Hydromorphone

Hydromorphone
ATC Code N02AA03
Formula C17H19NO3
Molar Mass (g·mol−1) 285,34
Physical State solid
Melting Point (°C) 266–267
PKS Value 8,2
CAS Number 466-99-9
PUB Number 5284570
Drugbank ID DB00327
Solubility poorly soluble in water / highly soluble in ethanol

Basics

Hydromorphone, also known as dihydromorphinone, is an opioid used to treat moderate to severe pain. Typically, long-term use is recommended only for pain due to cancer. It can be taken by mouth or by injection into a vein, muscle, or under the skin. The effect generally starts within half an hour and lasts up to five hours.

Pharmacology

Pharmacodynamics

Hydromorphone is a semisynthetic μ-opioid agonist. As a hydrogenated ketone of morphine, it shares pharmacological properties typical of opioid analgesics. Hydromorphone and related opioids exert their main effects in the central nervous system and gastrointestinal tract. Binding to μ-opioid receptors in the brain results in hydromorphone's potent analgesic effects.

Pharmacokinetics

Chemical modification of the morphine molecule to hydromorphone results in higher lipid solubility and easier crossing of the blood-brain barrier. This allows the drug to reach the receptors in the brain more quickly, resulting in a faster onset of action. The potency of hydromorphone is approximately 5 times that of morphine.

The typical half-life of intravenous hydromorphone is 2.3 hours. Maximum plasma levels usually occur between 30 and 60 minutes after oral administration. The onset of action of intravenous hydromorphone is less than 5 minutes and within 30 minutes of oral administration (immediate release).

Toxicity

Side effects

Common side effects are dizziness, drowsiness, nausea, itching, and constipation. Severe side effects may include low blood pressure, seizures, respiratory depression, and serotonin syndrome. Rapidly lowering the dose can lead to opioid withdrawal. In general, use during pregnancy or lactation is not recommended.

As with all opioids, there is a risk of abuse and dependence.

Toxicological Data

LD50 (mouse, i.v.): 104 mg-kg-1

Sources

  • Drugbank
  • PubChem
  • Aktories, Förstermann, Hofmann, Starke: Allgemeine und spezielle Pharmakologie und Toxikologie, Elsvier, 2017
Markus Falkenstätter

Markus Falkenstätter
Author

Markus Falkenstätter ist Autor zu pharmazeutischen Themen in der Medizin-Redaktion von Medikamio. Er befindet sich im letzten Semester seines Pharmaziestudiums an der Universität Wien und liebt das wissenschaftliche Arbeiten im Bereich der Naturwissenschaften.

Mag. pharm Stefanie Lehenauer

Mag. pharm Stefanie Lehenauer
Lector

Stefanie Lehenauer ist seit 2020 freie Autorin bei Medikamio und studierte Pharmazie an der Universität Wien. Sie arbeitet als Apothekerin in Wien und ihre Leidenschaft sind pflanzliche Arzneimittel und deren Wirkung.

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