Dihydrocodeine - Oral

Dihydrocodeine is a strong painkiller. It helps relieve moderate to severe pain when milder painkillers are not effective.

This medicine may also be used to help suppress dry cough.

Take Dihydrocodeine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Take this medicine together with food or immediately after a meal.

Dihydrocodeine available as a conventional tablet, modified-release tablet and an oral solution.

If you are taking the modified-release type of tablet, swallow it whole. Do not divide, chew, or crush the tablet.

If you are taking the oral solution, use the dropper supplied with each bottle to measure your dose. Refer to the package insert for directions on how the dropper should be used.

Alert your doctor if Dihydrocodeine does not seem to help control your pain or dry cough. Do not stop taking it suddenly as this may worsen your condition.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

Alert your doctor if you have the following conditions:

• severe lung or breathing problems e.g. slow or ineffective breathing, sudden asthma attack or severe asthma
• head injury or increased pressure in the brain
• consume large amounts of alcohol or frequent drinker
• known or at risk of having paralytic ileus (bowel obstruction caused by slow movement or paralysis of the intestines)

as Dihydrocodeine may not be suitable for you.

Do not take Dihydrocodeine if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.

Inform your doctor if you have the following conditions:

• mild to moderate lung disease
• sleep-related breathing problems e.g. sleep apnoea (sleep disorder that causes interrupted breathing during sleep)
• low blood pressure
• stomach or bowel problems e.g. constipation, bowel obstruction
• biliary tract (group of organs that manage or process bile in the body) disorders e.g. inflammation of the pancreas
• muscle weakness disorder
• epilepsy (fits or seizures)
• current or history of mood disorders e.g. anxiety, depression
• current or history of drug abuse
• Addison's disease (a rare disorder where the adrenal glands produce insufficient amounts of certain hormones)
• thyroid disease
• enlarged prostate gland
• kidney disease
• liver disease

Let your doctor know if you are pregnant or breastfeeding.

Be sure to check with your doctor or pharmacist before giving Dihydrocodrine to a child, the elderly, or debilitated individual (a person who is physically or mentally weak usually due to illness or old age). They may be more sensitive to the side effects.

Avoid long-term use of any painkillers.

Do not take Dihydrocodeine for any other purpose other than what your doctor has advised.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. lung function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
• Regular monitoring of pain relief, mental status, and signs of drug abuse, misuse, or addiction may also be needed.

Dihydrocodeine may cause drowsiness, dizziness, or blurred vision. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.

Other side effects include any of the following: headache, constipation, nausea, vomiting, dry mouth, stomach pain, tiredness, confusion, and mood changes.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• slow, shallow, or trouble breathing
• breathing problems during sleep
• severe constipation
• excessive sweating, difficulty sleeping, anxiety, restlessness, tremors, palpitations

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Dihydrocodeine if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.

Inform your doctor and pharmacist if you are taking any of these medicines:

• other medicines for depression
• medicines for mood disorders
• medicines for sleep disorders
• medicines for high blood pressure
• medicines for cold and allergy
• mexiletine (medicine for irregular heartbeat)
• metoclopramide (medicine for nausea or vomiting)
• cimetidine (medicine that reduces stomach acid production)

This list does not include all medicines that may interact with Dihydrocodeine.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol. Alcohol intake may worsen the dizziness and drowsiness caused by Dihydrocodeine.

Store in a cool, dry place away from the reach of children.

Protect from light.

Medicines must not be used past the expiry date.