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Acute use (1–3 days) yields a potency about 1.5× stronger than that of morphine and chronic use (7 days+) yields a potency about 2.5 to 5× that of morphine. Similarly, the effect of tramadol increases after consecutive dosing due to the accumulation of its active metabolite and an increase of the oral bioavailability in chronic use.
Approved indication for dihydrocodeine is the management of moderate to moderately severe pain as well as coughing and shortness of breath. As is the case with other drugs in this group, the antitussive dose tends to be less than the analgesic dose, and dihydrocodeine is a powerful cough suppressant like all other members of the immediate codeine family (see below) and their cousins ...
Hydrocodone is used to treat moderate to severe pain. In liquid formulations, it is used to treat cough. [10] In one study comparing the potency of hydrocodone to that of oxycodone, it was found that it took 50% more hydrocodone to achieve the same degree of miosis (pupillary contraction). [26]
In humans, N-demethylation of oxycodone to noroxycodone by CYP3A4 is the major metabolic pathway, accounting for 45% ± 21% of a dose of oxycodone, while O-demethylation of oxycodone into oxymorphone by CYP2D6 and 6-ketoreduction of oxycodone into 6-oxycodols represent relatively minor metabolic pathways, accounting for 11% ± 6% and 8% ± 6% ...
Dihydroisocodeine is an opioid. [1] The National Research Council of the United States reported in 1941 that isocodeine is one of four isomers of codeine known at the time (heterocodeine can be considered a fifth) and DHIC, then in use in Europe as a pharmaceutical, was four times stronger than dihydrocodeine as isocodeine is four times stronger than codeine.
[1] Dozens of derivatives and analogs of isocodeine and the related compound isomorphine have been produced. [ 2 ] One of these, dihydroisocodeine is a pharmaceutical four times stronger than dihydrocodeine and thus six times stronger than codeine which was used more extensively in the past in Continental Europe and other locales.
"Pain ladder", or analgesic ladder, was created by the World Health Organization (WHO) as a guideline for the use of drugs in the management of pain. Originally published in 1986 for the management of cancer pain, it is now widely used by medical professionals for the management of all types of pain.
10 mg dihydrocodeine as co-dydramol 10/500, this is also the preparation to be dispensed if no strength is specified on a prescription. 20 mg dihydrocodeine as co-dydramol 20/500 (e.g. branded products Paracod 500/20 and Remedeine). 30 mg dihydrocodeine as co-dydramol 30/500 (e.g. branded products Paracod 500/30 and Remedeine Forte).