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Dihydrocodeine
Clinical data
Other names
6α-Hydrocodol[1]
AHFS/Drugs.com
International Drug Names
Dependence liability
High
Addiction liability
High
Routes of administration
oral
subcutaneous
intramuscular
rectal
possibly sublingual / buccal
ATC code
N02AA08 (WHO)
Legal status
Legal status
AU: S3 (Pharmacist only)
(S3) (S4) (S8) depending on dose and other constituents
BR: Class A2 (Narcotic drugs)[2]
CA: Schedule I
DE: Prescription only (Anlage III for higher doses)
UK: Class B
US: Schedule II (Schedule III in drug combination)
Dihydrocodeine is a semi-synthetic opioid analgesic prescribed for pain or severe dyspnea, or as an antitussive, either alone or compounded with paracetamol (acetaminophen) (as in co-dydramol) or aspirin. It was developed in Germany in 1908 and first marketed in 1911.[4]
Commonly available as tablets, solutions, elixirs, and other oral forms, dihydrocodeine is also available in some countries as an injectable solution for deep subcutaneous and intra-muscular administration. As with codeine, intravenous administration should be avoided, as it could result in anaphylaxis and life-threatening pulmonary edema. In the past, dihydrocodeine suppositories were used. Dihydrocodeine is available in suppository form on prescription. Dihydrocodeine is used as an alternative to codeine.
It was first described in 1911 and approved for medical use in 1948.[5] Dihydrocodeine was developed during the search for more effective cough medication, especially to help reduce the spread of tuberculosis, pertussis, and pneumonia in the years from c.a. 1895 to 1915. It is similar in chemical structure to codeine. Dihydrocodeine is twice as strong as codeine.[6] Although dihydrocodeine does have extremely active metabolites, in the form of dihydromorphine and dihydromorphine-6-glucuronide (one hundred times more potent), these metabolites are produced in such small amounts that they do not have clinically significant effects.[7]
Dihydrocodeine is also the original member and chemical base of a number of similar semi-synthetic opioids such as acetyldihydrocodeine, dihydrocodeinone enol acetate, dihydroisocodeine, nicocodeine, and nicodicodeine.
^Karch SB (9 October 2007). Pharmacokinetics and Pharmacodynamics of Abused Drugs. CRC Press. pp. 56–. ISBN 978-1-4200-5460-6.
^Anvisa (2023-03-31). "RDC Nº 784 – Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 – Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 2023-04-04). Archived from the original on 2023-08-03. Retrieved 2023-08-03.
^ abRowell FJ, Seymour RA, Rawlins MD (1983). "Pharmacokinetics of intravenous and oral dihydrocodeine and its acid metabolites". European Journal of Clinical Pharmacology. 25 (3): 419–424. doi:10.1007/BF01037958. PMID 6628531. S2CID 29370394.
^Stolerman I (31 July 2010). Encyclopedia of Psychopharmacology. Springer Science & Business Media. ISBN 9783540686989.
^Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 52X. ISBN 9783527607495.
^"Equivalence table (in French)" (PDF). Archived from the original (PDF) on 1 February 2013. Retrieved 12 April 2018.
^Schmidt H, Vormfelde SV, Walchner-Bonjean M, Klinder K, Freudenthaler S, Gleiter CH, et al. (March 2003). "The role of active metabolites in dihydrocodeine effects". International Journal of Clinical Pharmacology and Therapeutics. 41 (3): 95–106. doi:10.5414/cpp41095. PMID 12665158.
Dihydrocodeine is a semi-synthetic opioid analgesic prescribed for pain or severe dyspnea, or as an antitussive, either alone or compounded with paracetamol...
control and prescription laws and Title 76 of the Schengen Treaty, but dihydrocodeine has been more widely used for the same indications since the beginning...
analgesic opioid drug dihydrocodeine. Dihydromorphine occurs in trace quantities in assays of opium on occasion, as does dihydrocodeine, dihydrothebaine,...
in Cold and Flu preparations) Salbutamol (Ventolin/Asmol) Rikodeine (dihydrocodeine) Schedule 4 (S4) drugs and poisons, otherwise known as prescription...
analgesic and cough suppressant, an ester of codeine closely related to dihydrocodeine and the codeine analogue of nicomorphine. It is not commonly used in...
although it is no longer in common use.[citation needed] Currently, dihydrocodeine and nicocodeine are used as second-line codeine replacements. The other...
in some cases negligible amounts of hydromorphone, dihydromorphine, dihydrocodeine, tetrahydro-thebaine, and hydrocodone (these compounds are rather synthesized...
Opioids include substances such as heroin, morphine, fentanyl, codeine, dihydrocodeine, oxycodone, and hydrocodone. A useful standard for the relative strength...
Australia. Paracetamol is also combined with other opioids such as dihydrocodeine, referred to as co-dydramol (British Approved Name (BAN)), oxycodone...
such as hydrocodone (1920 in Germany), oxycodone (1916 in Germany), dihydrocodeine (1908 in Germany), and its derivatives such as nicocodeine (1956 in...
using both (e.g. "each tablet contains 120 mg dihydrocodeine bitartrate, representing 80 mg dihydrocodeine base"). This method of citation is in theory...
was captured near the end of the war, he was found to be addicted to dihydrocodeine and was subsequently weaned off it. After the war, Pervitin remained...
concluded that its benefit alone or in combination with codeine or dihydrocodeine is unknown. Few studies have examined whether nonsteroidal anti-inflammatory...
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