Dihydrocodeine

What dihydrocodeine is for

Dihydrocodeine is a type of strong painkiller called an opioid. It's used to help relieve pain, such as pain from cancer.

It's often used when other painkillers, such as paracetamol and ibuprofen, have not worked.

There are some medicines that contain dihydrocodeine and other painkillers such as paracetamol.

How to take dihydrocodeine

Dihydrocodeine usually comes as tablets, or a liquid you swallow.

How much you need to take and for how long depends on the type you're taking and why you're taking it. Follow your doctor's advice.

Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you're not sure how to take it or have any problems taking it.

When taking dihydrocodeine:

• check the packet or leaflet to see if your tablets are "slow-release" (prolonged release) for instructions on how to take them
• swallow any tablets whole with a glass of water
• take it with or without food
• use the syringe or cup that comes with liquid dihydrocodeine to help you measure out the right dose

If you miss a dose of dihydrocodeine

If you forget to take a dose of dihydrocodeine, check the information leaflet inside the packet or ask a pharmacist or doctor for advice on what to do.

If it's nearly time for your next dose, skip the dose you missed and take your next dose at the usual time.

Do not take 2 doses to make up for a missed dose.

If you take too much dihydrocodeine

Taking an extra dose of dihydrocodeine can be dangerous.

How to stop taking dihydrocodeine

If you need to take dihydrocodeine for a long time, your body can become used to having it.

Do not stop taking it dihydrocodeine suddenly because this can cause withdrawal symptoms such as feeling agitated or anxious.

Your doctor will gradually reduce your dose over several weeks or months. Always follow your doctor's advice.

Side effects of dihydrocodeine

Like all medicines, dihydrocodeine can cause side effects, although not everyone gets them.

Common side effects

Common side effects of dihydrocodeine include:

• constipation
• feeling sick (nausea) or being sick (vomiting)
• drowsiness
• dry mouth
• headaches

If you feel drowsy after taking dihydrocodeine, do not drive, ride a bike or use machinery until the drowsiness stops.

Serious side effects

Dihydrocodeine can sometimes cause serious side effects, although most of them are rare.

Possible serious side effects of dihydrocodeine include:

• an allergic reaction (anaphylaxis) – causing symptoms such as a swollen throat or tongue, a raised, itchy rash and difficulty breathing
• your breathing slowing down or difficulty breathing
• an unusual heartbeat (palpitations)
• feeling dizzy, tired and having low energy – this could be a sign of low blood pressure (hypotension)

Who can and cannot take dihydrocodeine

Most adults and children aged 4 years and over can take dihydrocodeine.

Dihydrocodeine is not suitable for some people. For example, it may not be suitable if:

• you've had an allergic reaction or serious side effect from dihydrocodeine or another opioid painkiller
• you have liver or kidney problems
• you have ever had an addiction to alcohol, prescription medicines or recreational drugs
• you have lung or breathing problems such as COPD (chronic obstructive pulmonary disease) or asthma
• you have an underactive thyroid gland (hypothyroidism)
• you have a brain tumour, head or brain injury
• you have sleep apnoea

Before taking dihydrocodeine, tell your doctor if you have any medical conditions.

Breastfeeding and dihydrocodeine

Tell your doctor if you're breastfeeding. Dihydrocodeine is not usually used while breastfeeding because there's a chance it could cause side effects in your baby.

A doctor may recommend it for a few days if the benefits outweigh the risks, or they may recommend a different painkiller.

If you're taking dihydrocodeine while breastfeeding, speak to a healthcare professional or call NHS 111 if you have any concerns about your baby.

Do not sleep in the same bed (co-sleep) with your baby if you've taken dihydrocodeine or any other medicine that makes you sleepy or drowsy, as it can increase the risk of sudden infant death syndrome (SIDS).

Pregnancy and dihydrocodeine

Tell your doctor if you're pregnant or get pregnant while taking dihydrocodeine.

Dihydrocodeine is sometimes used during pregnancy if needed. Your doctor will talk to you about the risks and benefits of taking it while you're pregnant.

Find out more about pain relief during pregnancy on the Bumps (Best Use of Medicines in Pregnancy) website

Taking dihydrocodeine with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with dihydrocodeine.

These include:

• other opioid painkillers, such as codeine or morphine
• medicines for anxiety such as paroxetine
• antidepressants such as monoamine-oxidase inhibitors (MAOIs)
• some medicines to treat allergies (antihistamines)
• sleeping tablets including benzodiazepines like diazepam

Before taking dihydrocodeine, tell your doctor if you're taking any other medicines, herbal remedies, vitamins or supplements.

Taking dihydrocodeine together with recreational drugs, such as cannabis, cocaine, or heroin can increase the risk of serious side effects.

Food, drink and alcohol with dihydrocodeine

You can eat and drink normally while taking dihydrocodeine, but it's best not to drink alcohol because it can make you feel sleepy.