Dihydrocodeine, an opioid painkiller, is also known as. It is used to treat moderate-severe pain after surgery or serious injuries.
It can also be used to treat long-lasting pain when other painkillers such as paracetamol or ibuprofen have failed.
Dihydrocodeine can only be purchased with a prescription. You can also mix it with paracetamol. This is known as co-dydramol.
You can buy it as tablets, slow-release tablets or as a liquid you swallow. You can also inject it under the skin or into muscles. This is done usually in a hospital.
Dihydrocodeine can also be known as DHC Continus or DF118 Forte.
2. The key facts
Dihydrocodeine stops pain signals from traveling along nerves to brain.
To fully work, standard dihydrocodeine tablets can take between 1.5 and 2 hours.
Dihydrocodeine can be addictive. Your doctor will help you reduce your chances of becoming addicted.
Your treatment plan might include information about how and when you should stop taking dihydrocodeine if you are required to take it for longer than a few days.
Most common side effects include feeling sick or dizzy, constipation, and feeling sleepy.
3. Who can and who cannot take it
Dihydrocodeine is safe for children and adults over 4 years old.
Dihydrocodeine may not be suitable for everyone. If you are unsure, consult your doctor before you take the medication.
Have ever experienced an allergic reaction to dihydrocodeine, or any other medication
If you have any stomach issues, such as Crohn’s disease or IBS (irritable bowel syndrome), or if your medication is for these conditions
Lung problems, asthma or breathing problems
A head injury, condition that causes seizures or fits.
Hypothyroidism is an underactive thyroid gland.
An addiction to alcohol
Take any other painkillers, even those that you purchase at a supermarket or pharmacy.
Have liver or kidney disease
Myasthenia Gravis is a rare condition that causes muscle weakness.
Are you trying to get pregnant, or are pregnant already?
Are under 18 years old and have had your tonsils/adenoids removed to treat obstructive sleeping apnoea
Have a rare condition that causes galactose intolerance
4. When and how to do it
Dihydrocodeine should only be taken as directed by your doctor. This is especially important as dihydrocodeine may be addictive.
Take the tablets with water. Take them with or shortly after eating or snacking.
What amount will I pay?
Dihydrocodeine tablets come in 5 different strengths. Tablets contain 30mg-40mg 60mg 90mg 90mg and 120mg dihydrocodeine.
The strength of your tablet will determine how often you take them.
Tablets for immediate release
Adults and children 12 years old and older should take:
30 mg tablet – 1 tablet every 4-6 hours. Maximum daily intake is 6 tablets (180mg).
40mg tablet – 1 or 2 tablets maximum 3 times per 24 hours. Maximum daily intake is 6 tablets (240mg).
Did you know? Patients can buy Dihydrocodeine online via our store.
Tablets slow release
Adults and children 12 years old and older should take:
60mg, 90mg and 120mg tablets – 1 tablet every 12 hours
The tablets are 60mg, 90mg and 120mg respectively of dihydrocodeine. Taken twice daily, the usual dosage is 60 mg to 120 mg.
Liquid
One to three 5ml teaspoons of dihydrocodeine liquid are recommended every 4 to 6 hours. Each 5ml spoonful contains 10mg dihydrocodeine. Three spoonfuls contain 30mg.
Children aged 4-11 years old are given a dose based on their weight. The recommended dose is between 0.5mg to 1mg for every kg of bodyweight, with a maximum of 30mg every 4-6 hours.
You will receive a plastic medicine spoon/syringe if you are taking dihydrocodeine in liquid form. This will help you to measure the right amount. If you don’t have one, ask your pharmacist.
Don’t use a kitchen spoon to measure the liquid. It won’t give you the correct amount.
Is my dose going up or down?
You will usually start with a low dose standard dihydrocodeine. This may be increased gradually by your doctor until you feel comfortable with the pain.
Important
Do not stop taking dihydrocodeine if you have been using it for longer than a few months.
What happens if I forget to take it with me?
This can vary depending on the type of dihydrocodeine that you are taking.
You can always check the patient information leaflet in the packet if you forget to take your dose. Ask your pharmacist or doctor for help.
To make up for lost doses, never take two doses at once.
It may be helpful to set up an alarm to remind yourself of your doses if you forget them often. Ask your pharmacist for suggestions on how to remind yourself to take your medication.
What happens if I take too many?
Urgent advice: Call the 111 immediately if:
you take too much dihydrocodeine.
If you take too much dihydrocodeine you may feel:
Very sleepy, sick, or dizzy
It is difficult to breathe
Become unconscious
Do not drive to A&E if you are ill. Get someone to drive you, or call an ambulance.
You should bring the leaflet or dihydrocodeine packet, as well as any medicine that is left over, with you.
Dihydrocodeine: Where can I buy it?
It is very important to take dihydrocodeine if you are prescribed it.
It should be stored properly and securely at home
Keep it out of reach and sight of children
Do not give your medicine out to anyone else
Any dihydrocodeine that is not used should be returned to the pharmacy. They can then dispose of it in the correct way
5. Dihydrocodeine can be taken with other painkillers
You can safely take dihydrocodeine along with paracetamol or ibuprofen, but not aspirin for children younger than 16 years.
Dihydrocodeine should not be taken with codeine-containing painkillers. Side effects are more likely.
Codeine is found in painkillers such as co-codamol (codeine & paracetamol), Nurofen PLUS (codeine & ibuprofen), codaprin (codeine & aspirin), co-codaprin(codeine et ibuprofen), codaprin (codeine et ibuprofen), codaprin (codeine et ibuprofen), and co-codamol, codeine, paracetamol, codeine, ibuprofen, ibuprofen, ibuprofen, ibuprofen, ibuprofen,codeine eine and caffeine).
6. Side effects
Dihydrocodeine, like all medications, can cause side effects in certain people. However, many people experience no side effects, or very minor side effects.
Side effects are more common if you take higher doses of dihydrocodeine.
Common side effects
More than one in 100 people experience side effects. If side effects persist or bother you, talk to your doctor.
Constipation
feeling or being sick (nausea or vomiting)
Feeling sleepy
Vertigo (a feeling of spinning), confusion, feeling dizzy, and vertigo (feeling dizzy).
Dry mouth
Headaches
Serious side effects
In less than one in 100 cases, serious side effects occur. If you experience any of these side effects, it is important to contact your doctor immediately.
Stiffness in the muscles
Feeling tired, dizzy and sluggish could be an indication of hypotension (low blood pressure).
Severe allergic reaction
Rarely, an allergic reaction to dihydrocodeine can cause severe reactions (anaphylaxis).
These side effects aren’t the only ones that dihydrocodeine can cause. You can find a complete list in the leaflet included with your medicine packet.
Information:
Any suspected side effect can be reported using the Yellow Card safety scheme.
7. How to deal with side effects
What can you do?
Feeling sick? Take dihydrocodeine just before or after eating to reduce nausea. You can take small, frequent sips water if you feel sick. After a few days, this side effect should subside. If it continues, talk to your doctor and ask for an anti-sickness medication.
Feeling sleepy – This side effect should disappear within a few days once your body has adapted to dihydrocodeine. If it persists, consult your doctor.
Vertigo, confusion and feeling dizzy – dihydrocodeine can make you dizzy if you stand up. You can lie down until you feel more comfortable and don’t faint if you feel dizzy. The side effects should subside within a few days as your body adjusts to dihydrocodeine. If it persists, consult your doctor.
Dry mouth? Try chewing sugar-free gum, or sucking sugarless sweets. To keep your mouth moist, a doctor may recommend artificial saliva replacement. You can get it as a spray or gel, or even a lozenge.
Headaches – It’s safe to use a painkiller like paracetamol and ibuprofen. If headaches persist for more than one week or become severe, consult your doctor.
8. Pregnancy and breastfeeding
Dihydrocodeine should not be used during pregnancy or breastfeeding. You may be able to take safer medications – consult your doctor or pharmacist.
It can cause problems in your baby’s early pregnancy. There is a possibility that your baby could develop withdrawal symptoms from dihydrocodeine or become addicted to it when they are born.
It is important to manage pregnancy pain. Dihydrocodeine may be an option for pregnant women suffering from severe pain. Your doctor can help you choose the right treatment for you and your baby.
Breastfeeding and dihydrocodeine
Breastfeeding mothers should not take dihydrocodeine.
Breast milk can contain small amounts of dihydrocodeine, which can cause breathing problems for babies.
Talk to your doctor to see if they can recommend a different painkiller.
Non-urgent advice: Tell your doctor if you’re:
Trying to get pregnant
pregnant
Breastfeeding
9. Use caution when taking other medications
Dihydrocodeine can be affected by certain medications.
Before you begin dihydrocodeine, tell your doctor if you are taking any of these medications.
Sleeping pills or tranquillisers
Medicines for depression and other mental health issues
Medicines to stop nausea or vomiting such as metoclopramide or domperidone
Antihistamines and hay fever tablets
Anxiety medications
Dihydrocodeine can be mixed with herbal remedies or supplements
Dihydrocodeine can’t be taken with herbal remedies or supplements. They are not tested for their effects on prescription and pharmacy medicines.
Important: Medicine safety
If you are taking any other medications, such as herbal medicines or vitamins, tell your pharmacist.