codeine vs hydromorphone
Side-by-side comparison of codeine and hydromorphone Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Codeine Sulfate
Dilaudid
This medicine contains acetaminophen and codeine. It is used to treat mild to moderate pain when other pain medicines are not strong enough.
Hydromorphone (Dilaudid) is a strong pain medicine. It is used to treat severe pain when other pain medicines do not work well enough.
This medicine is used to manage mild to moderate pain. It is for when an opioid medicine is appropriate. You should only use it if other pain treatments are not working well enough for you.
This medicine treats severe pain that requires an opioid pain medicine. It is for use when other treatments are not adequate. Do not use it for long periods unless your pain stays severe and other options are still not adequate. This medicine carries risks of addiction, abuse, and misuse.
Codeine works in the brain to change how your body feels and responds to pain. Acetaminophen also helps to relieve pain. Together, they provide pain relief.
Hydromorphone works by binding to receptors in the brain and spinal cord. This blocks pain signals from reaching the brain. This results in a decreased feeling of pain.
- • Feeling drowsy
- • Lightheadedness
- • Dizziness
- • Feeling sleepy
- • Shortness of breath
- • Lightheadedness
- • Dizziness
- • Sleepiness
- • Nausea
- • Vomiting
- Allergic reaction to the medicine 806
- Feeling sick to your stomach 487
- Feeling unwell 374
- Medicine not working 370
- Throwing up 364
- Addiction to the drug 35,077
- Taking too much of the drug 22,994
- Pain 22,132
- Emotional upset 17,685
- Death 14,869
This medicine can be habit-forming, leading to addiction, abuse, and misuse, which can result in overdose and death. Serious, life-threatening breathing problems can occur, especially when starting the medicine or after a dose increase. Accidental ingestion, especially by children, can cause a fatal overdose. Do not give this medicine to children under 12 years old, or to children under 18 after tonsil or adenoid removal, due to the risk of life-threatening breathing problems. This medicine can also harm your liver. Taking this medicine with certain other medicines like benzodiazepines or other CNS depressants can cause serious side effects, including death.
This medicine has a boxed warning. It can cause serious and life-threatening risks. Taking too much can cause overdose and death. It can cause addiction, abuse, and misuse. It can also cause very slow or stopped breathing. Accidental intake, especially by a child, can cause a fatal overdose. Taking with alcohol or other depressants can cause coma and death. If you are pregnant, long-term use can cause withdrawal symptoms in the newborn.
This medicine can cause withdrawal symptoms in newborns if taken during pregnancy. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if this medicine passes into breast milk.
Using this medicine for a long time during pregnancy can cause withdrawal symptoms in the baby after birth. Talk to your doctor if you are pregnant or plan to become pregnant. This medicine may not be recommended during labor.
Also Compare — Nearby Drugs
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How to Read This codeine vs hydromorphone Comparison
codeine is classified in the Opioid Analgesic drug class, while hydromorphone sits within the Opioid Analgesic class. Because both drugs share the same classification, they are often considered interchangeable in theory — but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, codeine has 2,401 submissions while hydromorphone has 112,757. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between codeine and hydromorphone — always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.