Dihydrocodeine (Dihydrocodeinum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Opioid narcotic analgesics

Included in the formulation
  • DGK Continus
    pills inwards 
    Bard Pharmaceuticals Co., Ltd.     United Kingdom
    • АТХ:

    N.02.A.A.08   Dihydrocodeine

    Pharmacodynamics:

    Has antitussive and analgesic effect. Affects the μ-opiate receptors of the central nervous system, changes the emotional color of the pain syndrome, activates the antinociceptive (anesthetic) system, inhibits conditioned reflexes, raises the threshold of pain sensitivity, causes euphoria and drowsiness.

    Exceeds codeine for analgesic effect, but inferior to morphine. Increases the tone of the vagus nerve, suppresses cough center, activates the center of the oculomotor nerve, causing a narrowing of the pupil, increases the tone of the bronchi and smooth muscle sphincters of the intestine, bladder, bile ducts, weakens intestinal motility, reduces the secretion of the glands of the gastrointestinal tract.

    Penetrates through the blood-brain and placental barrier, enters the breast milk.

    With uncontrolled admission, addiction develops and drug dependence develops.

    Pharmacokinetics:

    After oral administration, an empty stomach is absorbed up to 20% in the gastrointestinal tract. The maximum concentration in the blood plasma is achieved after 1.2-1.8 hours.

    The therapeutic effect develops 2-4 hours after admission.Metabolism in the liver with the participation of the isoenzyme CYP2D6 with the formation of dihydromorphine, which has a pronounced analgesic activity.

    The half-life is 3.5-5 hours. Elimination by the kidneys.

    Indications:

    Pains of considerable intensity of various origin: in oncology practice, postoperative period, in trauma.

    ICD-10

    XVIII.R50-R69.R52.0   Acute pain

    XVIII.R50-R69.R52.2   Another constant pain

    Contraindications:

    Toxic dyspepsia, acute respiratory center depression, diarrhea, individual intolerance, children under 12 years.

    Carefully:

    Bronchial asthma, arrhythmias, convulsions, traumatic brain injury, renal or hepatic insufficiency, alcoholism, cholelithiasis, prostatic hyperplasia, cachexia, urethral stricture, suicidal tendencies, simultaneous treatment with MAO inhibitors, insufficiency of the adrenal cortex.

    Pregnancy and lactation:

    Recommendations for FDA - Category C. Contraindicated in pregnancy and lactation.

    Dosing and Administration:

    Inside for 60-120 mg every 12 hours.

    The highest daily dose: 240 mg.

    The highest single dose: 120 mg.

    Side effects:

    Central and peripheral nervous system: drowsiness, headache, dizziness, hallucinations, confusion, depression, ringing in the ears, increased fatigue, decreased ability to concentrate.

    Respiratory system: atelectasis, oppression of the respiratory center.

    The cardiovascular system: tachycardia, bradycardia, decreased or increased blood pressure.

    Digestive system: constipation, dry mouth, spasm of bile ducts, toxic megacolon, nausea, vomiting, paralytic intestinal obstruction, hepatotoxicity: pale stools, dark urine, icteric sclera.

    Musculoskeletal system: rigidity of the respiratory muscles.

    Dermatological reactions: skin rash, hives.

    Sense organs: diplopia.

    Urinary system: spasms of the ureters, atony of the bladder, decreased diuresis, frequent urge to urinate, painful urination.

    Allergic reactions.

    Overdose:

    Symptoms: bradycardia, lowering of arterial pressure, anxiety, hypothermia, miosis, convulsions, hallucinations, coma.

    Treatment: administration of a naloxone antagonist intravenously, intravenously,intramuscularly or subcutaneously at a dose of 0.4-2 mg, repeatedly - every 2-3 minutes until a total dose of 10 mg is reached.

    Interaction:

    Strengthens the inhibitory effect of ethanol.

    When used simultaneously with muscle relaxants, drugs that depress the central nervous system, there is an increase in sedation, suppression of the respiratory center.

    Strengthens the effects of antipsychotic and hypotensive drugs, barbiturates and tranquilizers.

    Antidiarrhoeal drugs, including loperamide, contribute to the occurrence of constipation, urinary retention and the suppression of the central nervous system.

    Reduces the effects of metoclopramide.

    Special instructions:

    Incompatible with ethanol. During treatment it is not recommended to drive vehicles and work with moving mechanisms.

    Instructions
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