Two medicines, side by side
Hydrocodone vs hydromorphone
Hydrocodone and hydromorphone are both labeled for pain. Drugs@FDA records approvals of hydrocodone since 2013 and of hydromorphone since 1984. Pharmacies paid $7.95 per hydrocodone ER 15 mg capsule and $0.219 per hydromorphone 4 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Hydrocodone's other strengths are brand-only: $13.31 per Hysingla ER 20 mg tablet. How each works, in its label's words: Hydrocodone, “Hydrocodone is a full opioid agonist with relative selectivity for the mu-opioid receptor, although it can interact with other opioid receptors at higher doses.”; Hydromorphone, “Hydromorphone is a full opioid agonist and is relatively selective for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses.”
Check it at the source: the hydrocodone FDA label on DailyMed (effective May 29, 2026); the hydromorphone FDA label on DailyMed (effective May 14, 2026).
Highlights of the hydrocodone record
Hydrocodone (Hysingla) · label of May 29, 2026
SERIOUS AND LIFE-THREATENING RISKS FROM USE OF HYSINGLA ER Addiction, Abuse, and Misuse Because the use of HYSINGLA ER exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death, assess each patient's risk prior to prescribing and reassess all patients regularly for the development of these behaviors and conditions [see Warnings and Precautions (5.1) ].
Used for
From the label: indicationsHYSINGLA ER is indicated for the management of severe and persistent pain that requires an opioid analgesic and that cannot be adequately treated with alternative options, including immediate-release opioids. […]
On the market
- Earliest approval on file
- October 25, 2013
- Generic labelers
- 1 labeler
- Pharmacy cost
- $7.95 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Highlights of the hydromorphone record
Hydromorphone (Dilaudid) · label of May 14, 2026
SERIOUS AND LIFE-THREATENING RISKS FROM USE OF HYDROMORPHONE HYDROCHLORIDE WARNING: SERIOUS AND LIFE-THREATENING RISKS FROM USE OF HYDROMORPHONE HYDROCHLORIDE See full prescribing information for complete boxed warning. Ensure accuracy when prescribing, dispensing, and administering hydromorphone hydrochloride oral solution. Dosing errors due to confusion between mg and mL can result in accidental overdose and death.
Used for
From the label: indicationsHydromorphone hydrochloride oral solution and hydromorphone hydrochloride tablets are indicated for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. […]
On the market
- Earliest approval on file
- January 11, 1984
- Generic labelers
- 13 labelers
- Pharmacy cost
- $0.219 per tablet
Supply and safety
- Shortage
- In shortage
- Recalls
- 30
Source: FDA drug labels via openFDA (Hydrocodone label of May 29, 2026, Hydromorphone label of May 14, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do hydrocodone and hydromorphone differ on the record?
How each works, in its label's words: Hydrocodone, “Hydrocodone is a full opioid agonist with relative selectivity for the mu-opioid receptor, although it can interact with other opioid receptors at higher doses.”; Hydromorphone, “Hydromorphone is a full opioid agonist and is relatively selective for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses.”
Both are in FDA's class opioid agonists.
Half-life, in each label's words: Hydrocodone, “The mean terminal half-life (t 1/2 ) was similar for all HYSINGLA ER dose strengths ranging from 7 to 9 hours.”; Hydromorphone, “The terminal elimination half-life of hydromorphone after an intravenous dose is about 2.3 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: hydrocodone since 2020; hydromorphone since 1995 (Drugs@FDA).
| Hydrocodone | Hydromorphone | |
|---|---|---|
| Labeled for | Pain | Pain |
| Pharmacologic class | Opioid Agonist | Opioid Agonist |
| How it works (label) | Hydrocodone is a full opioid agonist with relative selectivity for the mu-opioid receptor, although it can interact with other opioid receptors at higher doses. The principal therapeutic action of hydrocodone is analgesia. | Hydromorphone is a full opioid agonist and is relatively selective for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses. The principal therapeutic action of hydromorphone is analgesia. |
| Half-life (label) | The mean terminal half-life (t 1/2 ) was similar for all HYSINGLA ER dose strengths ranging from 7 to 9 hours. | The terminal elimination half-life of hydromorphone after an intravenous dose is about 2.3 hours. |
| Earliest approval on file (Drugs@FDA) | October 25, 2013 | January 11, 1984 |
| First generic approved | January 21, 2020 | August 23, 1995 |
| Generic labelers (NDC) | 1 labeler | 13 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $7.95 per capsule (Hydrocodone ER 15 mg capsule) | $0.219 per tablet (Hydromorphone 4 mg tablet) |
| 12-month price change | +34% | +11% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | In shortage |
| Recalls recorded | 0 | 30 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 43,191 | 91,453 |
| DEA schedule | CII | CII |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Hydrocodone label, warnings and precautionsUse with Benzodiazepines or Other CNS Depressants Profound sedation, respiratory depression, coma, and death may result from the concomitant use of HYSINGLA ER with benzodiazepines and/or other CNS depressants, including alcohol (e.g., non-benzodiazepine sedatives/hypnotics, anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics, gabapentinoids [gabapentin or pregabalin], and other …
Hydromorphone label, warnings and precautionsRisks from Concomitant Use with Benzodiazepines or Other CNS Depressants Profound sedation, respiratory depression, coma, and death may result from the concomitant use of hydromorphone hydrochloride oral solution and hydromorphone hydrochloride tablets with benzodiazepines and/or other CNS depressants, including alcohol (e.g., non-benzodiazepine sedatives/hypnotics, anxiolytics, tranquilizers, muscle relaxants …
Source: FDA drug labels via openFDA
What next?
- Alternatives to hydrocodone
- every medicine labeled for the same conditions