Dilaudid is commonly used in the hospital setting, mostly intravenously because its bioavailability is very low orally, rectally, and intranasally. It is administered under the tongue than to swallowing for bioavailability and effects. Hydromorphone is bitter and hydrophilic like most opiates, not lipophilic, so it is absorbed poorly and slowly through mouth membranes. Dilaudid is used to treat both acute and chronic severe pain. Also used for labor pain and pain due to myocardial infarction.