Which opioid is primarily given IV and PO and has an onset of 5 minutes and peaks in 5-15 minutes; duration greater than 5 hours?

• A. Morphine sulfate
• B. Fentanyl
• C. Dilaudid (Hydromorphone)
• D. Meperidine

Answer: (C)

When evaluating opioids for both IV and oral use, consider how fast they act (onset), how quickly they reach peak effect (time to peak), and how long the effect lasts (duration) across routes. Hydromorphone fits best here because it is commonly given by both IV and oral routes and provides rapid analgesia with a fairly long duration. After an IV dose, pain relief typically begins within a few minutes and peaks within a short hour, and the overall analgesic effect often lasts beyond five hours, especially with oral dosing. This combination of rapid onset with sustained duration and dual-route availability makes hydromorphone the best match for a drug that is effectively used IV and PO with the described timing.

In contrast, fentanyl has an even faster onset but a much shorter duration and is not reliably used orally due to poor oral bioavailability. Morphine can be given IV and PO and has a decent onset time, but its duration is usually around 3–5 hours, not clearly over five hours. Meperidine is less favored clinically for sustained analgesia due to safety concerns and a different pharmacologic profile.