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Dilaudid (Hydromorphone) Withdrawal Timeline

Published by Joseph, EditorCompiled from cited sources · not yet medically reviewedUpdated 8 sources

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Need help now? SAMHSA’s National Helpline is free, confidential and open 24/7 in English and Spanish: 1-800-662-4357. In a mental health crisis, call or text 988. In an emergency, call 911.

For information only, not medical advice. Talk to a doctor before stopping or changing any medication. Medical disclaimer

⚠ Medical warning

Don’t go through opioid withdrawal alone. It is very hard to get through, and the biggest danger comes afterward: once your tolerance drops, using your old amount can cause a fatal overdose. Get medical help to stop. Medicines such as buprenorphine and methadone work. Call SAMHSA at 1-800-662-4357, or 911 in an emergency. If the opioid is prescribed, don’t stop it suddenly: ask your prescriber about a taper.

Quick answer

Dilaudid (hydromorphone) is a short-acting opioid (IV half-life about 2.3 hours), so withdrawal usually starts within the first day after the last dose. MedlinePlus lists restlessness, teary eyes, runny nose, yawning, sweating, chills, muscle and joint pain, stomach cramps, nausea, vomiting, diarrhea, insomnia and a fast heartbeat. The FDA label warns that rapid reduction or abrupt discontinuation has resulted in serious withdrawal symptoms, uncontrolled pain and suicide. The biggest danger afterward is overdose if you use again after your tolerance drops.

Dilaudid withdrawal timeline at a glance

When did you last use or take it?

⚠ Medical warning (read before using this)

Don’t go through opioid withdrawal alone. It is very hard to get through, and the biggest danger comes afterward: once your tolerance drops, using your old amount can cause a fatal overdose. Get medical help to stop. Medicines such as buprenorphine and methadone work. Call SAMHSA at 1-800-662-4357, or 911 in an emergency. If the opioid is prescribed, don’t stop it suddenly: ask your prescriber about a taper.

This places the typical ranges from this article's sources on your date. It is not a prediction or a diagnosis, and being past a phase does not mean symptoms or risks are over.

A rough guide from published sources, not medical advice. Everyone is different.

PhaseWhenWhat you may feelSeverityRed flags
Early withdrawal8 to 24 hours after last useWatery eyes, runny nose; Sweating, yawning; Restlessness, anxiety, insomnia; Muscle achesModerate—
Fully developed withdrawal1 to 3 days after last useDilated pupils, goosebumps; Stomach cramps, nausea, vomiting, diarrhea; Muscle twitching, joint and muscle pain; Fast heart rate, higher blood pressureSevereVomiting or diarrhea you can’t keep up with, or signs of dehydration (dizziness, very little urine); Thoughts of suicide or self-harm: call or text 988 now
EasingDay 4 to day 10 (total acute withdrawal often 7 to 10 days)Physical symptoms gradually fade; Tiredness, poor sleepModerateSigns of overdose (slow or stopped breathing, can’t wake up, blue lips): call 911 and use naloxone if you have it
Protracted phaseWeeks to monthsLow mood (dysphoria); Cravings; Insomnia; Increased sensitivity to painModerateSigns of overdose (slow or stopped breathing, can’t wake up, blue lips): call 911 and use naloxone if you have it; Thoughts of suicide or self-harm: call or text 988 now

Print a daily symptom log for this timeline · My quit tracker

Symptoms, phase by phase

SAMHSA’s TIP 63 describes opioid withdrawal in stages. Early signs are watery eyes, runny nose, sweating, yawning, restlessness and insomnia, followed by dilated pupils, goosebumps, muscle twitching and aches. Fully developed withdrawal adds fast heart rate, high blood pressure, fever, nausea, vomiting, diarrhea and extreme restlessness. TIP 63 says it feels like gastroenteritis, severe flu, anxiety and dysphoria all at once. MedlinePlus calls the symptoms very uncomfortable but usually not life-threatening on their own. Complications such as dehydration and breathing vomit into the lungs can be serious, and the biggest risk is overdose after withdrawal, because tolerance drops. The Dilaudid label lists common withdrawal symptoms as restlessness, tearing, runny nose, yawning, sweating, chills, muscle aches and dilated pupils, and says that if symptoms arise during a taper, it may be necessary to pause the taper or return to the previous dose before going slower.

Early withdrawal: 8 to 24 hours after last use

  • Watery eyes, runny nose
  • Sweating, yawning
  • Restlessness, anxiety, insomnia
  • Muscle aches

Fully developed withdrawal: 1 to 3 days after last use

  • Dilated pupils, goosebumps
  • Stomach cramps, nausea, vomiting, diarrhea
  • Muscle twitching, joint and muscle pain
  • Fast heart rate, higher blood pressure

Easing: Day 4 to day 10 (total acute withdrawal often 7 to 10 days)

  • Physical symptoms gradually fade
  • Tiredness, poor sleep

Protracted phase: Weeks to months

  • Low mood (dysphoria)
  • Cravings
  • Insomnia
  • Increased sensitivity to pain

What makes withdrawal longer or shorter

  • How long and how much. The FDA label says physical dependence may not become clinically significant until after several days to weeks of continued use, and SAMHSA’s TIP 63 says the severity of withdrawal reflects how physically dependent you are.
  • Short- vs long-acting. Short-acting opioids usually cause withdrawal sooner than extended-release forms or methadone.
  • Medication support. MedlinePlus says methadone and buprenorphine relieve withdrawal symptoms, and the FDA label for lofexidine (Lucemyra) says it is approved to ease opioid withdrawal symptoms in adults stopping opioids abruptly.

When to see a doctor or get help now

  • Before you stop: medicines (buprenorphine, methadone, and the non-opioid lofexidine for withdrawal symptoms) make withdrawal safer and more bearable.
  • Get urgent care for vomiting or diarrhea you can’t keep up with, or signs of dehydration.
  • Call 911 for any overdose signs. If you return to use after withdrawal, even a smaller amount than before can be fatal.
  • Call or text 988 for thoughts of suicide.

Not sure where to start? Call SAMHSA’s free, confidential helpline at 1-800-662-4357, 24/7. See Get Help.

Tapering

The FDA label says not to rapidly reduce or abruptly stop the medicine in someone who may be physically dependent, because this has caused serious withdrawal, uncontrolled pain and suicide. We don’t publish dose-by-dose schedules. Your prescriber should set your plan, and adjust it if symptoms appear.

Tips for getting through it

  • Get medical help and ask about buprenorphine or methadone
  • Keep naloxone (Narcan) on hand and tell someone where it is
  • Drink enough fluids and eat several small meals, as NSW Health’s opioid withdrawal guidance advises; skip alcohol and go easy on caffeine
  • Never use alone, and know that tolerance drops fast after withdrawal
  • Find treatment at FindTreatment.gov or call SAMHSA at 1-800-662-4357

Frequently asked questions

How long does Dilaudid withdrawal last?

Acute withdrawal from short-acting opioids often lasts 7 to 10 days, with low mood, sleep problems and cravings sometimes lasting weeks to months.

When does Dilaudid withdrawal start?

Usually within the first day after the last dose, since it’s short-acting.

Can I taper Dilaudid myself?

Don’t. The label warns rapid tapers can cause serious withdrawal and suicide. Your prescriber can plan a gradual, monitored taper or offer buprenorphine or methadone.

Next steps

Talk to others going through it. Share your experience or ask questions on the Opioids & Kratom board in our community forum. Planning to stop? See the Tapering & Talking to Your Doctor board, and talk to a doctor before you stop. Forum posts are personal experiences, not medical advice. Please read the community guidelines.

Sources

  1. FDA label: Dilaudid (hydromorphone) tablets and oral solution (DailyMed)
  2. MedlinePlus: Hydromorphone
  3. SAMHSA: TIP 63, Medications for Opioid Use Disorder (updated 2021), Exhibit 2.10
  4. MedlinePlus (U.S. National Library of Medicine): Opiate and opioid withdrawal
  5. StatPearls: Opioid Withdrawal (NCBI Bookshelf)
  6. SAMHSA National Helpline
  7. NSW Health: NSW Clinical Guidelines: Treatment of Opioid Dependence, abbreviated version (2018)
  8. FDA label: Lucemyra (lofexidine) tablets (DailyMed)

Last reviewed: October 25, 2026. Researched and written by Withdrawal Timelines from the cited sources. This article has not yet been reviewed by a medical professional. See How We Review and our Medical Disclaimer. This is general information, not medical advice.

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