dihydrocodeine tartrate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
dihydrocodeine tartrate: clinical details
Prescribing considerations
- Confirm that severe cancer or other chronic pain matches the selected product's licensed indication.
- Review respiratory risk, frailty, renal and hepatic function, bowel function, sleep apnoea, mental health and substance-use history.
- Agree treatment goals and an eventual withdrawal strategy; avoid abrupt cessation after established use.
- Do not use this selected prolonged-release product for acute postoperative pain.
- Review analgesic need and signs of tolerance, hyperalgesia, misuse, dependence or addiction.
Contraindications and cautions
- Hypersensitivity to dihydrocodeine or an excipient.
- Severe respiratory depression with hypoxia, severe chronic obstructive lung disease, severe cor pulmonale or severe bronchial asthma.
- Current asthma attack.
- Paralytic ileus.
- Acute alcoholism.
- Relevant hereditary galactose intolerance, total lactase deficiency or glucose-galactose malabsorption because the selected tablet contains lactose.
Monitoring
- Pain control, function and continuing clinical need.
- Sedation, respiratory rate and symptoms of sleep-related breathing disorders.
- Constipation, nausea, urinary retention and hypotension.
- Tolerance, escalating use, loss of control, withdrawal symptoms and opioid-induced hyperalgesia.
- Infant breathing, alertness and feeding when exposure occurs during pregnancy or breastfeeding.
Clinical pharmacology
A semisynthetic opioid analgesic acting at central opioid receptors. It is absorbed from the gastrointestinal tract, metabolised mainly in the liver through several pathways and its metabolites are excreted mainly in urine.
Formulation and product differences
- The selected product is a prolonged-release oral tablet.
- It must remain intact; crushing, chewing or breaking can cause rapid release and potentially fatal overdose.
- The selected tablet contains lactose and differs in release characteristics from standard-release preparations.
dihydrocodeine tartrate preparations and strengths
Modified-release tablet
Route: Oral
Strengths: 60 mg, 90 mg, 120 mg
dihydrocodeine tartrate interactions
Tell the prescriber or pharmacist about prescribed, non-prescribed and recreational substances. Important interactions include:
Benzodiazepines, sleeping tablets and tranquillisers
Additive sedation can cause profound drowsiness, respiratory depression, coma or death.
Other opioids and codeine-containing painkillers
Combining opioids increases adverse effects and overdose risk; check combination-product ingredients carefully.
Alcohol
Alcohol can increase sleepiness and other serious opioid effects.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.