An opioid analgesic.

Moderate to severe pain.

(i) 30 mg tablet.

(ii) Oral solution, 10 mg/ml.

(iii) IM injection, 50 mg/ml.

All opioids are addictive and hence dihydrocodeine may be requested

specifically by a drug addict, irrespective of their level of pain. The

drug depresses respiration and so should be avoided in patients with

any form of respiratory impairment (e.g. chronic obstructive pulmonary

disease). Dihydrocodeine should be used with caution in those

who suffer from hypotension, hypothyroidism and prostatic hypertrophy.

The drug should be avoided during pregnancy and whilst

breastfeeding. Similarly avoid in patients with both renal and hepatic

impairment. Dihydrocodeine should not be used in patients who have

a suspected head injury or raised intracranial pressure. The respiratory

depressant properties of dihydrocodeine will raise the intracranial

pressure further and the action of the drug on the pupillary reflex

to light will mask signs of the level of consciousness.

Elderly and debilitated patients.

Dihydrocodeine is associated with a high prevalence of unwanted

effects which include nausea, vomiting, constipation, drowsiness,

dysphoria, impaired micturition, dry mouth, uteric or biliary spasm,

sweating, facial flushing, bradycardia and tachycardia. Whilst dihydrocodeine