Concomitant utilization of dihydrocodeine and sedative medicines which include benzodiazepines or associated drugs might end in sedation, respiratory depression, coma and Demise. Thanks to these risks, concomitant prescribing with these sedative medicines really should be reserved for patients for whom alternative treatment alternatives are not possible. If a call is made to prescribe dihydrocodeine concomitantly with sedative medicines, the bottom successful dose really should be utilized, as well as duration of treatment need to be as limited as possible (see also general dose suggestion in section four.

The anticoagulant effect of warfarin and other coumarins could possibly be Improved by prolonged common utilization of paracetamol with elevated possibility of bleeding; occasional doses have no significant influence.

Hyperalgesia Hyperalgesia may very well be diagnosed Should the patient on long-term opioid therapy provides with increased pain. This may very well be qualitatively and anatomically distinctive from pain related to disease development or to breakthrough pain ensuing from development of opioid tolerance.

Naloxone really should be administered cautiously to people who are known, or suspected, to get physically dependent on dihydrocodeine. In these kinds of cases, an abrupt or finish reversal of opioid effects might precipitate pain and an acute withdrawal syndrome.

Drug Interactions Though specified medicines should not be utilised jointly in any respect, in other cases two different medicines may very well be utilized jointly even though an interaction could arise. In these instances, your health practitioner should want to change the dose, or other safety measures may be vital.

4.6 Fertility, pregnancy and lactation Pregnancy There are not any or limited degree of details from the use of dihydrocodeine in Expecting Gals. Typical use during pregnancy might bring about drug dependence during the foetus, resulting in withdrawal symptoms during the neonate. Dihydrocodeine must only be utilized during pregnancy and labour if considered important because of the potential risk of neonatal respiratory depression.

Central Anxious Program The principal actions of therapeutic price of dihydrocodeine are analgesia and an antitussive outcome (depression with the cough reflex by immediate impact on the cough centre within the medulla). Antitussive effects may take place with doses decrease than These ordinarily essential for analgesia.

Approved indication for dihydrocodeine would be the management of reasonable to reasonably severe pain and coughing and shortness of breath. As is the situation with other drugs With this group, the antitussive dose tends to be fewer than the analgesic dose, and dihydrocodeine is a strong cough suppressant like all other customers from the speedy codeine family (see below) as well as their cousins hydrocodone, oxycodone and ethylmorphine, complete opium preparations, and the strong opioid hydromorphone.[8][nine]

4.6 Fertility, pregnancy and lactation Pregnancy Paracetamol: A large amount of facts on Expecting Girls point out neither malformative, nor feto/neonatal toxicity. Epidemiological studies on neurodevelopment in children subjected to paracetamol in utero present inconclusive outcomes.

If clinically wanted, paracetamol can be employed during pregnancy having said that it ought to be applied at the lowest efficient dose for the shortest probable time and at the bottom feasible frequency.

▪ The medicine has been prescribed to take care of a medical or dental issue; and ▪ You have taken it based on the instructions supplied from the prescriber and from the information supplied with the medicine.

If you purchase any medicines, check with a pharmacist that they're safe to take with an opioid painkiller.

AA. Characterization in the human cytochrome P450 enzymes involved with the metabolism of dihydrocodeine.

Before starting off treatment with opioids, a dialogue ought to be held with patients to put read more in position a method for ending treatment with dihydrocodeine in order to minimise the potential risk of addiction and drug withdrawal syndrome (see section four.four).