Compare Fentanyl vs. Dilaudid

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Duragesic
(fentanyl)

Dilaudid
(hydromorphone)

Treats severe pain. Duragesic (Fentanyl) is an excellent pain reliever, but should only be used by people who've tried other opioid pain medications and still need more relief.Treats moderate to severe pain. Dilaudid (Hydromorphone) is a fast-acting, potent medication that treats problems needing strong pain relief.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
5.83Fentanyl
Reviews for Fentanyl
79%
of people (All ages) say Fentanyl is worth it
70%
say it works well
14%
say it's a big hassle
Have you used Duragesic (fentanyl)?
Worth itNot sureNot worth it
Reviews for Dilaudid
78%
+1% better vs. Fentanyl
65%
+5% better vs. Fentanyl
10%
-4% worse vs. Fentanyl
Have you used Dilaudid (hydromorphone)?
Worth itNot sureNot worth it
Side effects
FentanylDilaudid
  • Nausea 27%
  • Fatigue 19%
  • Vomiting 17%
  • Abdominal pain 15%
  • Dyspnea 15%
  • Headache 14%
  • Dehydration 13%
  • Somnolence 13%
  • Dizziness 13%
  • Insomnia 3%
More Fentanyl side effects »
  • Constipation 15%
  • Nausea 12%
  • Somnolence 9%
  • Headache 8%
  • Vomiting 2%
  • Arthralgia 4%
  • Pruritus 5%
  • Insomnia 1%
  • Asthenia/fatigue 12%
  • Dizziness 11%
More Dilaudid side effects »
How it works
FentanylDilaudid
Duragesic (Fentanyl) is an opioid (narcotic) medicine that works in the brain to lower pain perception.Dilaudid (Hydromorphone) is an opioid medicine (similar to morphine) that works in the brain to lower pain perception.
Type of medication
FentanylDilaudid
Prescription onlyPrescription only
Available as
FentanylDilaudid
  • Patch
  • Patch extended release
  • Dissolving tablet
  • Mouth spray
  • Lozenge
  • Buccal tablet
  • Nasal spray
  • Pill
  • Extended release
  • Oral solution
  • Suppository
Used for
FentanylDilaudid
Risk factors for serious side effects
FentanylDilaudid
  • Current use of medicine that affects liver enzyme CYP 3A4
  • Age 65 or greater
  • Higher dose
  • People with not enough thyroid hormones
  • History of lung problems
Detailed Duragesic (fentanyl) risks & warnings »
  • Current use of medicine that affects liver enzyme CYP 3A4
  • Age 65 or greater
  • Higher dose
  • People with not enough thyroid hormones
  • History of lung problems
Detailed Dilaudid (hydromorphone) risks & warnings »
Pregnancy

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Alcohol
FentanylDilaudid
  • Never drink alcohol when using Duragesic (Fentanyl).
  • Never use alcohol when taking Dilaudid (Hydromorphone).
Pain
FentanylDilaudid
  • For pain, the patch takes 12 hours to start working and all other forms start working in 30 minutes or less.
  • Duragesic (Fentanyl) isn't for everyone. It's a really strong pain medication and taking too much can be deadly.
  • Works well to relieve moderate to severe pain.
Sleep
FentanylDilaudid
  • Often causes drowsiness and constipation. If using it long-term, use a stool softener.
  • Dilaudid (Hydromorphone) will cause drowsiness, so be really careful if you're taking other meds that also cause drowsiness, such as antidepressives, antianxiety meds, or muscle relaxants.
  • Dizziness and drowsiness are common when taking Dilaudid (Hydromorphone), but your body may adjust over time.
Upsides and benefits
FentanylDilaudid
  • It's used for people who have tried other opioid medications, but still need stronger pain relief.
  • Duragesic (Fentanyl) is stronger than morphine, works quickly, and doesn't cause as many stomach problems.
  • It's available in many dosage forms, including a patch, injection, film, nasal spray, and lollipop.
  • The Duragesic (Fentanyl) patch provides long-term pain relief and lowers the number of times you need to take pain medications each day.
  • Works well to relieve moderate to severe pain.
  • Dilaudid (Hydromorphone) is stronger than morphine and works quicker than other pain medications.
  • It doesn't cause as many side effects, like nausea and rashes, as morphine does.
  • It's available as fast-acting tablets, extended-release tablets, and as a liquid.
Downsides and risks
FentanylDilaudid
  • Duragesic (Fentanyl) isn't for everyone. It's a really strong pain medication and taking too much can be deadly.
  • It doesn't provide quick pain relief.
  • Often causes drowsiness and constipation. If using it long-term, use a stool softener.
  • Like all opioids, don't use when pregnant, since the baby can become dependent on it and have withdrawal symptoms after birth.
  • Shouldn't be used for people with breathing problems (like asthma and COPD), a slow heart rate, or in the elderly.
  • If using the patch, you won't be able to get the medicine out of your body quickly in case of an overdose.
  • People with breathing problems like asthma and COPD need to be monitored very closely if taking Dilaudid (Hydromorphone).
  • Dilaudid (Hydromorphone) isn't usually used for elderly or frail patients.
  • Dizziness and drowsiness are common when taking Dilaudid (Hydromorphone), but your body may adjust over time.
  • Everyone tends to get constipation while on this, so you'll need to stay hydrated and may need to take a stool softener medication.
  • Long-term use will likely cause physical dependence.
  • Must be weaned slowly off the medicine after using it longer than 2 weeks.
Tips from our pharmacists for people taking the medication
FentanylDilaudid
  • Duragesic (Fentanyl) should only be used for people whose pain is not controlled by other opioid medications for at least one week.
  • For pain, the patch takes 12 hours to start working and all other forms start working in 30 minutes or less.
  • If using the patch, keep it away from heat sources like heating pads, or else it'll cause the medication to be unsafely released into your skin.
  • Never stop taking Duragesic (Fentanyl) suddenly or else you'll have withdrawal effects. To stop taking it, you'll need to lower your dose slowly.
  • Never drink alcohol when using Duragesic (Fentanyl).
  • Just one dose can be harmful or fatal to children, so store and dispose of this medication in a way that children can't get to it.
  • Dilaudid (Hydromorphone) is usually taken for a short time. If you take it longer than 2 weeks, you'll need to lower your dose slowly to get off it since stopping suddenly can cause withdrawal symptoms.
  • Usually works within 30 minutes.
  • Dilaudid (Hydromorphone) will cause drowsiness, so be really careful if you're taking other meds that also cause drowsiness, such as antidepressives, antianxiety meds, or muscle relaxants.
  • Never use alcohol when taking Dilaudid (Hydromorphone).
  • It's very important to keep Dilaudid (Hydromorphone) away from children, since it can stop them from breathing.
Learn more
More about FentanylSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Duragesic (fentanyl)?
Worth itNot sureNot worth it
More about DilaudidSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Dilaudid (hydromorphone)?
Worth itNot sureNot worth it