Dihydrocodeine (DHC CONTINUS) 60mg - 1 tablet

Uses

• Dihydrocodeine is used to relieve pain.
• It is an opioid painkiller, sometimes known as an opioid analgesic.
• It is used to control and reduce moderate to severe pain. Dihydrocodeine acts on opioid receptors in the brain and blocks the feeling of pain.
• In general this drug is used to treat moderate to severe pain after an operation or injury or resulting from an illness, such as cancer.
• Benefits of being on this drug can include feeling less or no pain (analgesic effect).

Listed below are the typical uses of dihydrocodeine.

• Relief of moderate to severe pain
• Relief of severe pain resulting from long-term illnesses

How to use

• Dihydrocodeine is available as tablets, prolonged release tablets, oral solution and injection.
• The tablets should be taken orally usually every four to six hours, after food. The medication should be swallowed whole with a little water. Dihydrocodeine prolonged release tablets are designed to release dihydrocodeine more slowly into your body and do not need to be taken as often. The prolonged release tablets are taken usually every twelve hours. It is very important that prolonged release tablets are not crushed or chewed and are swallowed whole.
• This medication can also been taken as deep subcutaneous or intra-muscular injections, usually every four to six hours.
• This medication is also commonly used in combination with paracetamol e.g. co-dydramol.
• Use this medication for duration of the prescription in order to get the most benefit from it.
• Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
• It may take up to 30 minutes before the full benefit of this drug takes effect.
• Certain medical conditions may require different dosage instructions as directed by your doctor.

Dosage

• Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Side effects

• Nausea and vomiting
• Constipation
• Headache
• Drowsiness
• Sleepiness
• Skin rash
• Itchiness
• Problems urinating
• Biliary spasms or spasms in ureter (abdominal pain is usually a symptom)
• Dry mouth
• Mood changes
• Blurred vision and vision changes
• Sweating
• Decreased libido
• Facial flushing
• Abdominal pain
• Low blood pressure
• Tingling in fingers and toes
• Confusion
• Hallucinations and abnormal thoughts
• Decrease in intestinal movement
• Slow breathing (respiratory depression)

If any of these persist or you consider them severe then inform doctor or pharmacist

Tell your doctor immediately if you develop any of the following symptoms:

• Tolerance or dependence on medication

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions

Before taking dihydrocodeine, tell your doctor or pharmacist if you are allergic to it; or to other opioid painkillers; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have:

• Allergy to dihydrocodeine, or any of the ingredients in the medicine
• Severe breathing difficulties
• Head injuries
• Increased intracranial pressure (increased pressure in the brain)
• Acute alcoholism (drink alcohol to excess)
• Paralytic ileus (inactivity of intestine which results delayed emptying and movement through the gut)
• Bronchial asthma, as it should not be used during an asthma attack
• Obstructive airways disease
• Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption

Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following

• Breathing difficulties e.g. asthma, bronchitis
• Decreased function of thyroid gland (hypothyroidism)
• Decreased kidney function
• Decreased liver function
• Drug addiction or a history of drug abuse, especially opioids
• Enlargement of the prostate gland (prostatic hypertrophy)
• Inflammation of the pancreas (pancreatitis)
• Heart problem resulting from long-term lung disease known as cor pulmonale, if severe
• Obstructive bowel disorders
• Constipation
• Fits (seizures) e.g. epilepsy
• Inflammatory bowel disease, such as Crohn's disease and ulcerative colitis
• Decreased function of the adrenal gland (adrenocortical insufficiency)
• Low blood pressure (Hypotension)
• Difficulties passing urine
• Gall-bladder or other biliary problems

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

• It is not recommended to consume alcohol while on this medication, as it may increase the sedative effects of the drug and make you feel very drowsy.

The elderly: dihydrocodeine should be used with caution in the elderly as it may result in more side effects of the medication and dose adjustment may be required.

Interactions

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medications because very serious, possibly fatal interactions may occur:

• Excessive alcohol intake

If you are currently using any of these medications, tell your doctor or pharmacist before starting dihydrocodeine.

Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:

• Monoamine oxidase inhibitors (MAOIs) used to treat depression such as moclobemide, isocarboxazid, phenelzine - taking or stopped taking in the past 2 weeks
• Mexiletine or quinidine (used to control heart rhythm)
• Domperidone or metoclopramide (used to treat nausea and vomiting)
• Medications such as loperamide, kaolin (used to treat diarrhoea)
• Painkillers for headaches (if used too often or for too long your tolerance and dependence upon dihydrocodeine can be increased)
• Alcohol or other medicines which have an effect on breathing rate and sleepiness including sleeping pills and some drugs used to treat mental health problems.
• Tricyclic antidepressants (for depression, e.g. amitriptyline, dosulepin)
• Tranquilisers, sedatives, hypnotics, anxiolytics (for sleeping troubles and anxiety, e.g. diazepam, temazepam)
• Antipsychotics (for psychosis e.g. haloperidol)
• Alcohol or other medicines which have an effect on breathing rate and sleepiness including sleeping pills and some drugs used to treat mental health problems.

This information does not contain all possible interactions. Therefore, before using dihydrocodeine, tell your doctor or pharmacist of all the products you use.

Overdose

Signs of overdose may include sleepiness and drowsiness which can progress to a stupor and coma, slow breathing, pin-point pupils, low blood pressure, muscle weakness, cold and clammy skin and slow heart beat. Failure to pump blood around the body and deepening coma may occur in more severe cases. Convulsions (fits) may occur in infants and children.

Crushing of dihydrocodeine prolonged release tablets and ingestion of this medication could result in immediate medication release around the body which could result in a fatal overdose.

Missed dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.