Source: Medicines & Healthcare Products Regulatory Agency (GB) Revision Year: 2020 Publisher: Napp Pharmaceuticals Limited, Cambridge Science Park, Milton Road, Cambridge, CB4 0GW
Pharmacotherapeutic group: Natural opium alkaloids
ATC code: N02AA08
Dihydrocodeine is a semisynthetic narcotic analgesic with a potency between morphine and codeine. It acts on opioid receptors in the brain to reduce the patient’s perception of pain and improve the psychological reaction to pain by reducing the associated anxiety.
The principal actions of therapeutic value of dihydrocodeine are analgesia and an antitussive effect (depression of the cough reflex by direct effect on the cough centre in the medulla). Antitussive effects may occur with doses lower than those usually required for analgesia.
Dihydrocodeine may produce respiratory depression by direct action on brain stem respiratory centres.
Dihydrocodeine causes a reduction in motility associated with an increase in smooth muscle tone in the antrum of the stomach and duodenum. Digestion of food in the small intestine is delayed and propulsive contractions are decreased. Propulsive peristaltic waves in the colon are decreased, while tone is increased to the point of spasm resulting in constipation.
Dihydrocodeine is well absorbed from the gastrointestinal tract following administration of DHC CONTINUS tablets and plasma levels are maintained throughout the twelve hour dosing interval.
Like other phenanthrene derivatives, dihydrocodeine is mainly metabolised in the liver with the resultant metabolites being excreted mainly in the urine.
Metabolism of dihydrocodeine includes o-demethylation, n-demethylation and 6-keto reduction.
There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SPC.
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