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What Is the Difference between Dilaudid and Demerol?

syringe in bottle serum ready to injectDilaudid is the brand name for a potent opioid prescription painkiller, generically known as hydromorphone. Demerol is also a powerful opioid painkiller, with the generic name meperidine. Both of these prescription narcotics are used to treat moderate to severe pain, and they are strictly controlled by recommended prescribing practices and the Drug Enforcement Administration (DEA). They are both Schedule II drugs, both derived from morphine, and both potentially addictive.

Both Demerol and Dilaudid are used in limited ways, under the supervision of a medical professional. There are, however, some differences between these two substances.
Infographic of difference between demerol and dilaudid


The Food and Drug Administration (FDA) approved Dilaudid for prescription use in 1984. The drug was developed as a powerful painkiller to treat people who needed pain relief all day and for whom other painkillers stopped working. The liquid form of hydromorphone can be ingested every 3-4 hours, while the tablet form can be taken every 4-6 hours. There is also an extended-release version of Dilaudid in tablet form, which can be taken once per day without food, and it should relieve pain for 12 hours.

Dilaudid has many of the same side effects as other narcotics, including constipation, mild euphoria, nausea, lightheadedness, sweating, and drowsiness. Less common side effects from hydromorphone include:

  • Skin rash
  • Heart palpitations or irregular heartbeat
  • Sudden drop in blood pressure
  • Respiratory difficulties

These side effects have led to Dilaudid featuring a black box warning about potentially life-threatening problems. Fortunately, allergic reactions to Dilaudid are rare, so many people who are allergic to other narcotic painkillers can find relief with Dilaudid.

Like other narcotics, including Demerol, Dilaudid should not be taken with alcohol. A person who is taking Dilaudid as a prescription should also not drink grapefruit juice while taking this prescription medication, as grapefruit juice can prevent this medication from working.

Because Dilaudid is a powerful opioid painkiller, related to morphine, this drug can be subject to addiction and abuse. Prescribing practices typically prevent people from starting their struggle with addiction due to Dilaudid; oxycodone and hydrocodone medications are more likely to be temporarily prescribed, which can lead to addiction and abuse. Dilaudid is more likely to be used for long-term pain relief, but people who struggle with opioid addiction may ingest hydromorphone to get high, because it is a very potent narcotic.


The FDA approved Demerol for use as a pain reliever and surgical analgesic prior to an operation in 1942. Meperidine, or pethidine, was originally synthesized from morphine in 1932 and considered a potential antispasmodic medication. It is still used as a preanesthetic agent and to alleviate pain in post-operative situations, including obstetrics. However, it is not prescribed as often, as more effective and less sedating opioid drugs, including hydrocodone and oxycodone.

The drug can safely be ingested every 3-4 hours, and it comes in either tablet or syrup form. Meperidine is meant to be taken temporarily, and it can lead to addiction or physical dependence if taken for more than 3-4 weeks. People who use Demerol for longer than a month should speak with a doctor to gradually reduce the dosage, which can help prevent withdrawal symptoms.

Side effects from Demerol are very similar to other opioid drugs and include dizziness, drowsiness, constipation, sweating, changes in pupil size, and mild euphoria. More serious side effects include seizures, fainting, hallucinations, and very low blood pressure. Like other narcotics, Demerol can also lead to reduced or depressed breathing.

Meperidine has been linked to a syndrome with symptoms similar to Parkinson’s disease. Research has found that a metabolic byproduct of meperidine, called MPTP, can damage neurons that are also damaged by Parkinson’s disease. This is a side effect not found in other opioid medications, like Dilaudid.

Like Dilaudid and other opioid painkillers, alcohol and Demerol do not mix, and grapefruit juice can block the painkilling properties of this medication.

Help for Abuse of Demerol or Dilaudid

Although Dilaudid and Demerol have different potential long-term side effects, were approved at different times, and are prescribed at different potencies for different applications, both of these narcotic painkillers can be habit-forming and targets for abuse or addiction. Get help from a medical professional immediately to safely detox from these drugs and find a rehabilitation program that can help to overcome addictive behaviors. Individual and group therapy can help a person struggling with painkiller addiction understand the causes and triggers of their substance abuse and begin to overcome this problem. With proper help, individuals struggling with addiction can achieve long-term recovery.

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