Comparative Pharmacology
Head-to-head clinical analysis: DEMEROL versus DILAUDID HP.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DEMEROL versus DILAUDID HP.
DEMEROL vs DILAUDID-HP
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Meperidine is an opioid agonist that binds to mu-opioid receptors in the central nervous system, mimicking endogenous endorphins to produce analgesia, sedation, and euphoria. It also has additional weak actions at kappa and delta receptors.
Hydromorphone is a full mu-opioid receptor agonist with high affinity for mu-opioid receptors, producing analgesia, euphoria, and sedation. It also binds to kappa and delta opioid receptors with lower affinity.
50-150 mg IM, IV, or SC every 3-4 hours as needed for pain; oral 50-150 mg every 3-4 hours.
Initial dose: 0.2-0.6 mg IV/IM/SC every 2-4 hours as needed; usual adult dose: 0.2-0.4 mg IV/IM/SC. Oral: 1-2 mg every 3-6 hours. Dose titration based on pain severity.
None Documented
None Documented
2.5-4 hours; prolonged in hepatic impairment (7-11 hours) and elderly.
Terminal elimination half-life: 2.3–4 hours. In clinical context, consistent with dosing interval of 4–6 hours for immediate-release formulations; prolonged in hepatic or renal impairment.
Renal (90% as metabolites and unchanged drug; ~5% unchanged) and biliary/fecal (minor).
Renal: predominantly as hydromorphone-3-glucuronide (H3G), unchanged hydromorphone (<6%), and other metabolites. Biliary/fecal: minimal.
Category C
Category C
Opioid Analgesic
Opioid Analgesic