Two medicines, side by side
Hydromorphone vs morphine
Hydromorphone and morphine are both labeled for pain. Drugs@FDA records approvals of hydromorphone since 1984 and of morphine since 1984. Pharmacies paid $0.219 per hydromorphone 4 mg tablet and $0.226 per morphine sulfate ir 15 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. How each works, in its label's words: 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.”; Morphine, “Morphine is a full opioid agonist 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 hydromorphone FDA label on DailyMed (effective May 14, 2026); the morphine FDA label on DailyMed (effective July 13, 2026).
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
Highlights of the morphine record
Morphine (Duramorph) · label of July 13, 2026
ADDICTION, ABUSE, AND MISUSE; RISK EVALUATION AND MITIGATION STRATEGY (REMS); LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION; NEONATAL OPIOID WITHDRAWAL SYNDROME; and RISKS FROM CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS Addiction, Abuse, and Misuse Morphine sulfate exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death.
Used for
From the label: indicationsMorphine sulfate extended-release tablets are indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. […]
On the market
- Earliest approval on file
- September 18, 1984
- Generic labelers
- 22 labelers
- Pharmacy cost
- $0.226 per tablet
Supply and safety
- Shortage
- In shortage
- Recalls
- 66
Source: FDA drug labels via openFDA (Hydromorphone label of May 14, 2026, Morphine label of July 13, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do hydromorphone and morphine differ on the record?
How each works, in its label's words: 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.”; Morphine, “Morphine is a full opioid agonist 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: Hydromorphone, “The terminal elimination half-life of hydromorphone after an intravenous dose is about 2.3 hours.”; Morphine, “Excretion The elimination of morphine occurs primarily as renal excretion of M3G and its effective half-life after …”
Both labels carry a boxed warning; the records quote them.
Generics: hydromorphone since 1995; morphine since 1986 (Drugs@FDA).
| Hydromorphone | Morphine | |
|---|---|---|
| Labeled for | Pain | Pain |
| Pharmacologic class | Opioid Agonist | Opioid Agonist |
| How it works (label) | 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. | Morphine is a full opioid agonist is relatively selective for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses. The principal therapeutic action of morphine is analgesia. |
| Half-life (label) | The terminal elimination half-life of hydromorphone after an intravenous dose is about 2.3 hours. | Excretion The elimination of morphine occurs primarily as renal excretion of M3G and its effective half-life after intravenous administration is normally 2 to 4 hours. |
| Earliest approval on file (Drugs@FDA) | January 11, 1984 | September 18, 1984 |
| First generic approved | August 23, 1995 | October 7, 1986 |
| Generic labelers (NDC) | 13 labelers | 22 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.219 per tablet (Hydromorphone 4 mg tablet) | $0.226 per tablet (Morphine sulfate ir 15 mg tablet) |
| 12-month price change | +11% | -12% |
| Boxed warning | Yes | Yes |
| Shortage now | In shortage | In shortage |
| Recalls recorded | 30 | 66 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 91,453 | 120,591 |
| 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)
Do their labels mention each other?
Hydromorphone label, warnings and precautionsPatients considered opioid tolerant are those who are taking at least 60 mg oral morphine/day, 25 mcg transdermal fentanyl/hour, 30 mg oral oxycodone/day, 8 mg oral hydromorphone/day, 25 mg oral oxymorphone/day, or an equianalgesic dose of another opioid for one week or longer.
Source: FDA drug labels via openFDA
What do the labels say about using others of their kind?
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 hydromorphone
- every medicine labeled for the same conditions