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DIHYDROCODEINE is a brand name for Dihydrocodeine. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Dihydrocodeine is used to relieve moderate to severe pain.
Verbatim from this product's MHRA label. Tap a section to expand.
Posology Adults: 1 tablet (30mg) every four to six hours or at the discretion of the physician. 5 to 1mg/kg bodyweight every four to six hours.
Children under 4 years:
Not recommended Chronic hepatic disease: The dosage should be reduced Moderate to severe renal impairment: The dosage should be reduced For concomitant illnesses/conditions where dose reduction may be appropriate see
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.
Tolerance and some of the most common side effects – drowsiness, nausea, and vomiting, and confusion – generally develops with long term use. Immune system disorders: maculopapular rash has been seen as part of a hypersensitivity syndrome associated with oral codeine phosphate; fever, splenomegaly and lymphadenopathy also occurred.
Endocrine disorders: hyperglycaemia Metabolism and nutrition disorders: anorexia. 4) Nervous System disorders: convulsions (especially in infants and children), dizziness, drowsiness, headache, (prolonged use of a painkiller for headaches can make them worse).
Raised intracranial pressure may occur in some patients. Eye disorders: blurred or double vision or other changes in vision. Miosis. Ear and labyrinth disorders: vertigo. Cardiac disorders: tachycardia, palpitations and bradycardia. Vascular disorders: postural hypotension, facial flushing.
Large doses produce hypotension.
Respiratory, thoracic and mediastinal disorders:
Dyspnoea. Larger doses produce respiratory depression. Gastrointestinal disorders: nausea, vomiting, constipation, dry mouth, stomach cramps, pancreatitis.
Hepatobiliary disorders:
Biliary spasm (may be associated with altered liver enzyme values). Skin and subcutaneous tissue disorders: allergic reactions, such as skin rash, pruritus, urticaria, sweating, facial oedema.
Musculoskeletal and connective tissue disorders:
4). Method of administration For oral use. 3 Contraindications Acute respiratory depression. Obstructive airways disease Known hypersensitivity to dihydrocodeine, or other opioid analgesics, or to any of the excipients Acute alcoholism Severe hepatic dysfunction Head injury or raised intracranial pressure (in addition to the risk of respiratory depression and increased intracranial pressure, may affect papillary and other responses vital for neurological assessment).
Children under 4 years of age. Dihydrocodeine should not be given to comatose patients. g. pseudomembranous colitis) or diarrhoea caused by poisoning. 4 Special warnings and precautions for use Dihydrocodeine should be given in reduced doses or with caution to patients with asthma and decreased respiratory reserve.
3 Contraindication). 2 Posology) and in patients with adrenocortical insufficiency, prostatic hyperplasia, urethral stricture, hypotension, shock, inflammatory or obstructive bowel disorders, myasthenia gravis, hypothyroidism or convulsive disorders.
It should be avoided or the dose reduced in patients with hepatic or renal impairment. 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. Opioid analgesics should be avoided in patients with biliary tract disorders or used in conjunction with an antispasmodic.
Administration of pethidine and possibly other opioid analgesics to patients taking a monoamine oxidase inhibitor (MAOI) has been associated with very severe and sometimes fatal reactions. 5). Alcohol should be avoided whilst under treatment with dihydrocodeine.
The risk-benefit of continued use should be assessed regularly by the prescriber. Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Acute respiratory depression. Obstructive airways disease Known hypersensitivity to dihydrocodeine, or other opioid analgesics, or to any of the excipients Acute alcoholism Severe hepatic dysfunction Head injury or raised intracranial pressure (in addition to the risk of respiratory depression and increased intracranial pressure, may affect papillary and other responses vital for neurological assessment).
Children under 4 years of age. Dihydrocodeine should not be given to comatose patients. g. pseudomembranous colitis) or diarrhoea caused by poisoning.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
Other brands of Dihydrocodeine in United Kingdom.
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Uncontrolled muscle movements. Muscle rigidity may occur after high doses. Renal and urinary disorders: urinary retention, difficulty with micturition, ureteric spasm, dysuria. An antidiuretic effect may also occur with codeine. Reproductive system and breast disorders: sexual dysfunction, erectile dysfunction, decreased potency.
Decreased libido. General disorders and administration site conditions: malaise, tiredness, hypothermia, drug withdrawal syndrome. Dose-related increased post-operative pain has been reported following dental surgery. 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. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple app store.
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. 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 dihydrocodeine.
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.