Palladon® ( hydromorphone ) is one of the very strong semi-synthetic opioid analgesics.

Compared to morphine it is 10-fold and more potent.

It is used to treat very severe acute and chronic pain and requires a prescription.

Trade name: Palladon®, Dilaudid®

Chemical name: Hydromorphone, hydroxy-17-methyl-4, 5-epoxymorphinan-6-one (IUPAC formula)

Chemical molecular formula: C17H19NO3 ( hydromorphone ), C17H19NO3 · HCl ( hydromorphone · hydrochloride )

field of use

Palladon® can be taken orally as well as given as a solution for injection.

Taking Palladon ® is indicated for very severe pain such as tumor, neuropathic, postoperative pain or severe trauma.

In addition, it can also be used as an antitussive.
An antitussive is a medicine that reduces the cough.
In Germany, however, codeine and dihydrocodeine are preferred.

Application forms and dosage

Palladon ® can either be taken orally in the form of a capsule or retard capsule, on the other hand, it can be administered as a solution for injection.

A sustained-release capsule is a special form of medication in which the active ingredient is slowly released in a dosing manner. Thus, the patient is constantly supplied with the active ingredient over a certain period of time.

The dosage of Palladon ® varies and varies with the severity of the pain being treated.

Usually the starting dose is 4mg every 12 hours .

The drug is not suitable for children under 12 years.

Since it requires a prescription, a dosage that is appropriate for the respective patient is always discussed with the attending physician.

Pharmacological and chemical data

Palladon ® is related to the morphine.

It is a hydrogenated morphine ketone and a metabolite of morphine, codeine and dihydrocodeine.

A metabolite is a metabolite. It has a low plasma protein binding.
This offers an important advantage in the treatment of very thin patients, as they already have a low content of protein in their blood plasma, due to their nutritional status.

Mode of action of Palladon®

As already mentioned, Palladon ® belongs to the opioid analgesics.

These drugs act on our body's own painkilling system.
It mimics the effects of endogenous opioid peptides ( proteins ) such as endorphins and enkephalins.

This mechanism prevents pain transmission. This means that the pain stimulus does not even arrive at higher processing centers of our brain, such as the thalamus or the limbic system, and so we do not become aware of it.

Palladon ® forms few active metabolites ( metabolites ) and is therefore very well suited for patients with renal insufficiency.

As mentioned earlier, plasma protein production is very low, so Palladon ® does not interact so well with other drugs, which is another benefit.

Side effects of Palladon®

The side effects of Palladon ® s are typical of the drug class of opioid analgesics.

It can cause nausea, vomiting and dizziness.

In addition, constipation and urinary retention can occur.

As with many analgesic drugs, fatigue and low blood pressure ( hypotension ), as well as bradycardia and respiratory depression, can result.

Narrowed pupils ( miosis ) can be a sign of overdose.

In addition, hydromorphone has a euphoric effect and therefore also a certain addictive potential that can result in dependence.

In addition, hallucinations and hyperhidrosis ( excessive sweating ) can occur when taking Palladon ® .


The effect of hydromorphone can be enhanced and influenced by concomitant use of sedating drugs. There may be more side effects.

These medicines include muscle relaxants, barbiturates, benzodiazepines, phenotiazines ( neuroleptics eg for use in hallucinations ), tricyclic antidepressants and anesthetics.

In addition, interactions with alcohol, antihistamines ( for the treatment of allergies and mucosal inflammations ) and tranquillizers ( anxiolytic psychopharmaceuticals ) are known.


Taking Palladon ® is contraindicated in allergy to hydromorphone, respiratory problems such as respiratory depression, asthma and chronic obstructive pulmonary disease ( COPD ) and paralytic ileus.

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