The Metamorphosis of Hydromorphone Gary M
Pharmacy PersPective The metamorphosis of hydromorphone Gary M. Reisfield, MD George R. Wilson, MD introduction “That’s it. The Mayo Clinic at Rochester devel - oped it, the word and the drug, for it means a Hydromorphone hydrochloride, one of the oldest of drug, a pain relieving drug, five times as potent the extant opioid analgesics, has been in clinical use for as morphine, as harmless as water and with no more than 70 years. Its use by the oral route in chronic habit forming qualities. pain and hospice/palliative medicine settings has been limited, however, largely owing to its relatively short “The medical journals say it is particularly useful duration of action. With the recent US Food and Drug in the operation of cases where other drugs Administration (FDA) approval of a once-daily extended- seem to offer no relief from pain. Unlike mor - release formulation of the drug (Palladone, Purdue phine, there are no pleasurable sensations to its Pharma LP, Stamford, CT), hydromorphone joins mor - use, however, and if the doctors reckon correctly phine, oxycodone, and fentanyl as the only extended- its use may go far toward curing addicts of the release opioids available on the United States market. morphine habit.” Here, we review the history, pharmacokinetics, and other relevant issues concerning this invaluable opioid, and Montgomery (AL) Advertiser , Dec. 18, 1932 also discuss the role of the new formulation in the man - agement of chronic pain. From 1929 to 1939, the National Research Council’s Committee on Drug Addiction conducted exhaustive history research on the morphine molecule and its analogs, pro - ducing more than 150 semisynthetic and more than 300 Hydromorphone [also Dilaudid (Knoll Laboratories, synthetic compounds, of which more than 30 were tested Mount Olive, NJ), dihydromorphinone, dihydromorphe - clinically.
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