Dihydrocodeine 💊

Related Subjects: |💊 Analgesia |🛌 Sedation and Analgesia on ITU |🌿 Codeine |🌿 Dihydrocodeine

📖 About

• Always check the BNF link here for up-to-date advice.
• A semi-synthetic opioid analgesic used for moderate to severe pain, severe dyspnoea, or as an antitussive.
• Can be prescribed alone or in combination with paracetamol (e.g., co-dydramol).

⚙️ Mode of Action

• Binds to opioid receptors in the CNS → inhibits pain transmission pathways.
• Reduces perception of pain, alters pain response, and produces mild euphoria/sedation.

💉 Indication / Dose

• Pain: 30 mg every 4–6 hours PRN.
• Maximum: 240 mg in 24 hours.

🔗 Interactions

• Avoid with alcohol 🍷 and sedatives (e.g. benzodiazepines) → ↑ risk of respiratory depression & sedation.

⚠️ Cautions

• Monitor closely for respiratory depression → may require ventilation or reversal with naloxone.
• Use with caution in elderly, frail, or patients with reduced respiratory reserve.

🚫 Contraindications

• Acute respiratory depression
• Comatose patients
• Head injury / raised intracranial pressure
• Paralytic ileus

💊 Side Effects

• 😴 Drowsiness, confusion, delirium
• ❤️ Arrhythmias, hypotension (high doses), flushing
• 🧠 Hallucinations, headache, euphoria
• 👁️ Visual impairment, vertigo, miosis
• 🤢 Nausea, vomiting, dry mouth, constipation
• 💨 Respiratory depression (dose-related, serious)
• 🧴 Skin reactions, sweating (hyperhidrosis)
• 🚽 Urinary retention
• ⚡ Withdrawal syndrome if abruptly stopped

📚 References

• BNF – Dihydrocodeine