Dilaudid and Oxycodone: What are the Differences? (& Effectiveness)

In a survey from the National Center for Health Statistics in 2019, an estimated 20.4 percent of adults in the United States admitted they struggled with chronic pain. Another 7.4 percent had chronic pain that frequently limited life or work activities in the past three months. Those struggling with physical pain often turn to their doctors for alternatives, and at first, the physician could suggest over-the-counter medication like Tylenol. If you find that OTC medication is not easing your pain, they might point you in the direction of more potent drugs like Dilaudid or oxycodone. 

Over-the-counter medication is considered the first tier of pain medication, and the next tier would be an opioid like oxycodone, but the third tier that falls under the opioid category is hydromorphone, the active ingredient in Dilaudid. Dilaudid works faster than morphine and is commonly prescribed after a significant injury or surgery.

Both oxycodone and Dilaudid are effective for pain reduction, but which medication is appropriate can only be decided by a trained medical professional. Despite their pain-relieving qualities, both medicines are potent opioids that can be addictive, and administering these drugs should only occur under a doctor’s supervision. Despite falling under different tiers, both Dilaudid and oxycodone have similar side effects, so what are the differences?

Effects of Dilaudid Vs. Oxycodone

Dilaudid and oxycodone were both designed to relieve pain that can’t be achieved by over-the-counter medication. Both oxycodone and Dilaudid are considered opioids, but Dilaudid falls into the subcategory hydromorphone. Of the two, Dilaudid is more potent, but both drugs cause similar side effects. 

The list below shows the side effects both Dilaudid and oxycodone have in common:

  • Sedation
  • Confusion
  • Dry mouth
  • Itching
  • Digestive problems
  • Constipation
  • Drowsiness
  • Dizziness
  • Strong potential of addiction
  • Slowed breathing


Oxycodone is more likely to cause other typical side effects, including rashes, while Dilaudid is better known for making the individual flushed and sweaty upon use.

Which Drug is More Addictive?

Both Dilaudid and oxycodone possess addictive qualities, and using them for extended periods will likely cause dependence. Although the effects of Dilaudid are much stronger, particularly in a person not experiencing pain, it doesn’t mean it’s more addictive than oxycodone. Oxycodone works in a similar fashion to block pain receptors in the brain, causing feelings of euphoria. 

If you’ve been prescribed the medication, you shouldn’t stop taking either oxycodone or Dilaudid without your doctor’s approval. Your doctor will likely direct you to slowly taper off the drugs or substitute it with a less potent opioid, like codeine. Abrupt cessation of either drug will sometimes result in severe withdrawal symptoms. 

The most common withdrawal symptoms from both oxycodone and Dilaudid include:

  • Diarrhea
  • Watery eyes
  • Runny nose
  • Restlessness
  • Chills
  • Sweating
  • Dilated pupils
  • Body aches
  • Lethargy
  • Fatigue
  • Insomnia


If your doctor is in charge of weaning or tapering off one of the two medications, you’re less likely to experience severe symptoms. If either drug has been abused or used for purposes other than pain, you might be instructed to seek a treatment program to help free you from the grips of addiction. The first step in this process will be medical detox, which allows you to overcome the initial stage of withdrawal that former users explain to be the most challenging step.

Effectiveness of Dilaudid Vs. Oxycodone

Technically speaking, Dilaudid is the more potent of the two medications and produces effects that last much longer. The drug is most often chosen for individuals in constant pain with disorders that include fibromyalgia or reflex sympathetic dystrophy (RSD).

Oxycodone was formulated for fast relief, and it’s routinely given to individuals dealing with sporadic or acute pain. While there are some key differences between the two, they’re both classified as opioids that relieve pain.

The sole intention of opioids is to attach to receptors in your brain and block pain. Once connected, it sends signals throughout the body to block pain and slow breathing. The most common side effect is euphoria, and opioids are notorious for quickly completing the process and providing quick relief to someone in pain. 

Although it’s still an opioid, Dilaudid is synthesized a bit differently, and hydromorphone works faster than morphine. It is also much more potent, and as we’ve mentioned, it’s much more potent than comparable doses of oxycodone. Although the initial effects are similar, Dilaudid eases pain longer than oxycodone. 

Which Drug Is Most Effective?

Your doctor will choose which drug is the most effective for your specific needs. Generally speaking, Dilaudid is used for intense pain and after major surgeries. Medications are dispensed based on the severity of your pain, and the first step will be to use over-the-counter medications. If these provide no relief, an opioid like oxycodone may be the doctor’s next choice. 

Dilaudid would typically be a doctor’s final option, and it’s usually given to those in the most pain or experiencing continuous pain. When used for extended periods, hydromorphone can cause tolerance, dependence, and addiction. It may cause you to use more of the drug if it stops working over time. 

Oxycodone is likely to be used to treat acute pain, and it’s on the second tier of the painkiller list. Despite this, oxycodone is still considered a potent substance, and it’s known for reducing pain quickly. If you don’t see relief from over-the-counter medications to ease pain from an injury or small surgery, a doctor will likely prescribe this drug. 

Both drugs are available in injection and pill form and time-release versions. Since your level of pain may get worse or better with time, you must speak with the doctor to determine what’s best for you.  

Supervision is Necessary

Because of the risk of addiction, a doctor must always supervise usage. Although dosages will differ depending on how you administer the medication, only a doctor can choose which form is appropriate. Doctors must always supervise your use of these potent pain medications because side effects will vary from one person to another, and both are addictive. 

If either yourself or a loved one has become dependent on one of these drugs, it’s important to remember that help is available to you. The long-term effects of overuse and dependence can be dangerous to your physical and mental health. If you’ve become addicted, please remember that you shouldn’t feel shame. It happens, and you should focus your energy on getting better.

Getting the right treatment from an addiction specialist will help you lead a life free of opioid addiction. The first step is to admit there’s a problem, and the next is to seek help. If you’re worried about chronic pain and opioid treatment, clinicians will help you develop a plan to treat both without opioids. Your future is bright and is waiting for you to take that step.

Tap to GET HELP NOW: (855) 960-5456