimens, hydrocodone doses range from 2.

Furthermore, hydrocodone is given in combination with acetaminophen APAP. The dose limit is based on APAP doses and not hydrocodone. Because this medication is prescribed to be taken as needed, further variability may be observed in urine concentrations of both hydrocodone and hydromorphone due to intermittent dosing.

Given the range of possible doses and schedules, CYP2D6 variability 5 to 10 fold between subjects 10 , and variability between subjects in disease state, kidney function, liver function and age, the observation of high This study was also limited by the lack of information on which subjects were UMs or PMs and the potential of non-reported hydromorphone use.

For practitioners responsible for interpreting urine drug tests, it is helpful to know whether or not hydromorphone detection is expected and, when applicable, its relationship to the observed hydrocodone concentration. This work suggests that the MR of hydromorphone to hydrocodone is a useful marker because it can be compared to the reference ranges identified in this study and unusual findings can be further investigated by the physician.

Because this is a large dataset, we have enough power to identify clinically relevant metabolic ranges. The study shows that there is a wide range of observed values as expressed by the MR. This is consistent with the known polymorphic variance of CYP2D6 expression and function.

Google Scholar. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Barakat , Neveen H. Oxford Academic. Rabia S. Brookie M. Amadeo J. Email: apesce millenniumresearchinstitute.

Cite Cite Neveen H. Select Format Select format. Permissions Icon Permissions. Abstract Hydrocodone in combination with acetaminophen is commonly used to control moderate pain and is metabolized by cytochrome PD6 to form the active metabolite, hydromorphone. Figure 1. Open in new tab Download slide. Figure 2. Figure 3. Inter-subject statistics. Log MR. Geometric mean 1.