Can methadone be taken with Dilaudid?

The short answer is that, if you are under medical supervision, preferably in a hospital setting where you are being monitored, dilaudid (hydromorphone) can be taken for breakthrough pain when methadone is used as the primary analgesic (pain killer) for severe pain.

Methadone is a tricky drug to prescribe and finding the safe dosage that provides pain relief involves starting at a low dose and gradually increasing it until the patient gets relief, while monitoring the patient's vital signs and watching for the many possible side effects. The technical term for this is titration, and it is best done in a hospital setting, especially since patients in severe pain usually have other medical conditions that add to these risks.

Both dilaudid (hydromorphone) and methadone are opioid narcotics, but methodone is a more long-acting drug while hydromorphone is a more short-acting drug. Both are used for treating severe pain, but due to its short-acting nature, hydromorphone is more suited to treating breakthrough pain that occurs despite treatment with another drug.

The problem with taking hydromorphone with another opioid narcotic like methadone is that they can have a combined effect that can depress respiration to the point where medical intervention may be needed to prevent death. In a hospital setting where you can be monitored and where life support and other measures can be taken in an emergency, this is less of a concern. Outside a hospital setting, it is difficult and risky to determine the safe dosage for methadone for specific patients.

One of the difficulties in using methadone is that its effects on respiration can last long after it has stopped providing pain relief. This presents problems for the very patients that it is likely to be prescribed for - those with severe chronic pain. Taking another dose of methadone, or another opioid narcotic such as hydromorphone, when the first dose of methadone is wearing off, adds to the risk that, at some point, you may stop breathing.

A physician who specializes in pain management is best qualified to prescribe a course of treatment for severe pain, which may or may not include the use of multiple drugs. Self-prescribing narcotics, or experimenting with the dosage, can be very dangerous.