Products
Dihydrocodeine is commercially available as sustained-release tablets, drops, and syrup (Codicontin, Paracodin, Escotussin, Macatussin Syrup). It has been approved in many countries since 1957.
Structure and properties
Dihydrocodeine (C18H23NO3, Mr = 301.4 g/mol) is a hydrogenated derivative of codeine. It is present in drugs as dihydrocodeine thiocyanate, dihydrocodeine hydrochloride, or dihydrocodeine tartrate. Dihydrocodeine tartrate is a white crystalline powder that is readily soluble in water and has a bitter taste.
Effects
Dihydrocodeine (ATC N02AA08) is centrally analgesic and antitussive. The effects are due to binding to opioid receptors. Dihydrocodeine has a more potent effect than codeine.
Indications
For the treatment of pain or irritable cough.
Dosage
According to the professional information leaflet.
Contraindications
- Hypersensitivity
- Respiratory failure
- Coma
- Pancreatitis
- Liver disease
- Concurrent treatment with MAO inhibitors is not indicated.
For complete precautions, see the drug label.
Interactions
Dihydrocodeine is metabolized by CYP2D6 and others. Corresponding interactions are possible. Other drug-drug interactions may occur with alcohol, central depressant drugs, cimetidine, MAO inhibitors, opioid antagonists, morphine, sildenafil, antitussives, and expectorants.
Adverse effects
The most common possible adverse effects include digestive symptoms such as abdominal pain, constipation, dry mouth, nausea and vomiting, headache, fatigue, drowsiness, skin rash, and itching. Like other opioids, dihydrocodeine can be abused as a narcotic and become addictive.
