Dihydrocodeine

Dihydrocodeine

Dihydrocodeine is known as a synthetic opioid analgesic that is used to relieve moderate to severe pain. Opioids are sometimes referred to as narcotics and this group includes codeine and morphine. More information

A doctor will review your order and write you a prescription, if appropriate. This prescription is then forwarded to a pharmacy. The pharmacy will have your medicine delivered to you within one to three working days. Read more about this process here.

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Patient Leaflet(s)

Dihydrocodeine is a strong painkiller that belongs to the opioid group of medicines. It is used to treat moderate to severe pain, including post-operative pain. It is also sometimes used as a cough suppressant. This medicine is similar to codeine and is a derivative of codeine. But each is used for different purposes. Dihydrocodeine was developed in the early 1900s in Germany as a solution for an effective cough medicine to help prevent the spread of tuberculosis, pertussis and pneumonia, which were common during this era. It was first marketed in 1911 and approved for use as a medicine in 1948. 

What is Dihydrocodeine? 

Dihydrocodeine is known as a synthetic opioid analgesic that is used to relieve moderate to severe pain. Opioids are sometimes referred to as narcotics and this group includes codeine and morphine. Dihydrocodeine is stronger than codeine and can be addictive if taken for long periods. It is not as strong as morphine. Dihydrocodeine comes in the form of a flat, white tablet, capsules or an oral solution. The main active ingredient is dihydrocodeine tartrate. Dihydrocodeine is an analgesic. Analgesics are pain relievers. Dihydrocodeine works on the central nervous system (CNS) by blocking or reducing pain signals to the brain. Although the pain is still there feels less severe when taking this medicine. This is because the dihydrocodeine links to the body’s opioid receptors and activates them, so reducing the perception of pain.The liver metabolises dihydrocodeine into dihydromorphine which gives pain relief. This procedure works at a different pace for different people.  

When is Dihydrocodeine used? 

Dihydrocodeine is often used when other pain relievers (for example Paracetamol or Ibuprofen) are not effective or cannot be taken. 

This product is used to treat pain such as: 

  • Dental pain 
  • Muscular pain 
  • Migraines 
  • Backache 
  • Menstrual pain 
  • Nerve pain 
  • Joint pain 
  • Osteoarthritis 
  • Chronic rheumatoid arthritis  
  • Arthritis of the spine 
  • Peripheral vascular disease 
  • Post-herpetic neuralgia 
  • Pain caused by serious illness 
  • Pain caused by the flu 

Dihydrocodeine works rapidly, usually in less than 30 minutes and can provide pain relief for up to 4 hours. This medicine reaches its average peak effectiveness within 2 hours of taking it. It is also used to treat post-operative pain as well as the pain and illnesses listed above. Another common use of dihydrocodeine is as a cough suppressant to treat persistent coughs.  Dihydrocodeine is also used to treat severe dyspnea (shortness of breath) which is a feeling of tightening in the chest and the inability to breathe properly. However, it must not be used in an asthma attack. 

How do you use Dihydrocodeine? 

Dihydrocodeine is available in tablets, capsules or as an oral solution. There is a slow-release version of the tablets. The tablets or capsules should be taken with or after food to avoid stomach problems. They should be swallowed whole. The oral solution is mixed with water in a dosage beaker and should be drunk immediately it has been made. You should follow the advice of your doctor when taking dihydrocodeine to ensure you take the correct dosage. 

What dosages are there? 

The standard form of dihydrocodeine comes in a 30mg tablet form. The common dosage is one 30mg tablet every 4-6 hours for adults. No more than 8 tablets should be taken in a 24 hour period. It is essential you follow the advice of your doctor when taking this medicine as the dosage may be different for your individual situation. The dose you should take will depend on your height and weight, age and metabolism. 

This medicine is not suitable for children under 4 years of age. For children aged 4-12 years and teenagers, the dosage advice of a doctor must be followed. The elderly should also follow the dosage advice of their doctor as the standard dose may be reduced. 

When stopping this medication, you should also take the advice of your doctor as it may be necessary to gradually reduce the dosage. Otherwise, withdrawal symptoms may occur. There is a risk of painkiller addition when taking dihydrocodeine for a long period of time and this can be a serious problem. Therefore, you should always liaise with your doctor when taking this medicine. 

What are the side effects of dihydrocodeine? 

Dihydrocodeine may have certain side effects, as with all medicines. If you experience any of the following you should stop taking this medicine and inform your doctor. If the effects are severe you should contact your doctor immediately. 

  • Constipation 
  • Nausea 
  • Vomiting 
  • Diarrhoea 
  • Dizziness 
  • Breathing difficulties 
  • Seizures 
  • Itching 
  • Stomach ache 
  • Dry mouth 
  • Drowsiness 
  • Difficulty concentrating 

These are the most common side effects of taking dihydrocodeine – please refer to the product leaflet for further side effects. Taking this medicine long-term can cause constipation due to the slowing down of peristalsis (muscle contractions) in the digestive tract. This is known as opioid-induced constipation (OIC). According to research, between 21 and 90% of people taking opioid medication experience constipation. 

Therefore, it is advisable to drink plenty of water and eat fibrous foods to avoid constipation. If the problem becomes uncomfortable you should speak to your doctor as they may prescribe a laxative to ease the situation. It is important to know that taking dihydrocodeine for long periods of time can cause dependency on this medication. Addiction to painkillers is serious and therefore it is important to regularly review with your doctor the period of time that you take this medicine. 

When shouldn’t you use Dihydrocodeine? 

Using dihydrocodeine as a painkiller is not suitable for everyone. Do not use this medicine if you: 

  • Are pregnant or breastfeeding 
  • Are allergic to dihydrocodeine or any of its ingredients 
  • Have respiratory problems or lung disease 
  • Are having an asthma attack 
  • Are intolerant to some sugars 
  • Have problems with alcohol 
  • Have had a serious head injury 
  • Are at risk of an inactive bowel (paralytic ileus) 

It is advisable not to take dihydrocodeine as a regular painkiller for headaches as it can make them worse. This medicine can be used to treat migraine but should not be used long-term. You should tell your doctor before you start taking dihydrocodeine if you suffer from any of the following: 

  • Liver or kidney problems 
  • Are asthmatic (this medicine should not be taken during an asthma attack 
  • An underactive thyroid gland 
  • Prostate gland problems 
  • Low blood pressure
  • Convulsions 
  • Constipation or obstructive bowel disorders 
  • Pancreas inflammation 
  • Gall bladder problems 
  • Severe heart problems after long-term lung disease 
  • Drug addiction 
  • Alcoholism 
  • Adrenocortical insufficiency 

This medicine should not be given to children under 12 years of age. 

As some of the possible side effects of dihydrocodeine are drowsiness, dizziness and difficulty concentrating it is advisable not to drive or operate machinery if you experience any of these effects. Drinking alcohol while taking this medication can worsen these side effects. It is therefore important to reduce your alcohol intake or completely avoid drinking alcohol if you have been prescribed dihydrocodeine. Note that side effects can especially occur when you first start taking this medication until your body gets used to it. 

Does Dihydrocodeine interact with other medication? 

Dihydrocodeine can interact with other medicines which is why it is important to tell your doctor about any medication you are taking. This is especially important if you take antihistamines, soporifics (medicines to induce sleep) or antidepressants. Please refer to the medicine leaflet for a complete list of possible interactions, contraindications and warnings about the use of dihydrocodeine. 

Where can you buy Dihydrocodeine? 

Dihydrocodeine can only be bought with a prescription from a doctor. With a prescription, you can purchase this medicine from a pharmacy. 

Can I get Dihydrocodeine without a prescription? 

No, you cannot buy dihydrocodeine without a prescription. It is a prescription-only medication and can only be purchased from a pharmacy. 

 

 

References

Dihydrocodeine (n.d) Retrieved April 17, 2019 from https://www.drugbank.ca/drugs/DB01551 

Package Leaflet: DIHYDROCODEINE 30 mg TABLETS Retrieved April 17, 2019 from https://www.dokteronline.com/pils/en/patient_information_leaflet-3007-dihydrocodeine-uk.pdf-1510756509.pdf 

Sizar O,  Gupta M. (April 1, 2019).  National Center for Biotechnology Information. Opioid Induced Constipation. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK493184/