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Dihydrocodeine

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Dihydrocodeine is an opioid painkiller used to manage moderate to severe pain (Wotherspoon et al (1991)). It is often prescribed when other pain relief, such as paracetamol or ibuprofen, has not been effective. You may be given dihydrocodeine after a serious injury or surgery to help with postoperative pain. It can also be used for long-term chronic pain if weaker painkillers have not worked (NHS, 2022).

We also provide other prescription opioid-based pain relief medications.

  • An effective opioid painkiller
  • Helps treat moderate to severe pain
  • Provides effective relief
  • 100% genuine medication
  • Shipped from registered pharmacies
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More Information

A Pharmacist's Overview

Amardeep Bagga (MPharm, MBA) - GPhC Number 2226023

Pharmacist, Amardeep Bagga (MPharm, MBA) provides a simple explanation of the medication below:

'Dihydrocodeine is a strong opioid painkiller prescribed for moderate to severe pain where weaker painkillers are not effective.'.

If you think this is a treatment that can help you, start an online consultation now for a registered prescriber to review. If treatment is deemed suitable, they can prescribe it, and we can deliver it to you from the comfort of your own home with a range of convenient delivery and payment options for you to choose from. If you have any questions about a medication, you should always consult your doctor with any questions prior to starting treatment, to ensure that it is safe and suitable for you.

Buy Dihydrocodeine Online

Looking for a safe and trusted online clinic to buy dihydrocodeine? PharmXtra is an online clinic where you can purchase dihydrocodeine by completing our online consultation form. Once approved, we can dispense your medication and have it delivered to your door.

If you do not yet have a prescription, our online consultation, which is reviewed by a registered doctor, can provide you with one. The consultation ensures dihydrocodeine is suitable for your condition. If approved, you can order it with an electronic prescription. The same process applies to repeat prescriptions to ensure continued safety and suitability.

Type of drugNarcotic analgesics (pain medicine)
Health conditions prescribed forModerate to severe pain (e.g. following surgery or a serious injury)
Active Ingredient(s)Dihydrocodeine tartrate
Brand namesDF118 Forte, DHC Continus
Available strengths30mg, 60mg, 90mg or 120mg
Available astablet, oral solution
Possible side effectsVomiting, nausea, abdominal pain, dizziness, sleepiness, constipation, mood swings, headaches, dry mouth
Patient Information LeafletFor more information about this painkiller medication, see the Dihydrocodeine patient information leaflet.

Dihydrocodeine - Key Information

Dihydrocodeine UK

  • Dihydrocodeine is an opiate painkiller and a Class B controlled drug in the UK (BNF, 2023). It is regulated under the Misuse of Drugs Act 1971 and the Misuse of Drugs Regulations 2001 (GOV.UK, 2022).
  • Some medications combine dihydrocodeine with paracetamol, such as co-dydramol.
  • It is used to manage moderate to severe pain, including migraines, headaches, joint pain, muscle pain, toothache, and period pain (NHS, 2023).
  • Available in both short-acting and sustained-release forms.
  • Known under brand names such as DHC Continus and DF118 Forte.
  • Dihydrocodeine tablets are a morphine derivative with moderate potency (Flecknell, P.; 2016)
  • Always read the patient information leaflet for a complete list of side effects and precautions.

Dihydrocodeine is a semi-synthetic opioid that relieves pain by blocking pain signals in the central nervous system. It binds to opioid receptors, reducing or eliminating pain perception (Buckle, J., 2015). This means that your sensation of the pain is either reduced or eliminated (NHS, 2022).

It does not treat the underlying cause of pain but helps provide relief while recovering from an injury or surgery. Managing pain effectively can aid recovery, reducing the risk of post-operative complications such as blood clots or chest infections.

Dihydrocodeine Tablets

Dihydrocodeine is available as tablets or liquid. Tablets should be swallowed with water.

Taking it with food or a snack may help reduce the risk of nausea, vomiting, or headaches.

Each person’s experience with dihydrocodeine varies depending on their condition and individual response to the medication.

To read about other people’s experiences, visit iwantgreatcare.org and patientslikeme.com.

Always speak to a doctor before taking dihydrocodeine. They will assess whether it is suitable for you.

For further details, refer to the official Dihydrocodeine patient information leaflet, which is included with your medication.

Dosage

The standard dose for short-acting dihydrocodeine is 30mg every 4 to 6 hours, with a maximum daily dose of 180mg (NHS, 2022).

A slow-release version is available, taken twice a day in doses of 60mg to 120mg. This provides longer-lasting pain relief (NHS, 2022).

Side Effects

Like all medications, dihydrocodeine can cause side effects.

Dihydrocodeine Side Effects

The most common side effects include:

  • Constipation
  • Nausea or vomiting (feeling sick or being sick)
  • Headaches
  • Feeling sleepy
  • Confusion
  • Feeling dizzy
  • Dry mouth.

If side effects persist, consult a healthcare professional.

In some cases serious side effects can occur when taking dihydrocodeine. These include:

  • Feeling dizzy or tired due to low blood pressure
  • Stiff muscles.

You should speak to a doctor or pharmacist if these side effects occur.

Seek medical advice if these occur. Call 999 if you have difficulty breathing, a seizure, or a severe allergic reaction.

Warnings

Dihydrocodeine may not be suitable for everyone. Speak to a doctor if you have:

  • Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
  • Irritable bowel syndrome
  • Lung disease including asthma
  • Liver or kidney disease
  • A head injury
  • Seizures or fits
  • Thyroid disease
  • Myasthenia gravis
  • Galactose intolerance
  • Obstructive sleep apnoea
  • Alcohol or drug addiction

It may not be suitable during pregnancy, when trying to conceive, or while breastfeeding.

Some medications can interact with dihydrocodeine. You may be advised that dihydrocodeine will not suit you if you already take:

  • A painkiller that contains codeine
  • Sleeping tablets
  • Anti-sickness medications
  • Allergy medications
  • Anxiety medications.

Always inform your doctor about any medications, supplements, or herbal remedies you are taking.

Dihydrocodeine FAQs

No, combining dihydrocodeine with benzodiazepines can cause severe side effects, including breathing difficulties, sedation, coma, or death (Electronic Medicines Compendium, 2020). It is essential to speak to a doctor or healthcare professional before starting treatment with dihydrocodeine, any other opioid medication, or benzodiazepines to ensure they are safe and suitable for you Zamparutti et al (2011)

Although not commonly reported as a direct side effect of dihydrocodeine, a 2002 study by Goldmeier & Lamba documented two cases where dihydrocodeine interacted with sildenafil, leading to prolonged erections.

No, the BMJ (2013) does not recommend dihydrocodeine or other opioid painkillers for dental pain, as they are not very effective and can cause unwanted side effects. Always seek medical advice from your doctor to find the most suitable pain relief for your needs.

Are withdrawal symptoms possible if you stop taking dihydrocodeine?

Yes. Stopping dihydrocodeine suddenly may increase the risk of withdrawal symptoms, especially for those who have developed a dependence (NHS, 2022). Withdrawal symptoms can include:

  • Gastrointestinal disorders such as nausea and vomiting
  • Panic attacks
  • Involuntary shaking
  • Sweating
  • Anxiety
  • Heart palpitations
  • Trouble sleeping

The BNF (2020) advises that to minimise the risk of dependence, addiction, and withdrawal, dihydrocodeine should be tapered off gradually. Reducing a high dose safely can take weeks or even months. A doctor or healthcare professional can provide personalised advice on how to reduce the dosage safely.

If you are concerned about withdrawal symptoms or addiction, consult your doctor or a trusted healthcare professional before starting treatment. They can guide you on proper use and whether the medication is suitable for you.

According to a study by Leppert (2010), dihydrocodeine has a slightly stronger pain-relieving effect than codeine when taken orally. When administered intravenously, it can be twice as potent as codeine.

Research by Mayo Clinic Laboratories (2023) suggests that dihydrocodeine can typically be detected in urine for up to three days.

According to the NHS (2021), in cases where paracetamol is not enough to manage pain, the World Health Organization (WHO) suggests opioid medications as an option for healthcare professionals. Opioids vary in strength, release mechanisms, and forms. Alternatives to dihydrocodeine for mild to moderate pain include:

  • Dihydrocodeine
  • Codeine
  • Buprenorphine patches
  • Tramadol

Dihydrocodeine reduced breathlessness by 20% within 45 minutes, increased exercise tolerance by 18%, and lowered oxygen consumption and ventilation under certain conditions. However, as this study is dated, further research is needed to confirm its long-term safety and effectiveness (Woodcock et al, 1981). Dihydrocodeine, when combined with aspirin and caffeine, has also been linked to sleep-related breathing issues such as sleep apnoea (Mayo Clinic, 2023). Always consult a doctor or healthcare professional before using dihydrocodeine to ensure it is safe for you.

The Care Quality Commission (CQC) provides guidance on how care homes should work with pharmacies to dispose of controlled drugs safely. This includes proper storage and record-keeping (Care Quality Commission, 2022).

Yes. Paramol tablets contain dihydrocodeine as an active ingredient, along with paracetamol.

No, dihydrocodeine does not interfere with any form of contraception, including emergency contraception or the combined pill (NHS, 2022).

Medical Reviewer

Medical Reviewer

Irfan Siddique

Deputy Medical Superintendent (DMS) • MBBS

Dr Irfan Siddique is a qualified Medical Doctor licensed to practise in the UK by the General Medical Council (GMC). He earned his MBBS degree in 2017 from the University of Health Sciences, Lahore, and brings years of clinical experience and medical knowledge to his work.

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