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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: As an analgesic for the relief of moderate to severe pain. Dihydrocodeine Tablets 30mg are indicated in all painful conditions where an alert patient is desired, eg sciatica, osteo-arthritis, chronic rheumatoid arthritis, arthritis of the spine, peripheral vascular disease, post-herpetic neuralgia, Paget’s disease,…
Verbatim from this product's MHRA label. Tap a section to expand.
Posology Adults and children over 12 years:
One tablet every 4-6 hours or as recommended by the prescriber. Maximum dose in 24 hours 180mg (6 tablets).
Elderly:
Dosage should be reduced in the elderly. See also sub-section
The adverse drug reactions listed below are classified by system organ class according to their frequency using the following convention: very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<1/10,000), not known (cannot be estimated from the available data).
4) Nervous system disorders Somnolence Convulsions, dizziness, headache, paraesthesia, sedation , vertigo, respiratory depression. Muscle rigidity has been reported after high doses, sleep apnoea syndrome Eye disorders Blurred vision , miosis Cardiac disorders Bradycardia, tachycardia, palpitations Vascular disorders Hypotension, flushing , syncope, Respiratory, thoracic and mediastinal disorders Dyspnoea, respiratory depression Gastrointestinal disorders Abdominal pain, constipation, dry mouth, nausea, vomiting Diarrhoea, paralytic ileus Hepatobiliary disorders Biliary colic, hepatic enzymes increased sphincter of Oddi dysfunction Renal and urinary disorders Urinary retention, ureteric spasm Micturition may be difficult and there may be ureteric spasm Reproductive system and breast disorders Decreased libido General disorders and administration site conditions Drug withdrawal Syndrome, Asthenia, fatigue, malaise, drug tolerance Oedema, Drug withdrawal Syndrome neonatal Ear and labyrinth disorders Vertigo 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. Drug dependence Repeated use of Dihydrocodeine Tablets BP 30 mg , can lead to drug dependence, even at therapeutic doses.
4). 6). 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.
4 Special warnings and special precautions for use.
Paediatric population:
Not recommended for children under 12 years old. The analgesic effect of this product is not materially enhanced by increasing the above dose: in severe cases the interval between doses should be reduced to obtain the requisite analgesic effect.
4). Method of administration For oral use. It is recommended that this product should be taken during or after food. Treatment goals and discontinuation Before initiating treatment with Dihydrocodeine Tablets BP 30 mg , a treatment strategy including treatment duration and treatment goals, and a plan for end of the treatment, should be agreed together with the patient, in accordance with pain management guidelines.
During treatment, there should be frequent contact between the physician and the patient to evaluate the need for continued treatment, consider discontinuation and to adjust dosages if needed. When a patient no longer requires therapy with codeine, it may be advisable to taper the dose gradually to prevent symptoms of withdrawal.
4). Duration of treatment The duration of treatment should be as short as possible, and if no effective pain relief is achieved the patients/carers should be advised to seek the views of a physician. 1 • Respiratory depression • Obstructive airways disease • Risk of paralytic ileus.
• Head injuries or conditions in which intracranial pressure is raised • Acute alcoholism • As dihydrocodeine may cause the release of histamine, it should not be given during an asthma attack. 4 Special warnings and precautions for use Tolerance and opioid use disorder (abuse and dependence) Tolerance, physical and psychological dependence, and opioid use disorder (OUD) may develop upon repeated administration of opioids such as [product name].
Repeated use of [product name] can lead to OUD. A higher dose and longer duration of opioid treatment can increase the risk of developing OUD. Abuse or intentional misuse of [product name] may result in overdose and/or death. g. major depression, anxiety and personality disorders).
1 • Respiratory depression • Obstructive airways disease • Risk of paralytic ileus. • Head injuries or conditions in which intracranial pressure is raised • Acute alcoholism • As dihydrocodeine may cause the release of histamine, it should not be given during an asthma attack.
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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The patient should be made aware of the risks and signs of OUD as set out in the package leaflet. If these signs occur, patients should contact their physician. For patients who experience signs and symptoms of OUD, and/or exibit drug seeking behaviours, review of concomitant opioids and psycho-active drugs (like benzodiazepines) and consultation with an addiction specialist may be required.
”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 Tablets 30mg. 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 As with other opioids, in case of insufficient pain control in response to an increased dose of codeine, the possibility of opioid-induced hyperalgesia should be considered.
A dose reduction or treatment review may be indicated. Dihydrocodeine should be given in reduced doses or 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 elderly patients, debilitated patients, adrenocortical insufficiency, prostatic hyperplasia, urethral stricture, hypotension, shock, inflammatory or obstructive bowel disorders, hypothyroidism or convulsive disorders, reduced level of consciousness of uncertain origin, biliary tract disorders, pancreatitis, constipation, cor pulmonale.
However, these conditions should not necessarily be a deterrent to use in palliative care. Alcohol should be avoided whilst under treatment with dihydrocodeine. Opioids may cause sleep-related breathing disorders including central sleep apnoea (CSA) and sleep-related hypoxemia.
Opioid use may increase the risk of CSA in a dose-dependent manner in some patients. 8). In patients who present with CSA, consider decreasing the total opioid dosage. Hepatobiliary disorders Codeine may cause dysfunction and spasm […]