Index of drugs

Strong cancer pain and chronic pain with a different etiology.

1 tabl Modified release contains 60 mg or 90 mg dihydrocodeine tartrate (and 58.4 mg or 40.5 mg lactose, respectively)

A semi-synthetic opioid analgesic with a weaker effect than morphine. The drug acts on opioid receptors in the brain. The main therapeutic action of the drug is analgesic and antitussive (inhibition of cough reflex through direct effect on the cough center in the medulla). Dihydrocodeine is well absorbed from the gastrointestinal tract, and its therapeutic concentration in the blood is maintained for 12 hours. Like other phenanthrene derivatives, dihydrocodeine is mainly metabolised in the liver, its metabolites are mainly excreted in the urine.

Hypersensitivity to the active substance or to any of the excipients. Severe chronic obstructive pulmonary disease. Pulmonary heart. Severe respiratory depression with hypoxia. Severe bronchial asthma. Children under 12 years. Intestinal paralysis. Head injury or increased intracranial pressure. Alcoholism (acute phase). Hereditary galactose intolerance, lactase deficiency (Lapp type) or malabsorption of glucose-galactose.

Dihydrocodeine should be used with caution in the following cases: addiction to opioids, other medications or alcohol (either present or now); biliary function disorders; inflammation of the pancreas; liver dysfunction; severe renal failure; Chronic obstructive pulmonary disease; depression of the respiratory center with hypoxia; bronchial asthma; constipation; Hypothyroidism; hypertrophy of the prostate gland; concomitant use of MAO inhibitors or within 2 weeks after the end of treatment with drugs from this group; in elderly patients. During long-term use of the drug, a patient may develop a tolerance to dihydrocodeine, requiring a gradual increase in the dose of the drug to maintain pain control. Long-term use of the drug may lead to physical dependence. Sudden discontinuation syndrome may occur after abrupt cessation of treatment. Dihydrocodeine has addictive potential and may be misused by people with latent or manifest addiction. The patient may develop a mental addiction to opioid analgesics, including dihydrocodeine. Avoid administering the drug to patients with a high potential for addiction, not only opioid drugs, but especially - from alcohol or other drugs metabolised in the CYP450 system, in particular 2D6. In particular, dihydrocodeine should be supervised to patients with an alcohol problem if the benefit of dihydrocodeine is higher than the risk and to monitor liver function parameters (eg, AST, ALT, GGT) for people who previously use alcohol or drugs that may affect liver function. Since dihydrocodeine may cause the release of histamine, it should not be used in acute asthma attacks and should be used with caution in patients with asthma. It is recommended to reduce the dose in patients with hypothyroidism, liver and kidney failure and in elderly patients. Table. about modifications. release should be swallowed whole, not broken, chewed or crushed, because the administration of a broken or broken release modified tablet causes a quick release and absorption of a large dose of dihydrocodeine, which may result in symptoms of overdose and even lead to death.

In pregnant women, dihydrocodeine should only be used if absolutely necessary. It has not been established whether dihydrocodeine is excreted in human milk, therefore breastfeeding drug should be administered only in cases of absolute necessity.

Very common: sedation (depending on the dose, drowsiness to consciousness disorders), constipation. Common: pain and dizziness, nausea, vomiting, abdominal pain, dry mouth.Uncommon: angioneurotic edema, disorientation, drug addiction, hallucinations, mood changes, dysphoria, seizures (especially in people with epilepsy or prone to seizures), paresthesia, dizziness, hypotension, dyspnoea, asthma attack (especially in patients with asthma), respiratory depression, diarrhea, intestinal obstruction, biliary colic, bile ductile conditions, increased liver enzymes, excessive sweating, rash, pruritus, urticaria, urinary retention, weakness, physical dependence with withdrawal syndrome. Rarely: visual impairment. Not known: hyperprolactinemia.

Orally.Adults and children over 12 years. Table. 60 mg: 60 mg or 120 mg (1 or 2 tablets) every 12 hours.Table. 90 mg: 90 mg (1 tablet) every 12 hours.Special groups of patients. Administration of dihydrocodeine to children over 12 years depends on the doctor's decision and the medicine can be used if the benefit outweighs the risk. The dose should be reduced in elderly patients as well as in patients with hepatic and renal failure and hypothyroidism.Way of giving. The tablet should be swallowed whole, do not break, chew or crumble.