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Hydromorphone is more soluble than morphine and approximately eight times more active upon parenteral administration. High solubility permits a lower volume of injected fluid, which is important if multiple injections are needed. It begins to work faster than morphine, but lasts for a shorter amount of time. It has a high sedative effect and a lessened capability of causing euphoria. Hydromorphone is used the same way as morphine. Side effects are analogous. Synonyms for this drug are dilaudid and others.

Oxymorphone: Oxymorphone, 4,5-epoxy-3,14-dihydroxy-N-methyl-6-oxyomorphinane (3.1.26), is chemically similar to hydromorphone. It differs from hydromorphone in that it contains a hydroxyl group on C13. The drug is synthesized from thebaine (3.1.23), which during oxidation with hydrogen peroxide in formic acid changes into 14-hydroxycodeinone

(3.1.24). The double bond is then hydrogenated, transforming the compound into oxycodone

(3.1.25). It is demethylated by hydrogen bromide into oxymorphone [15,16].

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