Dilaudid Lethal Dosage?

I am a stage IV cancer patient and member of an invitational research and survey type website.

Members primarily consist of other stage IV cancer patients, but in some cases, may be the caregiver of a stage IV patient.

A little over a month ago, a caregiver launched a blog-like diary of sorts. He states his wife has end-stage, metastasized, breast cancer. His postings started with news his wife had to be hospitalized when she began the dying process and indicating shut-down. However, many of his statements do not sound clinically correct or even possible. For example, after she was admitted to the hospice section of the hospital, he stated she emerged from days of a coma-like state to experience what he called a rally. This rally consisted of engaging in conversation with himself and hospital staff...only to sink into another coma-like state after being administered IV anti-biotics for a major infection due to compromised immune system (an extremely low, chemo-caused low white blood count). During this time, he also stated that both kidneys shut down...then...a week later, miraculously regained normal function. In still another posting, he describes she emerged from yet another coma-like state to devour a huge meal, although she had and was still on a PEG feeding tube!!! (All patients I know had to slowly acclimate over a period of several days to oral feeding with jello, puddings, non-spicy soups, etc.) He now states he has moved his wife back home where she can die in the comfort of familiar surroundings. Now at home, he described another coma-like experience, followed by yet another rally of low-level activity as if she had no health issues at all. Today, (July 23) his posting states she was in great pain the night before and her doctor increased her Dilaudid pain medication to 7mg/hour. If you had read between the lines of every post since this person started about 6-weeks ago, you'd quickly get the idea this person has the capacity to cause a faster than normal passing of his wife. For what reason?...so he can start re-establishing his social life! More than one prior comment had this type “social life” focus, though subtle. Far more troublesome are comments I feel would cause any perceptive person to wonder if he is capable of engaging in deliberate acts to cause his wife to expire sooner than later. In hopes a professional monitors this board, I have a quick question: Under her circumstances, does 7MG/hr of Dilaudid seem appropriate and correct...or...is does it sound more like an accumulative, lethal dose? I apologize for the length of this post, but am somewhat bothered by what may be the abuse (or worse) of a person that cannot defend themselves. Thanking you in advance, Nodawgs

REPLY

REPORT

Well, unfortunately, there is no way to provide you with a definitive answer here. While I understand your suspicions, there are many factors at play that determine a person's appropriate dosage.

Such as: How long she has been taking narcotics and how much they have been giving her.

When you take narcotics on a regular basis, for a prolonged period of time, then your body becomes acclimated to them and you will consistenly need higher and higher doses to achieve a comfortable level of pain relief.

For patients who are terminal and in the end stages of their lives, it has been proven that giving them larger narcotic doses to help keep them more comfortable and, perhaps, able to spend a few last moments with their loved ones, without being in dire agony, DOES NOT hasten their deaths.

So, without knowing her medical history and what narcotics she has already been taking and the doses, there is no way to say for certain if 7mgs is or is not an appropriate dosage.

REPLY

Was this helpful? 5

I am a R.N. & am a Cancer Survivor. I had A Type of Bone Cancer. Now in regards to the comment that indicates the utmost concern for this patient. I'd like to say that Dilaudid, when given via I.V. (Intravenous), or I.M. (Intra muscular), or when is it being administered by mouth, have various effects on the individual that it is being administered to. 7mg / per hour, ... Isn't a fatal dosage, when the patient has shown resistance / tolerance, to the narcotic pain reliever. I'd like to think that, any individual posting comments in regards to a Terminally ill Person ... would not be so honest in stating how his partner is being medicated, if he / she were guilty of ... what may be suggested here as, helping one to pass, sooner than later!!! Maybe this person is reaching out to others by sharing that His / Her partner is having some, very sacred moments of clarity. Especially if the patient has only a little bit of time left.
Now in regards to The Drug Dilaudid, it can cause severe disorientation when the dosage is this strong, ... & can also cause the patient to seem Out of IT. ...
So to speak. I'm thinking that perhaps this Drug, ... is the one Chosen by the patients Doctor, & may be the one that works the best, for the patient in this very sensitive matter!!!
I'm not 100% .... (re: The amount of Dilaudid) ... But, if the Person that POSTED THE ORIGINAL POST, has that much concern, feel free to contact the necessary parties. I wish the Cancer Patient / 's ... Blue skies, & Sunshine.

REPLY

Was this helpful? 8

hi i read your question and i know alot about dosages and lethal doses i know i was off all opoids for about a year i got back on couple months ago within 2 weeks of taking dilaudid i was up to 35 mg per hour but not all day id shoot up alot of them for about 2 hours them be cool for about 6 hours then do some more so 7 mgs per hour i personally wouldnt even feel and i also believe if the person was on morphine based drugs over a period of more tha n3 months its almost impossible to overdose on morphine when i was doing heroine there was times id take a 140 mg shot of pure black tar heroine thats the max u can fit in a large rig but the first response is also something to look at about him telling you about the stuff about how long shed been on it and if she showed resistances to it well thats all i got for u

REPLY

Was this helpful? 7

I sincerely appreciate your responses, re: dialaudid. Quite obviously, I am very naive about these type subjects. The person's wife I was in reference did indeed pass several days after my query about potentially lethal dialuadid dosages. A hospice nurse that was also following the same thread noted that this same person (the husband) was applying his own doctoring as opposed to instructions he claimed were that of her physician. She noted that toward the end (which I missed), he removed all pain medications, causing her to die a horrifically painful death he described in minute detail as a series of Gran Mal seizures...gasping for air, ending with a (as he put it), a toothy smile on her face.

Apparently, a terminal illness in a family can result in a caregiver such as this husband becoming an absolute sicko...having no respect for his wife's privacy...even in her death. I find his acts as being respulsive, presuming he wasn't merely trying to dramatize events that never happened at onset.

REPLY

Was this helpful? 2

My doctor just changed me from Kadian(100mg-2x/day) to dilaudid #4 every 4 hours; it's just NOT enough!!!
I'm taking 2-3 #4's every two to three hours, considering more - am I killing myself? Even this does not give the same relief as the Kadian, which costs about $2,000.00 each month, my co-pay = $100.00. Any suggestions- PLEASE!

REPLY

Was this helpful? 5

Jerry, I am a chronic pain patient in NM. The medical board here told us that if our pain was being undertreated to report the physician to them for formal action. I had a go round with my pain Dr. in order to get appropriate pain relief. Currently I am on 8-16 Mg of Dilaudid q4hours along with 200 mcg Fentanyl patches that get changed every72 hours. This is bearly enough to allow me to stay out of bed and enjoy some time with my family. As for the original post. I would imagine that the patient in question was on narcotics for some amount of time. The siezures derscribed by her care giver sound more like withdrawal than cancer. Removing all pain meds probably killed her, I know it would me.

REPLY

Was this helpful? 5

Hello, I am curious if anyone know if Dilaudid causes edema (fluid swelling in the hands/feet/legs)? I just started taking it after 7 years of Actiq (Fentanyl) and then started swelling up in my hands and legs/feet. I can't find anything saying this is a side effect of the drug; however, it is noted that you shouldn't take this medicine if you have bladder or kidney problems-also, it states that a side effect if difficulty urinating and constipation. So I am in the dark. Anyone have an answer for me? Thank you! Kimkimby9

REPLY

Was this helpful? 2

Dilaudid is a seriosly misunderstood drug.It is the most effective pain CYCLE BREAKER I know of,however it is probably the worst maintenance pain killer.It's effectiveness decreases as the tolerance increases faster than any narcotic in the PDR.7mgs per hr is rediculus.168mgs of dilaudid [7mgs/per/hr]is equal to 840mgs of morphine but does not have the staying power of morphine.This just proves to me how stupid some Doctor's are or how much they are in collusion with drug company's.Morphine is the gold standard in pain releiver's and when a person exceeds 1to2 grains[64to128mgs] per day they should be detoxified w Methadone which is also an effective pain killer,then placed back on Morphine.To get back to the woman in pain,it sounds like she's worse off than dead being caught in that cycle of addiction.I'm not religious but I'd like to pray 4 her and the man taking care of her.He's not responsible 4 the massive dose of dilaudid the doctor is.

REPLY

Was this helpful? 1

I have ms,lupus and ra. I take morphine 30 mg tablets. 1 in the morning and 2 at night. I have dilaudid that I can take every 4-6 hours as needed for break through pain. Most of the time this has worked for me but sometimes not. My doctor has talked about sending me to a pain management clinic if I choose to do so. I have very caring doctors who take how I feel in consideration rather than either keeping me doped up all the time or in pain all the time. I also have tramadol that I can take during the day if I'm not in a whole lot of pain which is non-narcotic. I guess what I'm trying to say is that the best course of action is to find a doctor who listens to your concerns and what your needs are. I also forgot to put on here that I had thyroid cancer 3 years ago now. So my body has a lot of things going on and I have several different doctors but they're all at the same hospital and I have 1 doctor who prescribes my medications. If 1 of my doctors wants to change a medication they call my primary and let's him know and he writes the script for me. That way there's no confusion and less chance of having a problem with bad interactions of my meds. Finding caring doctors like mine is hard sometimes but its worth it to keep looking until you find the right doctor for you. Just because you see a specialist doesn't mean its the right doctor for you. I'm very blessed to have the group of doctors I have and I hope all of you having problems with your pain management will find the help you need. Being in pain is the worst part of any illness because you're focused on your pain instead of your life. And we all know that being in pain causes a lot of stress and stress makes you even sicker. Good luck to all and God bless. Sorry this was so long but thanks for reading.

REPLY

Was this helpful? 6

I take care of a stage IV breast cancer patient, with brain meds, who is left alone at times and has the ability to get out of bed on his own, he is tired and wants to go "home", I will not assist in this. I am concerned and would like to know if what he has available would be fatal if abused? 180mg IV and oral dillaudid, 600mg valium, 600 flexiril, and lortab 10's.

REPLY

Was this helpful? 1

kind euthenasia?

REPLY

Was this helpful? 0

My mom has stage 3 oral cancer that has moved quickly to her spinal cord and nerves in her head. Se is taking 13 mg/ml :per hour concentration. Her breakthrough is currently set to 16mg. Every thirty minutes as needed.

7mg lethal?? Doubt it

REPLY

Was this helpful? 2

POST #10
I hope this is not too late to reach this ONE nurse and I only pray the dear, very ill man this nurse speaks of (whom she should be reminded did NOT choose this illness nor unspeakable pain), is no longer suffering. I hope he has found a nurse whom is not more concerned with his or her own circumstances than of ANY patients she is tasked with seeing through their most sacred, personal, intimate, dehumanizing, terrifying journey to what should be a peaceful and painless death. I am facing terminal illness and deal with debilitating pain pretty much every minute of every day. The inability to shower one's self is dehumanizing, the complete and utter lack of control we as patients are left without is a failure of our society's ability to deal with death WELL, as we are all terminal, but we will not all die peacefully in our sleep. I understand you are conflicted with what you perceive this patient's wishes to be, but you are NOT able to truly understand what he is planning or wanting as I often say, on my most difficult of days, dear lord please take me now. Sometimes I mean it, sometimes I tell my spouse I am ready but I am NOT asking anyone to take my life. However I wish I had that choice, instead I will die an agonizing death because I do not want to die in a facility and I have hospice nurses that are healthy, with the same feelings as yourself. Don't you think it's fairly disgusting that I will bankrupt my family by running up hospital bills that exceed my Medicare limits? I am being sued but it is illegal for me to kill myself and yet I can't afford to die. I paid my taxes and worked for over two decades to find that I will have done it all for what? My dog was allowed a most kind, gentle and peaceful death as we had the ability to gather around him while HIS doctor sedated him and gave us time to cuddle w/him and love him as he drifted off to sleep where his cancer was NOT allowed to leave him trembling in pain in his own urine. We treat our animals w/more humanity than we do our sick and dying, where is our outrage that we cannot decide how our life ends when we are "ready"? When your lungs begin to fill with fluid and you will literally feel yourself drowning in your own fluids, the pressure crushing, the pain INTOLERABLE and the nurse can't give you enough medication for fear it may kill you, you may rethink your judgement. For now, I hope you will rethink your cases and leave such cases to nurses best equipped to show the terminally ill the unconditional compassion and right to mourn the loss of their life, the life they once knew, the life they dreamed of and planned for and to find a way to accept and deal with the unrelenting pain their disease has left them alone to bear. I for one pray for a merciful time where I too can gather my loved ones, have them comfort me while I am afforded the RIGHT drift off to sleep in a dignified and gentle manner to join my sweet and ever loyal dog. I pray you are afforded whatever choice you deem appropriate for yourself should this fate one day be your own (and I wish this on NO ONE). Until then, let's leave the judgement where it belongs and all pray that the same medicine that helps us live quality lives will one day, if necessary, help us have a quality death.

REPLY

Was this helpful? 18

I took lorcets. Because hydromorphone is a metabolite of lorcets, my Dr. thinks I took dalaudid. What is going on? I've never even seen a dalaudid.

REPLY

Was this helpful? 0

if I were to take 11 50 mg hydromorhophn pill would that constitute a fatal dose

REPLY

Was this helpful? 1

Is it possible for someone to take 1500 mg of dilaudid without over-dosing? Curious bc friend was on that amount for months. I thought that dosage was lethal. Worried about friend.

REPLY

Was this helpful? 2

no your not killing your self but the half life of dilaudid is somewhat short compared to mscotin I would try to explain to you doctor that morphine sulfate works better for you and is more cost effective than 4's

REPLY

Was this helpful? 1

My fiance admitted to me that while he was a nurse he and a Dr " helped" a woman die faster because she had pain. How often do nurses do that stuff

REPLY

Was this helpful? 4

Hydrocodone turns into hydromorphone in the liver.

REPLY

Was this helpful? 0

smoke a lot of cannabis with high levels of cbds in it for pain. also try cats claw as another erbal helper. I 2 was on kadian and others til put on dilaudid yrs ago, but I keep my consumption down as much as possible. im now on 8mg every 6hrs and I only get 50-60% pain benefit from it. im not wanting to take more so im trying other stuff always. I feel like a test tube now cause doctors r practicing on me and im havin to live thru it. hang in theyre and keep lookin outside the gov box. theyre not our friends at all. god bless.

REPLY

Was this helpful? 1

Re: Brynn (# 13)

You are so spot-on, I've been saying that my whole life as I watched my dad suffer and die of cancer... we have the mercy to put a dog down peacefully but not a human... dr. Kevorkian was the way to go

REPLY

Was this helpful? 0

Hi, I must comment on this discussion about Dilaudid. Unfortunately, I have suffered with chronic pain for over 25 years. During that time I have been on every known pain medication available.
I am presently under the care of a pain doctor and I live in New York. A few years ago a drug attic robbed a pharmacy in my area and killed the pharmacist and all the patients in the store . As a result New York and the insurance companies have begun to punish those patients with true pain syndromes from getting their necessary medication. Once a week I get a A letter from Aetna telling me that a dose of Dilaudid above 30mg a day is not effective and that he will start paying for it .This is completely unfair to patients they truly need it.. As many other readers have said unfortunately you build up a tolerance to all of these medications . I presently take 16 mg of Dialaudid every four or so hours. Up until eight months ago my pain doctor instructed me to make sure I took my pain medication on a regular basis to prevent my pain from becoming intolerable.So I have been doing that and now she has suddenly changed her and told me that I must less medication less often because the insurance company will no longer pay and the state is watching each dose we take. Having chronic pain is one of the worst things to live with . I recently was in the hospital for kidney stones. The pain was unbearable . I explained to the doctor that I was a chronic pain patient and presented him a letter from my pain doctor explaining the medication that I am prescribed.
The ER doctor says you're my wife oh my god this dose would kill an elephant! As you can imagine my wife became so alarmed . The doctor would give me no more than 1 mg of morphine as I was crying in pain. He didn't believe that the letter that I always carry with me and my wallet was legitimate and try calling my doctor at 1 AM. As is always the case my doctor was not on call and the doctor on call said I don't know the patient so I can't comment. So next 15 hours I screamed in pain until the stone moved. As you might expect I always have pain medication with me and the doctor scared my wife to such a point that she refused to give me any additional medicine.

I bring this up simply because as pain patients we go through hell every day. It's bad enough being in pain but for a doctor cannot believe you and for for the insurance companies are now decide if you're in pain or not because of the all mighty dollar is insane. You could be sure that if the CEO of Aetna wife had chronic pain this would never happen. I am so afraid that within the next few months make those is going to be cut and it will be completely out of my doctors hands because the state and the insurance companies are running the show.

Finally as pain patients everything is out of our control except the horrible pain that will rain every day. Are use tens unit, lidocaine patches, physical therapy, heating pad, you name it I've tried it and as a result my life is so miserable that I wish I could just die.

REPLY

Was this helpful? 0

I take 4mg 4 times a day and am also on a fentyal patch. They labeled my daiudid wrong once when I was on a dose of 3mg 4 times a day as need for pain to rake once every 3 hours. I was told if I had not listened to the doctor and followed what was written that I would have more than likely died the first night as that would have been way to much. So 7mg every hour seems wrong and fatal.

REPLY

Was this helpful? 0

My husband suffered from stage IV colon cancer with mets to liver and lungs. Morphine constipated him so severely that he spent hours everyday screaming in pain and discomfort, and the primary pain wasn't even alleviated. Dilaudid was the ONLY thing that worked. He took reasonable doses over the course of about a year, but by the time he was in the active dying process, he needed 16 mg/hr in order to maintain a MODERATE level of comfort. The doctor was in awe when lower doses didn't do the job, and even tried Morphine again, which just did not work for him. THANK GOD that this doctor was open-minded enough and had the compassion necessary to do WHATEVER it took to make my husband's passing a little less traumatic.

REPLY

Was this helpful? 0

JACK reply to post 35

Thank you for that post. I'm sorry you have such unrelenting pain.I too suffer from a similar condition and manage with about the same dosage as you. I'm a few years younger so my over riding concern is future pain relief without complete tolerance.Rarely do I hear the adminition to control the use of such potent narcotic containing pain meds so as to have some upward titration available in the days to come. Very well stated. Regards,

REPLY

Was this helpful? 0

Jo John
Yes that's fairly common once you become opiate tolerant the lethal dosage level is so tremendously high as to one cannot procure the amounts needed for this purpose. It's so sad chronic intractable pain patients almost always require some form of physiological support as a compendium therapy. So often professionals are oblivious to this fact.Many times secondary issues of substance abusers magnify this condition.I speak from painful experience . For those of you out there suffering help is available do not fear reaching out for assistance people truly do care.Just ask for help if they fail to hear you SCREAM OUT LOUD.Shame prevents so many of us from receiving the care that's currently available.Wishing you all the very best for a pain managed day...

REPLY

Was this helpful? 0

I've been on Dilaudid for a few years. Dilaudid only comes in 2mg, 4mg and 8mg. To do 7mg per hour she would have to do 3 pills of the 2mg then a half of a 2mg pill. Seems like a lot of work for her to take 7 mg per hour, why not just do the 8mg pill. I'm not sure what a lethal does would consist of, everyone is different. About 5 years ago I tried to take my life so I took 28 4mg dilaudid pills and around 60 50mg tramadol pills. Yes, I kind of passed out/fell asleep, woke up 6 hours later and I felt like a train hit me but I didn't die so I don't know what a lethal dose would be.

REPLY

Was this helpful? 0

7 mg an hour is too high of does you won't be able to comprehend anything I mean if your in hospice then ya by all means that's a good dose. But to get 3mg every two HR is more appropriate I've had alot of surgery on my stomach and waking up with big scars and staples I only received 2mg Q 4hrs it's a very strong opioate and I believe the strongest so the come off of it is hard as well as getting used to it will happen all in all just be careful

REPLY

Was this helpful? 0

My mother was a dialysis patient she hit her head after a fall and was given tramadol then dilaudid 5min in she coded coma and die. What went wrong.

REPLY

Was this helpful? 0

Dear Freiend- I have been on and off narcotic pain meds since I was hit head on in a high speed accident. My legs shattered and a foot reattached - plus multiple trauma injuries. Dosage should be considered when a patient has been on me medication for a long time- body weight and what other medications are on board. Kaduna is expensive- far too much for me- so EXALGO- E R dialysis has helped adequately. 16 mg every 12 hours and 4 mg dilaudid every 4 hours is what I take. This is not enough. I know you have built an immunity to narcotics- and I understand doo toes are not covering chronic pain adequately- I know. I live with it every day. You need to talk to your doctor- one suggestion: Switching opioids Helos. The body isn't familiar with the new drug and the neurotransmitters in the brain are not absorbing the drug so quickly- So try switching to a different drug and Tell your doctor that you cannot stand the Jain!!! I understand it- I wish you the best outcome for a horrific problem!

REPLY

Was this helpful? 0

I have a York is with cancer and can't afford to go to the vet. She weighs about 8 pounds and I have some 4 mg tabs ...

2 REPLIES

I was just changed from the best pain meds I have found in 12 years of chronic pain (Exalgo ER 16mg + 4mg x 4 for breakt...

9 REPLIES

I had a knee surgery yesterday. I have been using subutex to help me taper narcotics. I stopped the subutex 2 weeks befo...

95 REPLIES

Hi. I suffered a L1/L2 complete SCI injury some 4 years ago. After 6-7 weeks when the spinal shock wore off I noticed I ...

85 REPLIES

I am allergic to Vicodin and Percocet so for my last 2 surgical procedures have been prescribed 4mg oral Dilaudid. I und...

80 REPLIES

I would like to talk to anyone who has a pain pump with Dilaudid. My mother has a pain pump and I am worried she will be...

74 REPLIES

I am 19 weeks pregnant. I have been taking 2mg Dilaudid every four hours daily, which would be a total of 12mg in a 24hr...

61 REPLIES

my fiancée is on 25 mg of fentanyl she was on 12 mg of exalgo. what is the difference and what is stronger? the pai...

16 REPLIES

I am a 40 year old male.I have been taking 36mg of Dilaudid mixed with 120mg of Methadone,every day for 2 and 1/2 years....

16 REPLIES

my mother had a bypass which went well, she is now in a care facility due to a severe bed sore due to a hospital stay. t...

16 REPLIES