Dihydrocodeine BNF Summary
This is a plain-English summary of the BNF (British National Formulary) entry for dihydrocodeine. Always refer to the most recent BNF or the patient information leaflet inside the pack for the authoritative version.
Indications
- Moderate to severe pain
- Chronic cancer pain
- Post-operative pain
Cautions
- Acute abdomen
- Adrenocortical insufficiency
- Asthma (avoid during acute attack)
- Convulsive disorders
- Diseases of the biliary tract
- Elderly or debilitated patients
- Head injury or raised intracranial pressure
- Hypotension
- Hypothyroidism
- Inflammatory bowel disease
- Myasthenia gravis
- Prostatic hypertrophy
- Severe COPD
Contraindications
- Acute respiratory depression
- Acute alcoholism
- Comatose patients
- Head injury (where ICP raised)
- Risk of paralytic ileus
- Phaeochromocytoma
- Raised intracranial pressure
Dose
- Adults (oral, immediate release): 30mg every 4–6 hours when necessary, max 240mg/day in some products though typically capped at 180mg in UK practice
- Adults (oral, modified release): 60–120mg every 12 hours
- Elderly: reduce dose
- Renal impairment: reduce dose or avoid in severe impairment
- Hepatic impairment: reduce dose or avoid in severe impairment
Side effects
See our side effects guide for the patient-friendly breakdown.
Interactions
- MAOIs — avoid (risk of CNS excitation or depression)
- Other CNS depressants (benzodiazepines, alcohol, sedating antihistamines) — additive sedation and respiratory depression
- Naltrexone — antagonises analgesic effect
- Cimetidine — increased opioid effect
Pregnancy and breastfeeding
See dihydrocodeine in pregnancy and breastfeeding.
Order dihydrocodeine
Order dihydrocodeine online — UK next-day delivery.