Hidromorfona
Hydromorphone
Hydromorphone hydrochloride
También conocido como: Dilaudid-HP · Exalgo · Palladone · dihydromorphinone hydrochloride · Dolonovag · Hydal · HydroStat IR · Opidol · Sophidone
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As an analgesic | 0.1 mg/kg IV or SC q2h or as a CRI at 0.03 mg/kg/hr | IV/SC | q2h or CRI | — | 🌎 NA |
| For cancer pain | 0.08-0.2 mg/kg IV, IM, or SC | IV/IM/SC | Not specified | — | 🌎 NA |
| As an analgesic | 0.05-0.2 mg/kg IV, IM, SC q2-4h | IV/IM/SC | q2-4h | — | 🌎 NA |
| As an analgesic | 0.2-0.6 mg/kg PO q6-8h | PO | q6-8h | — | 🌎 NA |
| For perioperative pain | 0.1-0.2 mg/kg IV, IM, SC q2-4h | IV/IM/SC | q2-4h | — | 🌎 NA |
| As a premed prior to moderately painful procedures | 0.1 mg/kg | Not specified | Once | — | 🌎 NA |
| As a sedative/restraint agent for fractious or aggressive dogs | 0.1-0.2 mg/kg mixed with acepromazine (0.05 mg/kg) IM | IM | Once | — | 🌎 NA |
| As an alternate induction method (especially in critical patients) | 0.05-0.2 mg/kg IV, slowly to effect followed by diazepam 0.02 mg/kg IV | IV | Once | — | 🌎 NA |
- As an analgesic: Suggested doses based on pharmacokinetic study
- As a premed prior to moderately painful procedures: May be combined with acepromazine (0.02-0.05 mg/kg) in young, healthy patients.
- As a sedative/restraint agent for fractious or aggressive dogs: Maximal effect usually reached in about 15 minutes, but an additional wait of another 15 minutes may be necessary in some dogs.
- As an alternate induction method (especially in critical patients): Do not mix two drugs together. Positive pressure ventilation likely necessary. Treat bradycardia with glycopyrrolate or atropine if needed.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As an analgesic | 0.05-0.1 mg/kg IM, IV or SC q2-6 hours | IM/IV/SC | q2-6h | — | 🌎 NA |
| For cancer pain | 0.08-0.2 mg/kg IV, IM, or SC | IV/IM/SC | Not specified | — | 🌎 NA |
| For moderate to severe pain | 0.08-0.3+ mg/kg IV, IM or SC q2-6 hours | IV/IM/SC | q2-6h | — | 🌎 NA |
| As a premed prior to moderately painful procedures | 0.1 mg/kg | Not specified | Once | — | 🌎 NA |
| As an alternate induction method (especially in critical patients) | 0.05-0.2 mg/kg IV, slowly to effect followed by diazepam 0.02 mg/kg IV | IV | Once | — | 🌎 NA |
- As a premed prior to moderately painful procedures: May be combined with acepromazine (0.05-0.2 mg/kg) in young, healthy patients.
- As an alternate induction method (especially in critical patients): Do not mix two drugs together. Positive pressure ventilation likely necessary.
Pequeños mamíferos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a pre-op (Rabbits) | 0.05-0.1 mg/kg IV | IV | Once | — | 🌎 NA |
| As a CRI post-op (Rabbits) | 0.05 mg/kg IV loading dose, then 0.05-0.1 mg/kg/hr | IV | CRI | — | 🌎 NA |
Hurones
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a pre-op | 0.05-0.1 mg/kg IV | IV | Once | — | 🌎 NA |
| As a CRI post-op | 0.05 mg/kg IV loading dose, then 0.05-0.1 mg/kg/hr | IV | CRI | — | 🌎 NA |
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La hidromorfona es un agonista puro de los receptores mu-opioides semisintético y potente, utilizado ampliamente en medicina veterinaria como sedante, agente de contención, analgésico y preanestésico.
Las características clínicas clave incluyen:
- Potencia: Aproximadamente 5 veces más potente que la morfina en base al peso, y aproximadamente equipotente a la oximorfona.
- Ventajas sobre la morfina: Generalmente causa menos sedación, una liberación mínima de histamina tras la administración intravenosa y rara vez induce vasodilatación o hipotensión significativas.
- Utilidad clínica: Está reemplazando rápidamente a la oximorfona en la práctica veterinaria debido a su eficacia analgésica y duración de acción comparables, pero a un costo significativamente menor.
- Estatus regulatorio: Es una sustancia controlada de Lista II (C-II) debido a su alto potencial de abuso y dependencia física.
Mecanismo de acción
Hydromorphone exerts its effects by binding to opioid receptors, primarily the mu (μ) receptors, with some affinity for delta (δ) receptors.
Mechanism pathway: Agonist binding to mu-receptors in the CNS (limbic system, spinal cord, thalamus, midbrain) and peripheral tissues (GI tract, smooth muscle) → activation of G-proteins → inhibition of adenylate cyclase → decreased intracellular cAMP → opening of potassium channels (causing hyperpolarization) and closing of voltage-gated calcium channels → decreased presynaptic release of excitatory neurotransmitters (e.g., Substance P, glutamate) → profound analgesia and altered pain perception.
Secondary effects include respiratory depression (decreased sensitivity of the respiratory center to CO2), antitussive activity, and increased GI sphincter tone leading to decreased motility.
Seguridad y advertencias
Contraindicaciones
- Hypersensitivity to narcotic analgesics
- Diarrhea caused by toxic ingestion (until toxin is eliminated)
- Prior to GI obstructive surgery (due to vomiting risk)
- Patients stung by scorpion species Centruroides sculpturatus Ewing and C. gertschi Stahnke (may potentiate venom)
Efectos adversos
- Dogs: Nausea, vomiting, defecation, panting, vocalization, sedation, CNS depression, respiratory depression, bradycardia, decreased GI motility (constipation with chronic use)
- Cats: Nausea, ataxia, hyperesthesia, hyperthermia, behavioral changes (mania/excitement if given without tranquilization)
- Mild histamine release (infrequent compared to morphine)
Precauciones
Black Box Warning / Extreme Caution: Use with extreme caution in patients with respiratory disease, acute respiratory dysfunction, head injuries, increased intracranial pressure, and acute abdominal conditions (e.g., colic) as it may obscure diagnosis.
- Vomiting Risk: Contraindicated as a preanesthetic in animals with suspected gastric dilation, volvulus, or intestinal obstruction.
- Systemic Disease: Use cautiously in hypothyroidism, severe renal insufficiency (acute uremia), adrenocortical insufficiency (Addison's), and severe hepatic disease (prolonged duration of action).
- Cardiovascular: Can cause bradycardia; use cautiously in patients with preexisting bradyarrhythmias.
- Feline Hyperthermia: Can cause self-limiting hyperthermia in cats. High doses in cats should be combined with a tranquilizer to prevent bizarre behavioral changes.
- Vulnerable Populations: Geriatric, debilitated, or neonatal patients may be more susceptible and require lower dosages.
Interacciones farmacológicas
Potentially could antagonize opiate effects
Additive CNS depression effects possible
Opiates may decrease diuretic efficacy in CHF patients
Severe and unpredictable opiate potentiation; not recommended if MAOI used within 14 days
Hydromorphone may enhance muscle relaxant effects
May antagonize analgesic effects and increase risk for hypotension
Hydromorphone may exacerbate the effects of tricyclic antidepressants
Opiates may potentiate anticoagulant activity
Monitorización
- Respiratory rate and depth (pulse oximetry highly recommended)
- CNS level of depression or excitation
- Blood pressure (especially with IV use)
- Cardiac rate (monitor for bradycardia)
- Analgesic efficacy
Farmacocinética
Vida media
Absorción
Absorbed when given by IV, IM, SC, and rectal routes. Peak levels occur between 10-30 minutes after SC dosing in dogs.
Distribución
High volume of distribution in dogs (> 4 L/kg with both IV and SC dosing).
Metabolismo
Metabolized in the liver, primarily by glucuronidation. Cats are deficient in this metabolic pathway, leading to prolonged half-lives.
Eliminación
The glucuronidated metabolite is excreted by the kidney.
Sobredosis
Massive overdoses may produce profound respiratory and/or CNS depression in most species.
Other potential effects include:
- Cardiovascular collapse
- Hypothermia
- Skeletal muscle hypotonia
- Mania (especially in cats)
Treatment:
- Naloxone is the specific reversal agent of choice for treating respiratory depression.
- In massive overdoses, naloxone doses may need to be repeated, as naloxone's duration of action may be shorter than that of hydromorphone.
- Mechanical respiratory support should be considered in cases of severe respiratory depression.
- Provide supportive care as needed.
Productos disponibles
Formulaciones
- Powder for injection (lyophilized)
- Oral tablets
- Oral capsules (extended-release)
- Oral liquid
- Suppositories
Veterinario
- None
Etiquetado para humanos
- Hydromorphone HCl Injection: 1 mg/mL, 2 mg/mL, 4 mg/mL, 10 mg/mL (Dilaudid, Dilaudid-HP, generic)
- Hydromorphone HCl Powder for Injection, lyophilized: 250 mg (Dilaudid-HP)
- Hydromorphone HCl Oral Tablets: 2 mg, 4 mg, 8 mg (Dilaudid, generic)
- Hydromorphone HCl Oral Capsules (extended-release): 8 mg, 12 mg, 16 mg (Exalgo)
- Hydromorphone HCL Oral Liquid: 1 mg/1 mL (Dilaudid, generic)
- Hydromorphone Suppositories: 3 mg (Dilaudid, generic)
Estado regulador
Sin datos reguladores para: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Injection should be stored at room temperature and protected from light. A slight yellowish tint does not indicate loss of potency. Stable for at least 24 hours when mixed with commonly used IV fluids if protected from light. Tablets should be stored at room temperature in tight, light-resistant containers. Suppositories should be kept in the refrigerator.
Información para el cliente
La hidromorfona es un analgésico opioide potente.
- Supervisión: Cuando se administra mediante inyección, este medicamento se utiliza normalmente en un entorno hospitalario bajo supervisión veterinaria directa.
- Uso oral en casa: Si se le envía a casa con tabletas o líquido oral, mantenga este medicamento en un lugar seguro fuera del alcance de niños y otras mascotas. Es una sustancia estrictamente controlada.
- Qué esperar: Su mascota puede parecer sedada o somnolienta. En perros, el jadeo y los gemidos son efectos secundarios comunes y no significan necesariamente que la mascota tenga dolor. Los gatos pueden ocasionalmente mostrarse inquietos o tener una temperatura corporal ligeramente elevada.
- Efectos secundarios a vigilar: Esté atento a letargo severo, dificultad extrema para respirar o estreñimiento grave. Contacte a su veterinario si esto ocurre.
- No compartir: Nunca administre este medicamento a otra mascota o a un humano, ya que puede ser fatal si se usa incorrectamente.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.