Hydromorphone 18mg is a controlled-release capsule. It releases hydromorphone over approximately 12 hours and is prescribed for severe, persistent pain requiring continuous opioid treatment when other options are inadequate.
Medical benefits include:
- Strong, long-lasting relief of severe chronic pain
- More consistent, around-the-clock pain control
- Improved comfort, sleep, mobility, and daily function when severe pain is adequately managed
- Less frequent dosing than immediate-release hydromorphone
Critical warning: The 18mg strength is only for patients who are already opioid-tolerant—defined in the Canadian monograph as requiring at least 36 mg of oral hydromorphone equivalent daily. It can cause fatal respiratory depression in someone without this tolerance.
Do not crush, chew, dissolve, inject, or otherwise break the controlled-release contents; doing so can rapidly release a potentially fatal dose. Never mix it with alcohol, alprazolam, clonazepam, sleeping pills, GHB, or other opioids unless specifically managed by a clinician.
If someone cannot be awakened or has slow, weak, or absent breathing, call 911 and give naloxone if available.



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