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DF is a brand name for Dihydrocodeine. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: For the relief of severe and chronic pain Dihydrocodeine Tablets are indicated in all painful conditions where an alert patient is desired, e.g. sciatica, osteo-arthritis, chronic rheumatoid arthritis, arthritis of the spine, peripheral vascular disease, post-herpetic neuralgia, Paget’s disease, malignant disease,…
Verbatim from this product's MHRA label. Tap a section to expand.
4). Route of Administration Oral DF118 tablets should be administered with or after food. Adults and elderly and children over 12 years One or two tablets three times daily. The maximum daily dose is 240mg. Children under 12 years Not recommended.
• Skin disorders; rash, urticaria, pruritus, sweating. • Central and peripheral nervous system disorders; paraesthesia, dizziness, headache, vertigo, respiratory depression. Muscle rigidity has been reported after high doses. • Vision disorders; visual disturbances, miosis.
4) • Gastro-intestinal system disorders; dry mouth, nausea, vomiting, abdominal pain, constipation. • Liver and biliary system disorders; biliary spasm which may be associated with alterations in liver enzyme values. • Cardiovascular disorders general; hypotension.
• Heart rate and rhythm disorders; bradycardia, tachycardia, palpitations. • Vascular (extracardiac) disorders; facial flushing. • Urinary systems disorders; Micturition may be difficult and there may be ureteric spasm. • Body as a whole, general; oedema.
• General disorders and administration site conditions: Uncommon: Drug withdrawal syndrome • Regular prolonged use of dihydrocodeine is known to lead to addiction and tolerance. Symptoms of restlessness and irritability may result when treatment is then stopped.
• Prolonged use of a painkiller for headaches can make them worse. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.
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As dihydrocodeine may cause the release of histamine it should be given with caution to patients with asthma and decreased respiratory reserve. Avoid use during an acute asthma attack. Dihydrocodeine should be avoided, or the dose reduced in patients with hepatic or renal impairment Dihydrocodeine should be given in reduced doses or with caution to; debilitated patients, adrenocortical insufficiency, prostatic hyperplasia, urethral stricture, hypotension, shock, inflammatory or obstructive bowel disorders, hypothyroidism or convulsive disorders.
However, these conditions should not necessarily be a deterrent to use in palliative care. Use in caution in those with a history of drug abuse. Alcohol should be avoided whilst under treatment with dihydrocodeine. The risk-benefit of continued use should be assessed regularly by the prescriber.
Risk from concomitant use of sedative medicines such as benzodiazepines or related drugs: Concomitant use of Dihydrocodeine Tartrate 40mg Tablets and sedative medicines such as benzodiazepines or related drugs may result in sedation, respiratory depression, coma and death.
Because of these risks, concomitant prescribing with these sedative medicines should be reserved for patients for whom alternative treatment options are not possible. If a decision is made to prescribe Dihydrocodeine Tartrate 40mg Tablets concomitantly with sedative medicines, the lowest effective dose should be used, and the duration of treatment should be as short as possible.
The patients should be followed closely for signs and symptoms of respiratory depression and sedation. 5). Drug dependence, tolerance and potential for abuse For all patients, prolonged use of this product may lead to drug dependence (addiction), even at therapeutic doses.
, major depression). Additional support and monitoring may be necessary when prescribing for patients at risk of opioid misuse. A comprehensive patient history should be taken to document concomitant medications, including over- the-counter medicines and medicines obtained on-line, and past and present medical and psychiatric conditions.
• Hypersensitivity to any of the products ingredients. • Acute respiratory depression or Chronic Obstructive Airways Disease. • Asthma attack. • Acute alcoholism. • Biliary colic. • Head injuries or increased intracranial pressure. • Heart failure secondary to lung disease.
• Concurrent use with Monoamine Oxidase Inhibitors (including moclobemide), or within two weeks of their withdrawal. • Risk of paralytic ileus. • Phaeochromocytoma.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Patients may find that treatment is less effective with chronic use and express a need to increase the dose to obtain the same level of pain control as initially experienced. Patients may also supplement their treatment with additional pain relievers.
These could be signs that the patient is developing tolerance. The risks of developing tolerance should be explained to the patient. Overuse or misuse may result in overdose and/or death. It is important that patients only use medicines that are prescribed for them at the dose they have been prescribed and do not give this medicine to anyone else.
Patients should be closely monitored for signs of misuse, abuse, or addiction. The clinical need for analgesic treatment should be reviewed regularly. Drug withdrawal syndrome Prior to starting treatment with any opioids, a discussion should be held with patients to put in place a withdrawal strategy for ending treatment with DF118 FORTE.
Drug withdrawal syndrome may occur upon abrupt cessation of therapy or dose reduction. When a patient no longer requires therapy, it is advisable to taper the dose gradually to minimise symptoms of withdrawal. Tapering from a high dose may take weeks to months.
The opioid drug withdrawal syndrome is characterised by some or all of the following: restlessness, lacrimation, rhinorrhoea, yawning, perspiration, chills, myalgia, mydriasis and palpitations. Other symptoms may also develop including irritability, agitation, anxiety, hyperkinesia, tremor, weakness, insomnia, anorexia, abdominal cramps, nausea, vomiting, diarrhoea, increased blood pressure, increased respiratory rate or heart rate.
If women take this drug during pregnancy, there is a risk that their newborn infants will experience neonatal withdrawal syndrome. Hyperalgesia Hyperalgesia may be diagnosed if the patient on long-term opioid therapy presents with increased pain.
This might be qualitatively and anatomically distinct from pain related to disease progression or to breakthrough pain resulting from development of opioid tolerance. Pain associated with hyperalgesia tends to be more diffuse than the pre-existing pain and less defined in quality.
Symptoms of hyperalgesia may resolve with a reduction of opioid dose.