25
Dec
This should include the regular doses of oral morphine and any breakthrough prn doses. Show all parts of this monograph.
It may be used by mouth or by injection into a vein muscle or under the skin.
Bnf dihydrocodeine dose. Indications dose contra-indications side-effects interactions cautions warnings and other safety information for DIHYDROCODEINE TARTRATE. If you require BNF for Children use BNFC. Show all parts of this monograph.
Prescribing and dispensing information. Patient and carer advice. Less suitable for.
Co-dydramol paracetamol and dihydrocodeine is the preferred weak opioid for pain in the breastfeeding woman The metabolism of dihydrocodeine is not affected by individual metabolic capacity as the analgesic effect is produced by the parent drug compared to codeine which is a pro drug. Dihydrocodeine 30milligrammes is preferred over codeine as it has a cleaner metabolism. Dose of weak opioid Calculation to oral morphine Suggested prescribed total daily dose of oral morphine mg Codeine 60mg qds Codeine 240 10 24mgday 20 Dihydrocodeine 60mg qds Dihydrocodeine 240 10 24mg day 20 Tramadol 100mg qds Tramadol 400 10 40 References.
2014 Palliative Care Formulary PCF5. Weak opioids such as codeine dihydrocodeine and tramadol. Fixed-dose combination preparations are also available including.
For children under 16 years of age paracetamol or ibuprofen alone is a suitable first-line choice. No dose equivalence studies comparing sublingual buprenorphine with oral morphine have been published. Reports of undesirable effects in patients switched to high doses of buprenorphine 624 mg24 hours Codeine.
Dihydrocodeine is partially metabolised by CYP2D6. If a patient has a deficiency or is completely lacking this enzyme they will not obtain adequate analgesic effects. Estimates indicate that up to 7 of the caucasian population may have this deficiency.
However if the patient is an ultra-rapid metaboliser there is an increased risk of developing side effects of opioid toxicity even at low doses. As a starting dose one third of the total oral morphine dose given to the patient over the previous 24 hours can be converted to the 24 hour subcutaneous dose of diamorphine. This should include the regular doses of oral morphine and any breakthrough prn doses.
Pentazocine sold under the brand name Talwin among others is a painkiller used to treat moderate to severe pain. It is believed to work by activating agonizing κ-opioid receptors KOR and μ-opioid receptors MOR. As such it is called an opioid as it delivers its effects on pain by interacting with the opioid receptors.
It shares many of the side effects of other opioids like. Hydromorphone also known as dihydromorphinone and sold under the brand name Dilaudid among others is an opioid used to treat moderate to severe pain. Typically long-term use is only recommended for pain due to cancer.
It may be used by mouth or by injection into a vein muscle or under the skin. Effects generally begin within half an hour and last for up to five hours. A dose reduction of at least 50 is recommended when switching at high doses eg oral morphine or equivalent doses of 500mg24 hours or more in elderly or frail patients or because of intolerable undesirable effects.
The half-life and time to onset of action of the two drugs needs to be considered when converting so that the patient does not experience breakthrough pain or receive too much. Examples of weak opioids include codeine and dihydrocodeine. Although commonly described as weak opioids they are extremely effective analgesics often used to treat severe pain.
However they can lead to significant addiction and adverse effects so should not be underestimated. Examples of strong opioids include morphine oxycodone pethidine and tramadol. Most of the excretion products appear in the urine within six hours and up to 80 of the dose is excreted in 24 hours.
About 70 of the dose is excreted as free codeine 10 as free and conjugated morphine and a further 10 as free or conjugated norcodeine. Only traces are found in the faeces. The plasma half life is approximately three to four.
Academiaedu is a platform for academics to share research papers.