Hydromorphone (Dilaudid)

Raw research findings for this medication. Mostly single studies, not curated or confirmed robust.

About Hydromorphone

What it is

Hydromorphone is a potent opioid, several times stronger than morphine, made from morphine. It acts on mu opioid receptors and is used for moderate to severe pain, after surgery, in cancer and in palliative care, by mouth, injection or pump. It is also the active product the body makes from hydrocodone. It is sold as Dilaudid, among other names.

How genes come into it

Hydromorphone is cleared mainly by UGT2B7 and other UGT enzymes, not by CYP2D6, so it is not affected the way codeine and hydrocodone are; the CYP2D6 studies listed here mostly concern hydrocodone being turned into hydromorphone. Studies have also looked at the opioid receptor gene OPRM1, COMT and ABCB1 for how much hydromorphone people needed. There is no CPIC or DPWG guideline.

What research found

Every published finding on gene variants and Hydromorphone. Upload your DNA file to see which of these rows apply to you.

Metabolism (2 findings)

Studies of how quickly the body processes this medication.

CYP2D6 CYP2D6*5, CYP2D6*17: CYP2D6 *5/*17 is associated with decreased concentrations of hydromorphone in women.

UGT2B7 rs7439366: Allele T is not associated with metabolism of hydromorphone in healthy individuals as compared to allele C.

Response (3 findings)

Studies of how well it worked in people carrying a variant.

CYP2D6 CYP2D6 poor metabolizers and intermediate metabolizers: CYP2D6 intermediate metabolizer and poor metabolizer are associated with decreased response to codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone or tramadol in people with Neoplasms and Pain as compared to CYP2D6 normal metabolizer.

CYP2D6 CYP2D6 ultrarapid metabolizer: CYP2D6 ultrarapid metabolizer is associated with decreased clinical benefit to hydromorphone, oxycodone or tramadol in men with Pain, Emergencies and Surgical procedure.

CYP2D6 CYP2D6*4: CYP2D6 *4/*4 is associated with decreased response to hydromorphone, ketorolac, morphine, opioids or oxycodone in women.

Dosing (5 findings)

Studies of how much of the drug people needed or tolerated.

ABCB1 rs1045642: Allele A is associated with decreased dose of buprenorphine, dihydrocodeine, fentanyl, hydromorphone, methadone, morphine, oxycodone, piritramide, tilidine or tramadol in people with Pain as compared to allele G.

CYP2D6 CYP2D6 ultrarapid metabolizer: CYP2D6 ultrarapid metabolizer is associated with increased dose of fentanyl, hydromorphone, opioids, oxycodone or tramadol in women with surgery as compared to CYP2D6 normal metabolizer and intermediate metabolizer and poor metabolizer.

OPRM1 rs1799971: Genotype AA is associated with increased dose of fentanyl, hydromorphone, opioids, oxycodone or tramadol in women with surgery as compared to genotype AG.

COMT rs4680: Allele A is not associated with dose of buprenorphine, dihydrocodeine, fentanyl, hydromorphone, methadone, oxycodone, piritramide, tilidine or tramadol in people with Pain as compared to allele G.

Other findings (1 finding)

Studies that do not fall into the groups above.

OPRM1 rs1799971: Genotypes AG + GG is associated with increased response to hydromorphone in healthy individuals as compared to genotype AA.

Study findings and evidence levels: PharmGKB (CC BY-SA 4.0). Guidelines: CPIC and DPWG, as bundled in PharmCAT. Most studies were done mainly in people of European ancestry.

Related Drugs

More drugs from the same category

Alfenta (Opioids)

Codeine (Opioids)

Demerol (Opioids)

Not a prescribing recommendation. This page is educational information about pharmacogenomic research and clinical guidelines - it is not medical or dosing advice, and not a prediction of how any medication will work for you. Never start, stop, or change a medication or dose based on it; talk to your doctor or pharmacist, who can order clinical-grade testing if appropriate.

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Content updated September 2026.

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