Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Hydromorphone
Drug ID BADD_D01096
Description Hydromorphone is a pure opioid,[A176468] a semi-synthetic hydrogenated ketone derivative of [morphine] that has been available clinically since 1920. Structurally, hydromorphone derived from [morphine] in the modification of the hydroxyl group in the carbon 6 to a carbonyl and the absence of a double bond between the carbon 7 and 8. Due to these modifications, it presents a very high potency and comparable side effect profile to the parent compound.[A176471] Even though hydromorphone does not present a 6-hydroxyl group, it is categorized under the family of phenanthrenes and it is considered a chemical under the schedule II (medical purposes with high addiction potential).[A176495] The first reported approved product containing hydromorphone in the form of hydromorphone hydrochloride was developed by Fresenius Kabi USA and FDA approved in 1984.[L5795]
Indications and Usage Hydromorphone is indicated for the management of moderate to severe acute pain and severe chronic pain. Due to its addictive potential and overdose risk, hydromorphone is only prescribed when other first-line treatments have failed.[A176468] The WHO has proposed a three-step ladder for the management of pain in which it is suggested to start with a non-opioid medication followed by addition of weak opioids to the non-opioid treatment for moderate pain and finishing in the use of strong opioids such as hydromorphone along with the existing regimen for cases of severe pain.[A176471] Off-label, hydromorphone can be administered for the suppression of refractory cough.[A176468]
Marketing Status approved; illicit
ATC Code N02AA03
DrugBank ID DB00327
KEGG ID D08047
MeSH ID D004091
PubChem ID 5284570
TTD Drug ID D04JHN
NDC Product Code Not Available
UNII Q812464R06
Synonyms Hydromorphone | Dihydromorphinone | Hydromorphon | Palladone | Laudacon | Dilaudid | Hydromorphone Hydrochloride
Chemical Information
Molecular Formula C17H19NO3
CAS Registry Number 466-99-9
SMILES CN1CCC23C4C1CC5=C2C(=C(C=C5)O)OC3C(=O)CC4
Chemical Structure
ADRs Induced by Drug
*The priority for ADR severity classification is based on FAERS assessment, followed by the most severe level in CTCAE rating. If neither is available, it will be displayed as 'Not available'.
**The 'Not Available' level is hidden by default and can be restored by clicking on the legend twice..
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Poor quality sleep19.02.05.005; 17.15.04.002--Not Available
Hypophagia19.09.01.004; 14.03.01.006; 07.01.06.010--Not Available
Implant site pain12.07.02.008; 08.02.02.0080.000370%Not Available
Gastrointestinal inflammation07.08.03.007--Not Available
Skin haemorrhage24.07.01.103; 23.06.07.001--Not Available
Tumour invasion16.16.01.008--Not Available
Breakthrough pain16.32.03.016; 08.01.08.026--Not Available
Urethral stenosis20.07.03.003--Not Available
Cardiovascular insufficiency02.11.01.011; 24.06.03.005--Not Available
Hyperpathia17.02.07.015--Not Available
Substance abuse19.07.06.0180.000740%Not Available
Brain injury19.07.03.007; 17.11.01.0030.000185%Not Available
Granulomatosis with polyangiitis22.01.01.015; 20.05.01.013; 10.02.02.018; 24.12.04.0110.000185%Not Available
Multiple organ dysfunction syndrome08.01.03.057--
Abdominal mass07.01.01.0030.000185%Not Available
Apnoeic attack22.02.01.027; 17.02.05.0510.000185%Not Available
Flashback19.10.05.005--Not Available
Malignant pleural effusion22.05.04.001; 16.32.03.014--Not Available
Post-traumatic stress disorder19.06.06.002--Not Available
Self esteem decreased19.05.02.0040.003608%Not Available
Self esteem inflated19.05.02.0030.000370%Not Available
Foaming at mouth17.02.05.056; 08.01.03.070; 07.05.05.019--Not Available
Oncologic complication16.32.03.0250.000185%Not Available
Respiratory fatigue22.02.01.042--Not Available
Spinal pain15.02.01.008; 08.01.08.030; 17.10.01.0200.000500%Not Available
Substance dependence19.07.06.0190.000278%Not Available
Attention deficit hyperactivity disorder19.21.04.0040.000278%Not Available
Behaviour disorder19.01.01.0050.000185%Not Available
Biliary obstruction09.02.02.0050.000185%Not Available
Drug effect less than expected08.06.01.036--Not Available
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