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hydromorphone vs meperidine

Side-by-side comparison of hydromorphone and meperidine Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

Drug Class
hydromorphone Opioid Analgesic
meperidine Opioid Analgesic
Type
hydromorphone Prescription
meperidine Prescription
Summary
hydromorphone

Hydromorphone (Dilaudid) is a strong pain medicine. It is used to treat severe pain when other pain medicines do not work well enough.

meperidine

Meperidine is a strong pain medicine. It is used to treat severe, acute pain when other pain medicines are not strong enough.

What It Treats
hydromorphone

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.

meperidine

Meperidine is used to manage acute pain that is severe enough to need an opioid pain medicine. It is for use when other treatments do not work well enough. Meperidine should not be used for chronic, long-lasting pain. Taking meperidine for a long time may increase the risk of seizures.

How It Works
hydromorphone

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.

meperidine

Meperidine is an opioid agonist. It works by binding to receptors in the brain and spinal cord. This reduces the feeling of pain.

Common Side Effects
hydromorphone
  • Lightheadedness
  • Dizziness
  • Sleepiness
  • Nausea
  • Vomiting
meperidine
  • Lightheadedness
  • Dizziness
  • Sleepiness
  • Nausea
  • Vomiting
FAERS Reports
hydromorphone
  • Addiction to the drug 35,077
  • Taking too much of the drug 22,994
  • Pain 22,132
  • Emotional upset 17,685
  • Death 14,869
meperidine
  • Allergic reaction to the drug 3,248
  • Drug not working 1,271
  • Pain 1,250
  • Feeling sick to your stomach 1,133
  • Using the drug for a condition it is not approved for 861
Serious Warnings
hydromorphone

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.

meperidine

Meperidine has a boxed warning. This means it has serious risks. These risks include: Medication errors that can cause overdose, addiction, abuse, and misuse, life-threatening respiratory depression, accidental ingestion (especially by children) can cause a fatal overdose, dangerous effects when taken with benzodiazepines or other CNS depressants, and neonatal opioid withdrawal syndrome. Make sure you read the Medication Guide.

Pregnancy
hydromorphone

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.

meperidine

Taking meperidine for a long time during pregnancy can cause withdrawal symptoms in the newborn. Meperidine is not recommended during or right before labor because it can cause breathing problems in the baby.

Also Compare — Nearby Drugs

How to Read This hydromorphone vs meperidine Comparison

hydromorphone is classified in the Opioid Analgesic drug class, while meperidine 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, hydromorphone has 112,757 submissions while meperidine has 7,763. 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 hydromorphone and meperidine — 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.