Dihydrocodeine vs Codeine — Which Is Stronger?
Short answer: dihydrocodeine is roughly 1.5 to 2 times stronger than codeine on a milligram-for-milligram basis. That’s why 30mg dihydrocodeine often replaces 60mg codeine in UK prescribing once pain becomes unmanageable.
Potency at a glance
| Dose | Approx. equivalent | |—|—| | Codeine 30mg | ~Dihydrocodeine 15–20mg | | Codeine 60mg | ~Dihydrocodeine 30mg | | Codeine 120mg | ~Dihydrocodeine 60mg |
How they differ
Both are opioid analgesics, but their pharmacology is meaningfully different:
- Codeine must be metabolised by the liver enzyme CYP2D6 into morphine to produce pain relief. About 10% of people are poor metabolisers — codeine simply doesn’t work for them.
- Dihydrocodeine is active in its own right. It doesn’t depend on liver activation, so it works reliably regardless of your CYP2D6 status.
When to step up from codeine
If co-codamol 30/500 or codeine 30mg is no longer touching your pain, the natural next step in UK prescribing is dihydrocodeine 30mg. If that still isn’t enough, slow-release 60mg dihydrocodeine or tramadol is usually next.
Side effects
Both share the opioid side-effect profile — constipation, drowsiness, nausea — but dihydrocodeine tends to be less constipating at equivalent analgesic doses.
Where to buy
Buy dihydrocodeine online from Dihydrocodeine UK Store with discreet Royal Mail next-day delivery.