Before taking dihydrocodeine tablets
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking dihydrocodeine tablets, it is important that your doctor knows:
- If you are pregnant or breastfeeding.
- If you have a problem with the way your liver works, or a problem with the way your kidneys work.
- If you have prostate problems or any difficulties passing urine.
- If you have any breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD).
- If you have been told you have low blood pressure.
- If you have any problems with your thyroid gland or adrenal glands.
- If you have epilepsy.
- If you have a problem with your bile duct or pancreas.
- If you have been constipated for more than a week or have an inflammatory bowel problem.
- If you have a condition causing muscle weakness, called myasthenia gravis.
- If you have recently had a severe head injury.
- If you have ever been dependent on drugs or alcohol.
- If you have ever had an allergic reaction to a medicine.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
How to take dihydrocodeine dosage
- Before you start the dihydrocodeine dosage treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about dihydrocodeine and will provide you with a full list of the side-effects which you may experience from taking it.
- Take dihydrocodeine exactly as your doctor tells you to. There are several different strengths of tablet available, so your doctor or pharmacist will tell you how often you should take your doses. As a guide, 30 mg tablets are usually taken every 4-6 hours as needed and prolonged-release tablets (DHC Continus® brand) are taken every 12 hours. The directions for taking the tablets will be printed on the label of the pack to remind you about what the doctor said to you.
- Swallow the tablets with a drink of water. Dihydrocodeine should preferably to taken after food, as this can help prevent feelings of sickness which can sometimes occur with the first few doses.
- If you have been given tablets called DHC Continus®, these are specially formulated to release dihydrocodeine slowly to give you a more even painkilling effect throughout the day. It is important that you swallow the tablets whole (do not chew or crush them), otherwise the medicine will be released into your bloodstream too quickly and cause problems.
- If you have been given dihydrocodeine liquid medicine for your child, check the label carefully to make sure you are giving the correct dose.
- If you forget to take a dose, take it as soon as you remember and then continue taking your doses as before. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- You should not drink alcohol while you are taking dihydrocodeine. This is because dihydrocodeine will increase the risk that you experience side-effects from the alcohol, such as feeling dizzy and sleepy.
- If you are a driver, please be aware that dihydrocodeine is likely to affect your reactions and ability to drive. It is an offence to drive while your reactions are impaired. Even if your driving ability is not impaired, you are advised to carry with you some evidence that the medicine has been prescribed for you – a repeat prescription form or a patient information leaflet from the pack is generally considered suitable.
- You will not be given dihydrocodeine for longer than is necessary. This is because when you take dihydrocodeine repeatedly over a period of time and then stop taking it, it can cause withdrawal symptoms such as making you feel restless or irritable. If you have been taking it for some time and want to stop it, your doctor will recommend that you reduce your dose slowly in order to avoid the risk of these effects.
- Dihydrocodeine is normally prescribed for short periods of pain. If you take it over a longer period of time, your body can become used to it and it will not work as well. This is called tolerance.
- If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking dihydrocodeine.
- If you buy any medicines, check with a pharmacist that they are safe to take with an opioid painkiller.
Can dihydrocodeine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with dihydrocodeine. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common dihydrocodeine side-effects
||What can I do if I experience this?|
|Feeling sick (nausea) or being sick (vomiting), tummy (abdominal) pain||Stick to simple meals – avoid rich or spicy foods. Take your doses after food, as this may help protect your stomach|
|Constipation||Eat a well-balanced diet and drink plenty of water each day. If this continues to be a problem, speak with your doctor|
|Feeling dizzy or sleepy||Do not drive and do not use tools or machines. Do not drink alcohol|
|Dry mouth, mood changes, headache, tummy pain (may be caused by spasm of the bile ducts)||Speak with your doctor if troublesome|
Important: people taking dihydrocodeine, and their family and friends, should be aware of the risk of accidental overdose and know when to seek medical help. The risk is higher if you also take other medicines that make you feel drowsy. Signs you have taken too much medicine include:
- Feeling very sleepy or dizzy.
- Feeling sick (nausea) or being sick (vomiting).
- Breathing difficulties.
- Loss of consciousness.
If you have taken more dihydrocodeine than you should or someone else accidentally swallows your medication, call for an ambulance and tell them the name of your medicine.
If you experience other symptoms which you think may be due to dihydrocodeine, speak with your doctor
or pharmacist for further advice.
Dihydrocodeine side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
- Signs of high potassium levels like a heartbeat that does not feel normal; feeling confused; feeling weak, lightheaded, or dizzy; feeling like passing out; numbness or tingling; or shortness of breath.
- Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
- Very bad dizziness or passing out.
- Trouble breathing, slow breathing, or shallow breathing.
- Noisy breathing.
- Feeling very sleepy.
- Feeling confused.
- Chest pain or pressure or a fast heartbeat.
- Severe stomach pain.
- Very bad constipation.
- Feeling very tired or weak.
- Any unexplained bruising or bleeding.
- Ringing in ears.
- Hearing loss.
- Mood changes.
- A severe and sometimes deadly problem called serotonin syndrome may happen if you take this drug with certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or severe headache.
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Feeling sleepy.
- Upset stomach or throwing up.
- Feeling tired or weak.
- Stomach pain.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
How to store dihydrocodeine
- Keep all dihydrocodeine out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Who can take dihydrocodeine
Most adults can take dihydrocodeine tablets . Although it can be given to children from the age of 1 year, it is usually only given to children aged 4 and over.
Who may not be able to take dihydrocodeine
Dihydrocodeine is not suitable for some people. To make sure it’s safe for you, tell a pharmacist or doctor before taking the medicine if you:
- have ever had an allergic reaction to dihydrocodeine or any other medicine
- have any stomach problems, such as irritable bowel syndrome (IBS) or Crohn’s disease, or if you’re taking medicines for these conditions
- have lung problems, asthma, breathing difficulties or allergies
- have a head injury or a condition that causes seizures or fits
- have an underactive thyroid gland (hypothyroidism)
- have an addiction to alcohol
- have liver or kidney problems
- have myasthenia gravis, a rare illness that causes muscle weakness
- are trying to become pregnant, are already pregnant or are breastfeeding
- are under 18 years and have had your tonsils or adenoids taken out to treat obstructive sleep apnoea
- have a rare condition causing problems with galactose intolerance
How and when to take dihydrocodeine dosage
It’s important to take dihydrocodeine as your doctor has asked you to. This is particularly important because dihydrocodeine can be addictive.
Dosage and strength
You’ll usually start on a low dose of standard dihydrocodeine. Your doctor may increase this gradually until your pain is well controlled.
Dihydrocodeine standard tablets come in different strengths. They contain 30mg or 40mg of dihydrocodeine.
The usual dose for adults and children aged 12 years and over is:
- 30mg tablet – take 1 tablet every 4 to 6 hours. The maximum dose in 24 hours is 6 tablets (180mg)
- 40mg tablet – take 1 or 2 tablets up to 3 times in 24 hours. The maximum dose in 24 hours is 6 tablets (240mg)
Dihydrocodeine slow-release tablets contain 60mg, 90mg or 120mg of dihydrocodeine.
The usual dose for adults and children aged 12 years and over is:
- 60mg, 90mg or 120mg tablets – take 1 tablet taken every 12 hours
The usual dose of dihydrocodeine liquid is one to three, 5ml spoonfuls taken every 4 to 6 hours. One 5ml spoonful or syringe measure has 10mg of dihydrocodeine in it.
Dose for children under 12
For children aged between 1 and 11 years, their dose is based on weight.
The usual dose is between 0.5mg and 1mg per kg of body weight. They can be given a maximum dose of up to 30mg every 4 to 6 hours.
How to take it
Swallow the tablets whole with a drink of water. It’s best to take them with or soon after a meal or snack.
If you’re taking dihydrocodeine as a liquid, it will come with a plastic medicine spoon or syringe to help you measure the correct amount. Ask a pharmacist for one if you do not have it.
Do not measure the liquid with a kitchen teaspoon because it will not give the right amount.
How long to take it for
This will depend on why you’re taking dihydrocodeine.
If you’re taking it for pain after an operation you may only need to take if for a short time.
You may need to take it for longer if you have a long-term pain or illness such as cancer.
Always check with a doctor if you want to stop taking dihydrocodeine.
It’s possible that you could become dependent on dihydrocodeine and have withdrawal symptoms if you stop suddenly. These can include:
- muscle twitching
- feeling worried or anxious
- poor sleep
- pain, including stomach pain
- feeling or being sick
- feeling restless
If these happen to you, speak to a doctor. It may be possible to reduce your dose slowly to stop these from happening.