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Common questions about dihydrocodeine - Brand names: DHC Continus, DF118 Forte

How does dihydrocodeine work?

Dihydrocodeine belongs to a group of medicines called opioids. It works by blocking pain signals from the central nervous system and the brain.

How long does it take to work?

This depends on whether you're taking standard dihydrocodeine or slow-release tablets. Dihydrocodeine liquid takes around 30 to 60 minutes to work and standard tablets can take between 1 and a half to 2 hours to work fully.

Slow-release tablets may take a little longer to work, but will last longer.

Are there any long-term side effects?

Some people with conditions that need long-term pain relief may need to take dihydrocodeine for a long time.

If you need to take it for a long time your body can become used to it (known as tolerance). That means you need higher doses to control your pain over time.

Some people can become more sensitive to pain (hyperalgesia). If this happens, your doctor will reduce your dose gradually to help these symptoms.

It's possible to become addicted to dihydrocodeine. For this reason, your dose will be reviewed to make sure you're only having the amount you need to control your pain.

Your treatment plan may include details of how and when you'll stop dihydrocodeine.

If you're having treatment for cancer pain or other severe long-term pain, your pain control will be carefully monitored. Speak to your doctor if you're worried about tolerance, hyperalgesia or becoming addicted.

How will I know if I'm addicted?

If you're addicted to dihydrocodeine, you may find it difficult to stop taking it or feel you need to take it more often than necessary.

If you stop taking it suddenly you may get withdrawal symptoms.

These can include:

  • feeling agitated, anxious or nervous
  • panic attacks
  • feeling your heartbeat (palpitations)
  • difficulty sleeping
  • shaking
  • sweating
  • body aches
  • feeling restless

Talk to your doctor if you:

  • are worried about addiction
  • need help with addiction
  • want to stop taking dihydrocodeine
How does dihydrocodeine compare to other opioids?

Dihydrocodeine works in the same way as a lot of other opioids but may cause fewer breathing difficulties as a side effect.

It's not better than other opioids for treating specific conditions or pain, but may be more suitable for you, depending on other conditions you have or other painkillers you have tried.

Will it affect my contraception?

Dihydrocodeine does not stop any type of contraception from working, including the combined contraceptive pill, progestogen-only pill and emergency contraception.

However, if dihydrocodeine makes you vomit, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Find out more:

Can I drive or ride a bike?

Do not drive a car, ride a bike or operate machinery if dihydrocodeine gives you blurred vision, or makes you feel dizzy, sleepy, clumsy or unable to concentrate.

These side effects may be more likely when you first start taking dihydrocodeine but could happen at any time, for example, when starting another medicine or if a doctor increases your dose.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to a doctor or pharmacist if you're unsure whether it's safe for you to drive while taking dihydrocodeine. GOV.UK has more information about the law on drugs and driving.

Can I drink alcohol while taking dihydrocodeine?

Drinking alcohol while you're taking dihydrocodeine can make you feel more sleepy. It can also increase the risk of serious side effects.

It's best to stop drinking alcohol during the first few days of treatment, or if a doctor increases your dose, until you see how dihydrocodeine affects you.

If you feel sleepy while taking dihydrocodeine, do not drink alcohol.

Is there any food or drink I need to avoid?

You can eat and drink normally while taking dihydrocodeine.

Will recreational drugs affect it?

If you take recreational drugs, such as cannabis, cocaine or heroin, while you're taking dihydrocodeine, you're more likely to get the serious side effects of dihydrocodeine including breathing difficulties, muscle stiffness, low blood pressure and seizures or fits.

Some recreational drugs, such as cannabis, will also increase dihydrocodeine side effects and make you feel sleepy and dizzy.

Taking heroin while you're taking prescribed dihydrocodeine is especially dangerous. You're more likely to get all the side effects of dihydrocodeine, including addiction.

Tell your doctor if you take any recreational drugs while you're taking dihydrocodeine.

Find out more about the side effects of recreational drugs on the Frank website

Page last reviewed: 17 November 2022
Next review due: 17 November 2025