Dihydrocodeine
Introduction[edit]
Dihydrocodeine is an opioid analgesic . It is used for the relief of moderate to severe pain, often in combination preparations with paracetamol. It has also been used as a cough suppressant.
| Generic Name 藥名 | HA Code 藥物代碼 | Classification藥物分類 |
|---|---|---|
| Dihydrocoedine | DIHY01 | DD |
Mechanism of Action[edit]
Equivalent doses of opioid analgesics
| Analgesic/Route | Dose |
|---|---|
| Codeine: PO | 100 mg |
| Diamorphine: IM, IV, SC | 3 mg |
| Dihydrocodeine: PO | 100 mg |
| Morphine: PO | 10 mg |
| Morphine: IM, IV, SC | 5 mg |
| Oxycodone: PO | 6.6 mg |
| Tramadol: PO | 100 mg |
| Route of Administration | PO (tablet form) |
|---|
Dosage[edit]
Moderate to severe pain:
| Oral | 30mg after food every 4 to 6 hours; up to 240mg daily. |
|---|---|
| Modified-release preparations are taken twice daily. | |
| Subcutaneous or intramuscular | 50 mg every 4 to 6 hours. |
Doses in children:
- may be given orally, or by deep subcutaneous or intramuscular injection;
1 to 3 years: 500 micrograms/kg every 4 to 6 hours
4 to 12 years: 0.5 to 1 mg/kg every 4 to 6 hours
Older children may be given the usual adult dose.
Side Effects[edit]
As for Opioid Analgesic in general[edit]
The commonest adverse effects are nausea, vomiting, constipation, drowsiness and confusion.
Large doses of opioids produce respiratory depression and hypotension, with circulatory failure and deepening coma. Death may occur from respiratory failure.
Treatment of Adverse Effects[edit]
Abdominal pain, hyperthermia, pancreatitis Euphoria, nausea and vomiting, respiratory depression, constipation and cough suppression.
Pharmacokinetics[edit]
| Oral bioavailability | Oral bioavailability is only about 20%, probably because of substantial first-pass metabolism in the gut wall or liver. |
|---|---|
| Onset of action | peak concentrations of dihydrocodeine occur about 1.2 to 1.8 hours after oral doses. |
| Metabolism | Dihydrocodeine is metabolized in the liver, and is excreted in urine. |
| Elimination half-life | Elimination half-life is reported to range from about 3.5 to 5 hours. |
Drug Management[edit]
Efficiency[edit]
Pain control
Safety[edit]
mental status, blood pressure, respiratory drive, and misuse / overuse.
Caution[edit]
Pancreatitis, severe cor pulmonale Tolerance and dependence
FAQ[edit]
How should I take the tablet?[edit]
Follow the doctor's prescription, Take with or without food Take the medication with plenty of water Can be crushed Do not crush modified-released tablet (DF-118)
What should I avoid while taking?[edit]
Avoid abrupt withdrawal
What happen if I overdose?[edit]
Emergency situation, called 999 immediately Antidote: Naloxone
What happen if I miss a dose?[edit]
Take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
