What is the usual conversion from oxycodone to Dilaudid (hydromorphone) by milligrams?
There is no single “exact” mg-to-mg conversion that fits everyone, but commonly used clinical equianalgesic guidance treats oxycodone and hydromorphone as follows:
- Hydromorphone (Dilaudid) is roughly 4–5 times as potent as oxycodone by oral dose.
- That means 1 mg of oxycodone is often treated as roughly equivalent to about 0.2–0.25 mg of oral hydromorphone (Dilaudid).
- Put another way, 5 mg of oxycodone is roughly equivalent to about 1–1.25 mg of oral hydromorphone.
How much Dilaudid corresponds to a specific oxycodone dose?
Using the rough ratio above (1 mg oxycodone ≈ 0.2–0.25 mg oral hydromorphone):
- 10 mg oxycodone ≈ 2–2.5 mg Dilaudid (oral)
- 15 mg oxycodone ≈ 3–3.75 mg Dilaudid (oral)
- 20 mg oxycodone ≈ 4–5 mg Dilaudid (oral)
These are approximations meant for equianalgesic conversions, not patient-specific dosing.
Does it matter if the doses are immediate-release vs extended-release?
Yes. Extended-release oxycodone and immediate-release oxycodone aren’t interchangeable on a straight mg basis without adjusting for dosing interval and opioid exposure over time. Conversions are typically done at the same “total daily” opioid exposure level, with careful clinical judgment.
Does oral vs IV/other routes change the conversion?
Yes. Hydromorphone and oxycodone conversions differ depending on route (for example, oral vs intravenous). The mg-to-mg figures above are for oral dosing equivalence.
Why can’t you just use one fixed number?
Equianalgesic tables account for average potency differences, but real-world dosing varies with:
- prior opioid exposure and tolerance
- age, liver and kidney function
- whether the patient is switching from short-acting to long-acting opioids (or vice versa)
- individual response and safety targets
Clinicians often reduce the calculated equivalent dose when switching opioids to lower overdose risk.
If you tell me the oxycodone dose (and whether it is immediate-release or extended-release, and the route for Dilaudid you mean), I can calculate the approximate corresponding Dilaudid dose range using the standard potency ratio.