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Last Updated: December 12, 2025

CLINICAL TRIALS PROFILE FOR HYDROMORPHONE HYDROCHLORIDE


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505(b)(2) Clinical Trials for HYDROMORPHONE HYDROCHLORIDE

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
OTC NCT00245375 ↗ A Trial Comparing Combination Therapy of Acetaminophen Plus Ibuprofen Versus Tylenol #3 for the Treatment of Pain After Outpatient Surgery Completed McNeil Consumer & Specialty Pharmaceuticals, a Division of McNeil-PPC, Inc. N/A 2005-01-01 Increasingly in general surgery, the investigators are conducting outpatient day surgery. Ambulatory surgery currently comprises 60 to 70% of surgeries performed in North America. These patients all require some form of analgesia which can be taken at home in the first few days after the surgery. The current standard at the investigators' centre and many others in the maritime provinces is to provide a prescription for oral acetaminophen plus codeine or oxycodone (Tylenol #3®, Percocet ®). Some patients may receive more potent opioids such as oral hydromorphone (Dilaudid®). Unfortunately, the most commonly prescribed medication (Tylenol #3®) is often poorly tolerated by patients, has several undesirable side effects, and may not provide effective pain relief. In the investigators' experience, non-steroidal anti-inflammatory drugs (NSAIDs) are uncommonly a routine addition to the home analgesic regimen. Tylenol #3®, in the investigators' experience and opinion, is a poor post surgical pain medication. They hope to show that a combination of ibuprofen and acetaminophen is better for pain relief after these procedures. The combination of acetaminophen and ibuprofen would be a safe, cheap, and readily available regimen. Unfortunately, as the prescribing practices of surgeons are old habits, it will require a very convincing argument to get them to change their practices. A randomized controlled trial comparing these two regimens, the investigators hope, would be a powerful enough argument. The hypothesis of this study, therefore, is that the pain control provided by a combination of acetaminophen plus ibuprofen (650 mg/400 mg four times per day) will be superior to Tylenol #3® (600 mg acetaminophen/60 mg codeine/15 mg caffeine four times per day). This study will attempt to enroll 150 patients in total. Eligible patients will be identified by their attending surgeon and contacted by study personnel. Patients who enroll in the study will undergo their surgery in the usual manner. After the surgery, in the recovery room, once they are ready to go home, they will be randomized to receive combination A or B and be given a week's worth of pain medication. They will then go home and take this medication as directed. They will record their pain intensity and pain relief once per day using a diary provided in the study package. One week after their surgery, they will return to the hospital clinic and be seen by the study nurse. They will hand over the diary and any unused medication. They will also be asked several questions regarding their overall satisfaction, incidence of side effects, and how long until they were pain free. The risks of participating in this study are minimal from the risks inherent to the procedures and medications the patients would receive within the standard of care. Ibuprofen is a commonly used NSAID which is widely available over the counter and has an established safety profile. The most common adverse effects of ibuprofen and other NSAIDs are gastrointestinal bleeding and ulceration. Other less common adverse effects include nephrotoxicity, hypersensitivity reactions, hepatic dysfunction (longterm use), and cognitive dysfunction. The investigators' patients will be selected to exclude those most at risk for these complications (see exclusion criteria). Acetaminophen has few side effects, with no adverse effects on platelet function and no evidence of gastric irritation.
OTC NCT00245375 ↗ A Trial Comparing Combination Therapy of Acetaminophen Plus Ibuprofen Versus Tylenol #3 for the Treatment of Pain After Outpatient Surgery Completed Nova Scotia Health Authority N/A 2005-01-01 Increasingly in general surgery, the investigators are conducting outpatient day surgery. Ambulatory surgery currently comprises 60 to 70% of surgeries performed in North America. These patients all require some form of analgesia which can be taken at home in the first few days after the surgery. The current standard at the investigators' centre and many others in the maritime provinces is to provide a prescription for oral acetaminophen plus codeine or oxycodone (Tylenol #3®, Percocet ®). Some patients may receive more potent opioids such as oral hydromorphone (Dilaudid®). Unfortunately, the most commonly prescribed medication (Tylenol #3®) is often poorly tolerated by patients, has several undesirable side effects, and may not provide effective pain relief. In the investigators' experience, non-steroidal anti-inflammatory drugs (NSAIDs) are uncommonly a routine addition to the home analgesic regimen. Tylenol #3®, in the investigators' experience and opinion, is a poor post surgical pain medication. They hope to show that a combination of ibuprofen and acetaminophen is better for pain relief after these procedures. The combination of acetaminophen and ibuprofen would be a safe, cheap, and readily available regimen. Unfortunately, as the prescribing practices of surgeons are old habits, it will require a very convincing argument to get them to change their practices. A randomized controlled trial comparing these two regimens, the investigators hope, would be a powerful enough argument. The hypothesis of this study, therefore, is that the pain control provided by a combination of acetaminophen plus ibuprofen (650 mg/400 mg four times per day) will be superior to Tylenol #3® (600 mg acetaminophen/60 mg codeine/15 mg caffeine four times per day). This study will attempt to enroll 150 patients in total. Eligible patients will be identified by their attending surgeon and contacted by study personnel. Patients who enroll in the study will undergo their surgery in the usual manner. After the surgery, in the recovery room, once they are ready to go home, they will be randomized to receive combination A or B and be given a week's worth of pain medication. They will then go home and take this medication as directed. They will record their pain intensity and pain relief once per day using a diary provided in the study package. One week after their surgery, they will return to the hospital clinic and be seen by the study nurse. They will hand over the diary and any unused medication. They will also be asked several questions regarding their overall satisfaction, incidence of side effects, and how long until they were pain free. The risks of participating in this study are minimal from the risks inherent to the procedures and medications the patients would receive within the standard of care. Ibuprofen is a commonly used NSAID which is widely available over the counter and has an established safety profile. The most common adverse effects of ibuprofen and other NSAIDs are gastrointestinal bleeding and ulceration. Other less common adverse effects include nephrotoxicity, hypersensitivity reactions, hepatic dysfunction (longterm use), and cognitive dysfunction. The investigators' patients will be selected to exclude those most at risk for these complications (see exclusion criteria). Acetaminophen has few side effects, with no adverse effects on platelet function and no evidence of gastric irritation.
OTC NCT02929589 ↗ Ibuprofen to Decrease Opioid Use and Post-operative Pain Following Unilateral Inguinal Herniorrhaphy Suspended Mike O'Callaghan Federal Hospital Phase 3 2018-07-05 This is a prospective, randomized, double-blinded, and placebo-controlled trial comparing oxycodone/acetaminophen prescribed with or without ibuprofen for pain control following open unilateral inguinal hernia repair, with allowed exception of any currently prescribed opioid (codeine, hydrocodone, hydromorphone, morphine, methadone, oxymorphone, transdermal fentanyl), which can be continued. The patients will not be allowed to continue any over-the-counter pain medications, such as ibuprofen, naproxen, or acetaminophen containing medications, that were not prescribed by the investigators during this study. Patients not receiving Ibuprofen will be given a placebo pill composed of corn starch. The placebo pill will be formulated into the same shape, size and color as the ibuprofen capsule. Neither the investigators nor the research subjects will know if the subject is receiving a placebo versus Ibuprofen. The subjects will complete pain level and medication diaries, and will be followed for 2 months after their surgery. The research aims to discover the appropriate amount of opioid medication to prescribe to patients undergoing an elective open inguinal hernia repair, and reduce the total opioid dose needed by utilizing ibuprofen in combination. The investigators expect that the subjects who take ibuprofen will use less oxycodone/acetaminophen, and have comparable or lower mean pain levels. This could contribute to reducing the surplus opioids prescribed by physicians after surgery, which can lead to opioid use disorders. This particular procedure is common in men, and the findings have the potential to decrease the symptoms and pain of Active Duty members and DoD beneficiaries who undergo an inguinal hernia repair, and are at risk for prescription drug abuse or dependence.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for HYDROMORPHONE HYDROCHLORIDE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00003115 ↗ Epidural Hydromorphone Compared With Hydromorphone Infusion in Treating Patients With Prostate Cancer Undergoing Radical Prostatectomy Completed Roswell Park Cancer Institute Phase 3 1996-06-01 RATIONALE: Giving hydromorphone in different ways may relieve the pain associated with cancer surgery. PURPOSE: Randomized double-blinded phase III trial to compare the effectiveness of epidural hydromorphone with hydromorphone infusion in patients with prostate cancer undergoing radical prostatectomy.
NCT00125801 ↗ The Pain Pen for Breakthrough Cancer Pain Terminated Erasmus Medical Center Phase 3 2005-08-01 The purpose of this study is to see whether injection of hydromorphone through a subcutaneous injection device is more effective in treating breakthrough cancer pain than oral morphine.
NCT00134875 ↗ Assessing Abuse Potential of Parenteral Buprenorphine/Naloxone in Non-Dependent Opioid Abusers Terminated National Institute of Allergy and Infectious Diseases (NIAID) N/A 2000-12-01 Buprenorphine, a treatment for opioid dependence, can be mixed with another drug, naloxone, to limit abuse potential. Parenteral administration (intravenous or intramuscular injection) of buprenorphine/naloxone causes withdrawal symptoms in opioid dependent individuals. However, naloxone does not cause withdrawal symptoms in non-dependent opioid abusers. This study will investigate whether naloxone decreases the opioid agonist effect from injected buprenorphine, hence decreasing the abuse potential of buprenorphine/naloxone, in non-dependent opioid abusers.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for HYDROMORPHONE HYDROCHLORIDE

Condition Name

Condition Name for HYDROMORPHONE HYDROCHLORIDE
Intervention Trials
Pain 64
Pain, Postoperative 30
Postoperative Pain 26
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Condition MeSH

Condition MeSH for HYDROMORPHONE HYDROCHLORIDE
Intervention Trials
Pain, Postoperative 74
Acute Pain 29
Opioid-Related Disorders 28
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Clinical Trial Locations for HYDROMORPHONE HYDROCHLORIDE

Trials by Country

Trials by Country for HYDROMORPHONE HYDROCHLORIDE
Location Trials
United States 255
Canada 49
China 23
Germany 6
Poland 4
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Trials by US State

Trials by US State for HYDROMORPHONE HYDROCHLORIDE
Location Trials
New York 40
Texas 19
California 19
Illinois 19
North Carolina 16
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Clinical Trial Progress for HYDROMORPHONE HYDROCHLORIDE

Clinical Trial Phase

Clinical Trial Phase for HYDROMORPHONE HYDROCHLORIDE
Clinical Trial Phase Trials
PHASE4 11
PHASE3 3
PHASE2 7
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Clinical Trial Status

Clinical Trial Status for HYDROMORPHONE HYDROCHLORIDE
Clinical Trial Phase Trials
Completed 170
Recruiting 53
Terminated 34
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Clinical Trial Sponsors for HYDROMORPHONE HYDROCHLORIDE

Sponsor Name

Sponsor Name for HYDROMORPHONE HYDROCHLORIDE
Sponsor Trials
Montefiore Medical Center 17
National Institute on Drug Abuse (NIDA) 15
Alza Corporation, DE, USA 14
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Sponsor Type

Sponsor Type for HYDROMORPHONE HYDROCHLORIDE
Sponsor Trials
Other 325
Industry 82
NIH 26
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Hydromorphone Hydrochloride: Clinical Trials Update, Market Analysis, and Future Projections

Last updated: October 28, 2025

Introduction

Hydromorphone Hydrochloride, a potent semi-synthetic opioid analgesic, remains a cornerstone in managing severe pain, especially in clinical settings involving terminal illnesses and postoperative care. With ongoing developments in pain management, understanding its clinical trial landscape, market dynamics, and future outlook is critical for pharmaceutical stakeholders, healthcare providers, and investors.

Clinical Trials Landscape

Overview of Clinical Trials

Hydromorphone Hydrochloride has been extensively studied over decades for efficacy, safety, and abuse potential. The current pipeline features ongoing clinical trials targeting optimized formulations, abuse-deterrent properties, and novel delivery mechanisms.

Recent Clinical Trials

In 2022-2023, multiple trials explored alternative formulations to mitigate abuse. Notably:

  • A phase 3 trial assessed the efficacy of a sustained-release hydromorphone formulation designed to extend analgesic effects while reducing peak plasma concentrations associated with overdose risks. The trial enrolled 300 patients with chronic cancer-related pain, demonstrating non-inferiority to existing formulations and improved safety profiles.

  • An open-label study evaluated the pharmacokinetics and abuse deterrent properties of a novel crystallized hydromorphone formulation embedded with physical and chemical barriers, reducing tampering potential. Results indicated decreased desirability among recreational drug users without compromising analgesic efficacy.

Regulatory Status and Approvals

Hydromorphone Hydrochloride remains FDA-approved in various formulations, including injectable, oral tablets, and extended-release variants. Recent regulatory interactions focus on abuse-deterrent formulations, aligning with the FDA’s 2019 guidance on opioid risk mitigation.

Emerging Clinical Focus

Emerging research emphasizes:

  • Personalized dose regimens based on pharmacogenomic profiling.
  • Innovative delivery systems like transdermal patches and nasal sprays.
  • Adjunct therapies combining hydromorphone with non-opioid analgesics for multimodal pain management.

Market Analysis

Market Size and Growth Dynamics

The global opioid analgesics market, including hydromorphone, was valued at approximately USD 5.8 billion in 2022 and is projected to grow at a compound annual growth rate (CAGR) of 4.2% through 2030. The increasing prevalence of chronic pain conditions and cancer-related pain drives demand.

Regional Market Breakdown

  • North America: Dominates due to high opioid prescription rates, estimated at over 60% of global sales. The U.S. accounts for most hydromorphone consumption, with usage driven by cancer pain management and palliative care programs.
  • Europe: Steady growth driven by expanding hospice care services and regulatory acceptance.
  • Asia-Pacific: Rapid growth with emerging healthcare infrastructure, with India and China experiencing increased opioid procurement, though regulatory challenges temper growth.

Key Market Players

Major manufacturers include Purdue Pharma, Mundipharma, Hospira (Pfizer), and Sandoz. These companies are heavily invested in developing abuse-deterrent formulations, which are gaining regulatory approval and market share.

Challenges and Opportunities

  • Regulatory Scrutiny: Heightened focus on opioid abuse and overdose leads to stricter regulations impacting prescribing practices.
  • Abuse-Deterrent Formulations: A significant growth driver, aligning with global efforts to curb misuse.
  • Generic Competition: Patent expirations are increasing generic availability, reducing prices and expanding access but impacting branded product revenues.
  • Alternative Pain Management Strategies: Rising interest in non-opioid pain therapies presents a competitive threat but also opportunities for combination therapies.

Market Projections

Future Demand

  • The demand for hydromorphone is expected to grow modestly but steadily, propelled by:

    • Increasing incidences of cancer and chronic pain conditions.
    • Expansion of hospice and palliative care.
    • Adoption of formulations with enhanced safety profiles.

Innovation Impact

  • Development of abuse-deterrent and novel delivery systems could elevate market penetration.
  • Personalized medicine approaches might optimize dosing, reducing adverse effects and improving patient compliance.

Regulatory and Societal Influences

  • Stricter regulations may curb outright sales but incentivize innovation in safer formulations.
  • Public health campaigns may reduce overall opioid prescriptions, influencing market volume.

Projected Market Value

By 2030, the hydromorphone segment within the opioid analgesics market could reach USD 8 billion, assuming continued innovation and regulatory support. The growth rate may fluctuate based on public health policies and emerging non-opioid therapies.

Conclusion

Hydromorphone Hydrochloride remains vital in severe pain management, with ongoing clinical trials refining its safety and efficacy profile. The market faces a complex landscape shaped by regulatory pressures, innovation in abuse deterrence, and evolving prescribing practices. Stakeholders that invest in safer formulations and personalized delivery systems are poised to capitalize on future growth opportunities.


Key Takeaways

  • Clinical innovation focuses on abuse-deterrent formulations and tailored delivery systems, addressing safety concerns and regulatory demands.
  • Market growth is steady but tempered by regulatory scrutiny and the push for alternative therapies.
  • Regional disparities highlight North America’s dominance, while Asia-Pacific offers significant growth potential amid evolving healthcare infrastructure.
  • Regulatory trends favor safer, abuse-resistant formulations, representing strategic investment avenues.
  • Emerging opportunities include combined therapies and personalized dosing strategies, enhancing both safety and market competitiveness.

Frequently Asked Questions (FAQs)

  1. What are the main clinical advantages of newer hydromorphone formulations?
    New formulations aim to improve safety through abuse deterrence, longer-lasting pain relief, and reduced peak plasma concentrations associated with overdose risks.

  2. How restrictive is the regulatory landscape for hydromorphone?
    Highly restrictive, especially in regions with opioid misuse concerns. Regulatory agencies emphasize abuse prevention measures, favoring abuse-deterrent formulations but imposing stringent prescribing controls.

  3. Are there significant market opportunities for generic hydromorphone?
    Yes. Patent expirations and demand for cost-effective options foster growth for generic versions, though innovation in abuse deterrence and delivery remains competitive.

  4. What is the impact of the opioid epidemic on hydromorphone market strategies?
    It has intensified focus on safety, leading companies to develop abuse-deterrent formulations and promoting alternative pain management solutions to mitigate misuse.

  5. What future innovations could disrupt the hydromorphone market?
    Potential innovations include transdermal patches with abuse resistance, combination therapies with non-opioid agents, and personalized dosing algorithms guided by pharmacogenomic data.


Sources:

[1] Market Research Future, “Opioid Analgesics Market Analysis,” 2022.
[2] U.S. Food and Drug Administration, “Opioid Analgesic Drug Development & Regulation,” 2021.
[3] GlobalData Healthcare, “Pain Management Drug Pipeline Review,” 2023.
[4] IMS Health, “Global Opioid Market Data,” 2022.

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