This sheet talks about using hydromorphone in a pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is hydromorphone?
Hydromorphone belongs to a group of medications called opioids. Opioids are sometimes called narcotics. Hydromorphone is used to treat pain. A brand name for hydromorphone is Dilaudid®. Hydromorphone can be given by injection and by mouth.
I am taking hydromorphone, but I would like to stop taking it before becoming pregnant. How long does it stay in my body?
People eliminate medications from their bodies at different rates. In healthy, non-pregnant adults, it takes up to 2 days for most of the hydromorphone to be gone from the body.
Will taking hydromorphone make it harder for me to get pregnant?*
It is not known if taking hydromorphone could make it harder to get pregnant.
I just found out I am pregnant. Should I stop taking hydromorphone?
Talk with your healthcare providers before making any changes to how you take your medication(s). If you have been taking hydromorphone regularly or have a dependency (also called opioid use disorder), you should not just stop suddenly (also called “cold turkey”). Stopping an opioid medication suddenly could cause you to go into withdrawal. More research is needed to know how going through withdrawal might affect a pregnancy. It is suggested that any reduction in hydromorphone be done slowly, and under the direction of your healthcare provider.
Can taking hydromorphone during my pregnancy increase the chance of miscarriage?
Miscarriage can occur in any pregnancy. There are no published studies looking at whether hydromorphone increases the chance of miscarriage. This does not mean there is an increased chance or that there is no increased chance, it only means that this question has not been answered.
Can taking hydromorphone increase the chance of having a baby with a birth defect?*
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Not every opioid medication has been studied on its own; therefore, we do not know if these medications increase the chance for birth defects or not. Some studies suggest that opioids as a general group might be associated with birth defects including heart defects and cleft lip and palate. However, these and other studies have not found a specific pattern of birth defects caused by opioids. Based on these studies, if there is an increased chance for birth defects with opioid use in pregnancy, it is likely to be small.
Could taking hydromorphone cause other pregnancy complications?*
Studies involving those who regularly use opioids during their pregnancy have found an increased chance for poor pregnancy outcomes such as poor growth of the baby, stillbirth, preterm delivery (birth before 37 weeks of pregnancy), and C-section. This is more commonly reported in those who are taking heroin or who are using opioids in higher doses or for longer than recommended by their healthcare provider. Use of an opioid close to the time of delivery can result in withdrawal symptoms in the baby (see the section below on neonatal abstinence syndrome.)
I need to take hydromorphone throughout my entire pregnancy. Will it cause withdrawal symptoms (neonatal abstinence syndrome) in my baby after birth?*
Studies have reported a chance for neonatal abstinence syndrome (NAS) with hydromorphone use towards the end of a pregnancy. Because there are only a few studies, it is not known if the chance is higher or lower than with other opioids.
NAS is the term used to describe withdrawal symptoms in newborns from medication that a person takes during pregnancy. For any opioid, symptoms can include difficulty breathing, extreme drowsiness (sleepiness), poor feeding, irritability, sweating, tremors, vomiting and diarrhea. Symptoms of NAS may appear at birth and may last more than two weeks. If needed, babies can be successfully treated for withdrawal while in the hospital. If you used hydromorphone in your pregnancy, it is important that your baby’s healthcare providers know to check for symptoms of NAS.
Will taking hydromorphone during pregnancy affect my child’s behavior or cause learning problems?*
There are not enough studies on hydromorphone to know whether there is a chance for long-term problems. Some studies on opioids as a general group have found more problems with learning and behavior in babies exposed to opioids for a long period of time during pregnancy. It is hard to tell if this is due to the medication exposure or other factors that may increase the chances of these problems.
What if I have been taking more hydromorphone than recommended by my healthcare provider?*
Studies have found that people who are pregnant and take opioids in higher doses or for longer than recommended by their healthcare providers (i.e. misuse or “abuse” opioids) have an increased chance for pregnancy problems. These include poor growth of the baby, stillbirth, preterm delivery, and C-section. Some people who misuse opioids also have other habits that can result in health problems for themselves and their pregnancy. For example, poor diet choices can lead to not having enough nutrients to support a healthy pregnancy and could increase the chance of miscarriage and preterm birth. Sharing needles to inject opioids increases the chance of getting diseases like hepatitis C and/or HIV, which can cross the placenta and infect the baby.
Can I breastfeed my baby if I am taking hydromorphone?*
While the amounts of hydromorphone that get into breast milk are very small, some babies might have problems with those small amounts. Use of some opioids in breastfeeding may cause babies to be very sleepy and have trouble latching on. Some opioids can cause trouble with breathing. If you are using any opioid, talk to your healthcare provider about how to use the least amount for the shortest time and how to monitor (watch) your baby for any signs of concern. Contact the baby’s healthcare provider immediately if your baby has any problems such as increased sleepiness (more than usual), trouble feeding, trouble breathing, or limpness. Be sure to talk to your healthcare provider about all your breastfeeding questions.
I take hydromorphone. Can it make it harder for me to get my partner pregnant or increase the chance of birth defects?*
There are no studies looking at possible risks to a pregnancy when a father or sperm donor takes hydromorphone. However, use or misuse of opioids in general has been shown to lower fertility in men. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.
* Section Updated November 2020
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OTIS/MotherToBaby recognizes that not all people identify as “men” or “women.” When using the term “mother,” we mean the source of the egg and/or uterus and by “father,” we mean the source of the sperm, regardless of the person’s gender identity.
