Dihydrocodeine is only available on prescription.

Dihydrocodeine is also known by the brand names DHC continous and DF118 Forte.

• Dihydrocodeine works by stopping pain signals travelling along the nerves to the brain.
• Standard dihydrocodeine tablets take 1.5 to 2 hours to work fully.
• It’s possible to become addicted to dihydrocodeine, but your doctor will explain how to reduce the risks of becoming addicted.
• If you need to take dihydrocodeine for more than a few weeks, your treatment plan may include details of how and when to stop taking this medicine.
• The most common side effects are feeling or being sick, feeling drowsy or constipation.

Adults and children aged 4 years and over can take dihydrocodeine.

Dihydrocodeine is not suitable for some people. Tell a doctor before taking the medicine if you:

• have ever had an allergic reaction to dihydrocodeine or any other medicine
• have any stomach problems, such as irritable bowel syndrome (IBS) or Crohn’s disease, or if you’re taking medicines for these conditions
• have lung problems, asthma or breathing difficulties
• have a head injury or a condition that causes seizures or fits
• have an underactive thyroid gland (hypothyroidism)
• have an addiction to alcohol
• take any other painkillers (including those you buy from a pharmacy or supermarket)
• have liver or kidney problems
• have myasthenia gravis, a rare illness that causes muscle weakness
• are trying to become pregnant, are already pregnant or are breastfeeding
• are under 18 years and have had your tonsils or adenoids taken out to treat obstructive sleep Apnoea
• have a rare condition causing problems with galactose intolerance

It’s important to take dihydrocodeine as your doctor has asked you to. This is particularly important because dihydrocodeine can be addictive.

Swallow the tablets whole with water. It’s best to take them with or soon after a meal or snack.

How much will I take?

Dihydrocodeine tablets come in 5 different strengths. The tablets contain 30mg, 40mg, 60mg, 90mg or 120mg of dihydrocodeine.

How often you take your tablets will depend on the strength.

Immediate release tablets

The usual dose for adults and children aged 12 years and over is:

• 30mg tablet – 1 tablet every 4 to 6 hours – maximum dose in 24 hours is 6 tablets (180mg)
• 40mg tablet – 1 or 2 tablets up to 3 times in 24 hours – maximum dose in 24 hours is 6 tablets (240mg)

Slow release tablets

The usual dose for adults and children aged 12 years and over is:

• 60mg, 90mg or 120mg tablets – 1 tablet taken every 12 hours

The tablets contain 60mg, 90mg or 120mg of dihydrocodeine. The usual dose is between 60mg and 120mg, taken twice a day.

Liquid

The usual dose of dihydrocodeine liquid is one to three 5ml Spoonfuls taken every 4 to 6 hours. One 5ml spoonful has 10mg of dihydrocodeine in it (3 spoonfuls contain 30mg).

For children aged between 4 and 11 years dose is worked out based on weight. The usual dose is between 0.5mg and 1mg per kg of body weight, up to a maximum dose of 30mg every 4 to 6 hours.

If you’re taking dihydrocodeine as a liquid, it will come with a plastic medicine spoon or syringe to help you measure the correct amount. Ask a pharmacist for one if you do not have it.

Will my dose go up or down?

Usually you’ll start on a low dose of standard dihydrocodeine.

What if I forget to take it?

This will vary depending on which type of dihydrocodeine you’re taking.

If you forget to take a dose, check the patient information leaflet inside the packet or ask a pharmacist or doctor for advice on what to do.

If you often forget doses, it may help to set an alarm to remind you.

What if I take too much?

If you go to A&E, do not drive yourself – get someone else to drive you or call for an ambulance.

Take the dihydrocodeine box or leaflet inside the packet plus any remaining medicine with you.

Where to store dihydrocodeine

If you’re prescribed dihydrocodeine, it’s really important that you:

• store it properly and safely at home
• keep it out of the sight and reach of children
• do not give your medicine to anyone else
• return any unused dihydrocodeine to a pharmacy so they can throw it away in the right way

It’s safe to take dihydrocodeine with paracetamol, ibuprofen or aspirin (do not give aspirin to children under 16 years of age).

Do not take dihydrocodeine with painkillers that contain codeine. You will be more likely to get side effects.

Painkillers that contain codeine include co-codamol (codeine and paracetamol), Nurofen Plus (codeine and ibuprofen), co-codaprin (codeine and aspirin) and Solpadeine (codeine, paracetamol, ibuprofen and caffeine).

You’re more likely to have side effects if you take the higher strengths of dihydrocodeine.

Common side effects

Talk to a doctor or pharmacist if the side effects bother you or do not go away:

• constipation
• feeling or being sick (nausea or vomiting)
• feeling sleepy
• confusion, feeling dizzy and vertigo (a sensation of spinning)
• dry mouth
• headaches

Serious side effects

• muscle stiffness
• feel dizzy, tired and have low energy – this could be a sign of low blood pressure (hypotension)

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to dihydrocodeine.

These are not all the side effects of dihydrocodeine. For a full list see the leaflet inside your medicine packet.

What to do about:

• feeling or being sick – take dihydrocodeine with or just after a meal or snack to ease feelings of sickness. If you’re being sick, try small frequent sips of water. This side effect should wear off after a few days. Talk to a doctor about taking an anti-sickness medicine if it carries on for longer.
• feeling sleepy – this side effect should go away within a few days as your body gets used to dihydrocodeine. Talk to a doctor if it carries on for longer. This side effect should wear off within a few days as your body gets used to dihydrocodeine. Talk to a doctor if it carries on for longer.
• dry mouth – try chewing sugar-free gum or sucking sugar-free sweets.

 There may be safer medicines that you can take – ask a doctor or pharmacist for advice.

In early pregnancy, it’s been linked to some problems for your baby. For some pregnant women with severe pain, dihydrocodeine might be the right option. Your doctor is the best person to help you decide what’s right for you and your baby.

Dihydrocodeine and breastfeeding – Buy dihydrocodeine online

Dihydrocodeine is not usually recommended if you’re breastfeeding.

Small amounts of dihydrocodeine pass into breast milk and can cause breathing problems in your baby.

Speak to a doctor as they may be able to recommend a different painkiller.

Some medicines interfere with the way dihydrocodeine works.

Mixing dihydrocodeine with herbal remedies and supplements – Buy dihydrocodeine online UK

It’s not possible to say that dihydrocodeine is safe to take with herbal remedies and supplements.