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Dihydrocodeine ( Contugesic ).

  Dihydrocodeine ( Contugesic ) additional information
Common uses

Dihydrocodeine ( Contugesic ) is a synthetic opioid analgesic used for the treatment of postoperative pain, severe breathlessness or as an antitussive. The structure and pharmacokinetics of Dihydrocodeine ( Contugesic ) are similar to that of codeine and Dihydrocodeine ( Contugesic ) is approximately twice as potent as codeine; take this into consideration while dosing Dihydrocodeine ( Contugesic ).

Dihydrocodeine ( Contugesic ) is mainly used as a pain reliever, but is also used for the relief of a non-productive cough, and as a anti-diarrheal agent.

Dihydrocodeine ( Contugesic ) and codeine are absorbed quickly from the GI tract and their first pass through the liver results in very little loss of the drug. This contrasts with morphine in which over 90% of the drug is metabolized in the first pass through the liver resulting in a considerable loss of potency when administered orally. The ease of oral administration is one of the reasons why codeine and Dihydrocodeine ( Contugesic ) are common in the relief of pain.

Directions

Dihydrocodeine ( Contugesic ) comes as a tablet (60 mg.). When administered orally, Dihydrocodeine ( Contugesic ) can be taken with full glass of water and/or food to minimize gastrointestinal irritation.

Starting doses of Dihydrocodeine ( Contugesic ) for the treatment of mild pain to moderate pain: Adults: 10-30 mg every 4-6 hours

For the treatment of non-productive cough: Adults: 5-20 mg every 4-6 hours

For the treatment of diarrhoea: Adults: 15 mg

The LD50 (the lethal dose in 50% of the cases) for codeine is 800 mg. (Dihydrocodeine ( Contugesic ) is, approximately, twice as potent) for average weighed non-tolerant adult person. The lowest reported lethal dose is 12mg/kg. The lethal dose varies and depends on many factors including weight, gender and developed tolerance to the drug.

If you miss a dose of Dihydrocodeine ( Contugesic ), take it as soon as remembered if it is within an hour or so. If you do not remember until later, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Precautions

Dihydrocodeine ( Contugesic ) is readily absorbed from the gastrointestinal tract. Dihydrocodeine ( Contugesic ) is rapidly distributed from the intravascular spaces to the various body tissues, with preferential uptake by the liver, spleen, and kidneys.

Effects of Dihydrocodeine ( Contugesic ) start at 10-30 minutes after ingestion, peak within 1 to 2 hours and may last 4-6 hours, depending on dose administered.

Concurrent administration of an opiate agonist with other Central Nervous System (CNS) depressants listed below can potentiate the CNS effects (eg increased sedation, respiratory depression, or hypotensive responses) of either drug:

Alcohol, antihistamines, phenothiazines, general anaesthetics, tricyclic antidepressants, anxiolytics, sedatives, skeletal muscle relaxants, hypnotics, butorphanol, nalbuphine, pentazocine, tramadol, entacapone.

Large doses of Loperamide seem to have additive positive effects when administered with other opioids.

Consumption of carbonated beverages tends to accelerate the absorption of orally administered opiates.

Tropane alkaloids obtained from Belladonna (Atropa belladonna), Henbane (Hyoscyamus niger) or Thornapple (Datura stramonium) such as atropine, hyoscine (scopolamine) and hyoscyamine, can greatly potentiate the effects of opioids. The combination of the two produces a tranquillised state of consciousness known as twilight sleep. These alkaloids can be very poisonous and sometimes fatal in large doses.

You should know that Dihydrocodeine ( Contugesic ) may make you drowsy. Do not drive a car or operate machinery until you know how Dihydrocodeine ( Contugesic ) affects you. Remember that alcohol can add to the drowsiness caused by Dihydrocodeine ( Contugesic ).

Possible side effects

Common side effects from Dihydrocodeine ( Contugesic ) include drowsiness, light-headedness, dry mouth, urinary retention, constipation and euphoria.

Other possible side effects are relaxation, dizziness, difficulty in concentrating, changes in physical activity, mild anxiety or fear, nervousness or restlessness, pupillary constriction, confusion, blurred vision and impaired night vision.

Adverse effects can include itchiness, confusion, nausea and vomiting. The nausea experienced with Dihydrocodeine ( Contugesic ) is less common and less intense than that experienced with the stronger opiates such as morphine. If you ever experience nausea on opiates it is different than the commonly experienced nausea as it is more of a light-headed nausea. Lying down will almost always relieve the nausea in a couple minutes, which after you can attempt to stand up again.

Overdose

In case of overdose, call your local poison control center. If the victim has collapsed or is not breathing, call local emergency services.

Additional information

Keep Dihydrocodeine ( Contugesic ) in a tightly closed container and out of reach of children. Store Dihydrocodeine ( Contugesic ) at room temperature and away from excess heat and moisture (not in the bathroom).

Dihydrocodeine ( Contugesic ) is converted to morphine in the brain. This of course will result in a positive result in a drug test for opiates. It is not known whether or not the drugs heroin, morphine or codeine can be separately determined on a drug test.

Note

The above information is intended to supplement, not substitute for, the expertise and judgment of your healthcare professional. It should not be construed to indicate that use of Dihydrocodeine ( Contugesic ) is safe, appropriate, or effective for you. Consult your healthcare professional before using Dihydrocodeine ( Contugesic ).