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Hydromorphone is a prescription opioid analgesic used to manage moderate to severe pain when other treatments are ineffective. It must be prescribed by a licensed healthcare provider following a thorough medical evaluation and used exactly as directed. For immediate-release oral hydromorphone, typical starting doses are 2–4 mg every 4–6 hours as needed for pain, with careful adjustments based on response and tolerance. Lower doses are recommended for older adults or those with kidney or liver impairment. Avoid alcohol and other sedatives, and use the lowest effective dose under close medical supervision.