hydromorphone vs meperidine
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
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.
Dilaudid
Demerol
Hydromorphone (Dilaudid) is a strong pain medicine. It is used to treat severe pain when other pain medicines do not work well enough.
Meperidine is a strong pain medicine. It is used to treat severe, acute pain when other pain medicines are not strong enough.
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 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.
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 is an opioid agonist. It works by binding to receptors in the brain and spinal cord. This reduces the feeling of pain.
- • Lightheadedness
- • Dizziness
- • Sleepiness
- • Nausea
- • Vomiting
- • Lightheadedness
- • Dizziness
- • Sleepiness
- • Nausea
- • Vomiting
- Drug Dependence 35,077
- Overdose 22,994
- Pain 22,130
- Emotional Distress 17,685
- Death 14,868
- Drug Hypersensitivity 3,249
- Pain 1,248
- Nausea 1,132
- Hyperhidrosis 821
- Rash 775
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 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.
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.
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.
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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 112,754 submissions while meperidine has 7,225. 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 represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for hydromorphone or meperidine.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.