How Long Dilaudid (Hydromorphone) Stays in Your System

Dilaudid is detected in blood and urine tests for days after use

Dilaudid (hydromorphone) is a prescription pain medication that begins to act within minutes, has a diminished effect within a few hours, and stays in your system for several days. It is prescribed for pain relief, especially after surgery.

Dilaudid is an opiate analgesic, and it works by changing the way the brain and nervous system respond to pain. It can cause dangerous physical consequences if you overdose, as well as withdrawal symptoms and addiction. Dilaudid is a Schedule II controlled substance with a potency two to eight times higher than morphine.

Dilaudid's Effects on Your System

The way in which Dilaudid affects your system depends on the route of administration. It can be taken as a pill, a liquid, injected intravenously (IV), intramuscularly (IM) or inserted rectally. The onset of the effects depends on the method it was administered.

Oral Administration

When Dilaudid is taken orally in pill or liquid form, it begins to work quickly, often in about 15 minutes, and usually reaches its peak effect in 30 minutes to an hour. The elimination half-life of oral Dilaudid is about four hours. This means that about half of the drug is eliminated from the body in four hours, although some of the drug is expected to remain in your body for two to three days.

Intravenous (IV) Injection

IV injections of Dilaudid begin to take effect in about five minutes, and the half-life is about two hours, but it can remain in the body for about two to three days.

Intramuscular (IM) Injection

IM injections of Dilaudid begin to work in about 15 minutes, with about a three-hour half-life, and it can remain in the body for several days.

Rectal Administration

Administration of Dilaudid rectally, which may be used in cases of severe nausea or when you can't have an injection, should take effect in about 30 minutes, with a half-life of about four to five hours, and the drug is evident in the body for several days.

Dilaudid can make you drowsy, so until you know how it affects you, it is safer to not drive or operate heavy machinery for two days after taking it.

Dilaudid can cause serious or life-threatening breathing problems, especially during the first two days of taking it. You should be carefully monitored when you start taking this medication.

Interactions with Medications and Alcohol

Several medications can change the way Dilaudid affects your body by increasing, decreasing, or prolonging the effects. It is very important to discuss all other prescriptions, over-the-counter medications, vitamins, and herbs with your doctor or pharmacist so they can advise you and adjust your prescriptions properly for safety.

You must not drink alcohol while using Dilaudid. Specific medications that interact with Dilaudid include MAO inhibitors, blood pressure medicine, diuretics (water pills), antidepressants, phenothiazine, and anything that makes you sleepy. It can also have interactions with St. John's wort and tryptophan.


An overdose of Dilaudid can cause serious injury and may be fatal. If you take too much Dilaudid or take it with other medications, you may suffer from an overdose.

Some of the symptoms of a Dilaudid overdose include:

  • Difficulty breathing
  • Slowed or stopped breathing
  • Excessive sleepiness
  • Dizziness
  • Fainting
  • Limp or weak muscles
  • Narrowing or widening of the pupils
  • Cold, clammy skin
  • Slow or stopped heartbeat
  • Blue coloration of skin, fingernails, lips
  • Loss of consciousness or coma

If someone is having symptoms of a Dilaudid overdose, you should call 9-1-1 immediately. If contacted quickly enough, first-responders may use medications such as Narcan to revive the victim.

Medication Errors That Cause Dilaudid Overdose

One of the errors that can lead to an overdose is crushing the capsule, which causes too much medication to be released all at once. If you miss your Dilaudid dose, do not try to make up for the missed dose. It can be dangerous to take two doses of Dilaudid too close together.


It is critical to continue to take Dilaudid on the schedule provided by your doctor. If you suddenly stop taking it after you have been taking it for several days, you are likely to go through withdrawal, which can be dangerous. Only reduce your Dilaudid when advised to do so by your doctor and follow the schedule provided.

Symptoms of Dilaudid withdrawal include:

  • Severe cravings for Dilaudid
  • Sweating
  • Fever or chills
  • Headaches
  • General aches and pains
  • Nausea
  • Vomiting
  • Diarrhea
  • Rapid breathing
  • Rapid heartbeat
  • High blood pressure
  • Tremors and muscle spasms
  • Anxiety, depression, or suicidal thoughts
  • Restlessness, agitation, or trouble sleeping
  • Decreased appetite

Individuals are more likely to relapse and make poor decisions when withdrawal symptoms are at their peak. Physical symptoms can lead to many cognitive issues as well, such as attention deficit problems, issues with problem-solving and memory function.

Drug Screening Tests

Dilaudid is detected in urine drug screens. If you have been prescribed Dilaudid and need to take a urine drug test for employment or other purposes, tell the testing lab that you have been prescribed the drug and taking Dilaudid so that they are able to interpret the test appropriately. The drug is detected in the blood for about 24 hours, in the urine for two to three days, in the saliva for two to three days, and in the hair for about six months.

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