Dihydrocodeine: Difference between revisions
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==Pharmacology== | ==Pharmacology== | ||
Normally, we take dihydrocodeine in orally. As it is a opioid, it has a opioid effects, and most of dihydrocodeine’s opioid receptor effect is on to µ-receptor. <ref>Sobczak, Ł., & Goryński, K. (2020). Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse. *Table 2.1*. [https://pmc.ncbi.nlm.nih.gov/articles/PMC7504308/ PMC7504308]</ref> It is twice stronger then codeine, and 1/6 times of morphine orally. <ref>Leppert, W. (2010). Dihydrocodeine as an opioid analgesic for the treatment of moderate to severe chronic pain. *Current Drug Metabolism*, 11(6), pp. 515-520. [https://pubmed.ncbi.nlm.nih.gov/20540693/ PMID: 20540693]</ref> Dihydrocodeine is a famous prodrug that metabolizes in the liver, expecially through the CYP2D6 enzyme. But also, it actives in CYP3A4. Through CYP2D6, dihydrocodeine became dihydromorphine, which is 1.3 times stronger then the original morphine. | Normally, we take dihydrocodeine in orally. As it is a opioid, it has a opioid effects, and most of dihydrocodeine’s opioid receptor effect is on to µ-receptor. <ref>Sobczak, Ł., & Goryński, K. (2020). Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse. *Table 2.1*. [https://pmc.ncbi.nlm.nih.gov/articles/PMC7504308/ PMC7504308]</ref> It is twice stronger then codeine, and 1/6 times of morphine orally. <ref>Leppert, W. (2010). Dihydrocodeine as an opioid analgesic for the treatment of moderate to severe chronic pain. *Current Drug Metabolism*, 11(6), pp. 515-520. [https://pubmed.ncbi.nlm.nih.gov/20540693/ PMID: 20540693]</ref> Dihydrocodeine is a famous prodrug that metabolizes in the liver, expecially through the CYP2D6 enzyme. But also, it actives in CYP3A4. Through CYP2D6, dihydrocodeine became dihydromorphine, which is 1.3 times stronger then the original morphine. But less then 10% of the dihydrocodeine convert to dihydromorphine <ref>Webb, J. A., Rostami-Hodjegan, A., Abdul-Manap, R., Hofmann, U., Mikus, G., & Kamali, F. (2001). Contribution of dihydrocodeine and dihydromorphine to analgesia following dihydrocodeine administration in man: a PK–PD modelling analysis. *British Journal of Clinical Pharmacology*, 52(6), pp. 619–628. [https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1046/j.0306-5251.2001.01414.x DOI: 10.1046/j.0306-5251.2001.01414.x]</ref>, and other metabolism is not for opioid effects. Even dihydrocodeine itself has a opioid effect, but is so weak which is almost hard to find a article about how much effect does the dihydrocodeine itself has. <ref>Wilder-Smith, C. H., Hufschmid, E., & Thormann, W. (1998). The visceral and somatic antinociceptive effects of dihydrocodeine and its metabolite, dihydromorphine. A cross-over study with extensive and quinidine-induced poor metabolizers. *British Journal of Clinical Pharmacology*, 45(6), 575–581. [https://pmc.ncbi.nlm.nih.gov/articles/PMC1873649/ PMC1873649]</ref> substances metabolised by CYP3A4 is nordihydrocodeine, which is also not a good receptor in opioid. | ||
So most of the effects are from dihydromorphine, and some people says because dihydrocodeine itself has a opioid effect, it has no ceiling effect, but no. If you are not a person who can feel euporia with dihydrocodeine itself, you can even have euporia with 5 tablets of DXM, which is not a opioid, but has some opioid effects. | |||
The streagth of the dihydrocodeine is differ by person, because 5-10% of white people and some more percentage of Asian people has low metabolism in CYP2D6. <ref>Wilder-Smith, C. H., Hufschmid, E., & Thormann, W. (1998). The visceral and somatic antinociceptive effects of dihydrocodeine and its metabolite, dihydromorphine. A cross-over study with extensive and quinidine-induced poor metabolizers. ''British Journal of Clinical Pharmacology'', 45(6), pp. 575–581 [https://pmc.ncbi.nlm.nih.gov/articles/PMC1873649/ PMC1873649]</ref> Because CYP2D6 metabolism is almost everything of this drug’s effect, CYP2D6 inhibitors such as Fluoxetin, Paroxetine, Bupropion, Quinidine makes dihydrocodeine’s effect weaker. <ref>Wilder-Smith, C. H., Hufschmid, E., & Thormann, W. (1998). The visceral and somatic antinociceptive effects of dihydrocodeine and its metabolite, dihydromorphine. A cross-over study with extensive and quinidine-induced poor metabolizers. ''British Journal of Clinical Pharmacology'', 45(6), 575–581. [https://pmc.ncbi.nlm.nih.gov/articles/PMC1873649/ PMC1873649]</ref> | |||
===Different routes of taking dihydrocodeine=== | ===Different routes of taking dihydrocodeine=== | ||
Revision as of 05:25, 8 March 2026
Dihydrocodeine is a semi-synthetic opioid developed in 1908 in Germany based on codeine and morphine. It was first marketed in 1911.[1] It is 2 times stronger than the original codeine,[2] and 1/6 times than the oral morphine.[3] Usually prescribed for pain relief or antitussive. If it is prescribed for pain relief, usually they use XR which lasts for 12 hours, giving them 60mg per dose, and 60-120mg per day. [4] If it is for cough, they usually use 10mg per dose, and 3 doses per day. [5] But they use tablets combined with things like Paracetamol, Methylephedrine, Guaifenesin, Chlorpheniramine, or Caffeine.

| semi-synthetic opioid |
| Chemical name: Morphinan-6-ol,
4,5-epoxy-3-metoxy-17-metyl-, (5α,6α)- |
| Chemical Formula: C18-H23-N-O3 |
| Molecule weight: 301 |
| Routes of administration: oral has to be the most good way to take Dihydrocodeine. About the prodrug oral vs other route, please go to the hyperlinked document |
| Oral bioactivity: 21% (range 12-34;rathers between person’s activity of CYP2D6). [7] It can be more active when it takes together with grapefruit |
| Oral Dose of recreational use | |
| Dosage Levels | |
|---|---|
| 20-50mg | Minimal |
| 50-100mg | Light |
| 100-150mg | Common |
| 150-200mg | Strong |
| 200-400mg+ | Heavy |
| Pharmacological Profile | |
| Onset | 45-55 minutes |
| Comeup | 40-50 minutes |
| Peak | 2-2.5 hours |
| Offset | 3-4 hours |
| Total Duration | 7-8 hours |
| Half-life | 3.3-4.5 hours |
Chemical
Pharmacology
Normally, we take dihydrocodeine in orally. As it is a opioid, it has a opioid effects, and most of dihydrocodeine’s opioid receptor effect is on to µ-receptor. [9] It is twice stronger then codeine, and 1/6 times of morphine orally. [10] Dihydrocodeine is a famous prodrug that metabolizes in the liver, expecially through the CYP2D6 enzyme. But also, it actives in CYP3A4. Through CYP2D6, dihydrocodeine became dihydromorphine, which is 1.3 times stronger then the original morphine. But less then 10% of the dihydrocodeine convert to dihydromorphine [11], and other metabolism is not for opioid effects. Even dihydrocodeine itself has a opioid effect, but is so weak which is almost hard to find a article about how much effect does the dihydrocodeine itself has. [12] substances metabolised by CYP3A4 is nordihydrocodeine, which is also not a good receptor in opioid.
So most of the effects are from dihydromorphine, and some people says because dihydrocodeine itself has a opioid effect, it has no ceiling effect, but no. If you are not a person who can feel euporia with dihydrocodeine itself, you can even have euporia with 5 tablets of DXM, which is not a opioid, but has some opioid effects.
The streagth of the dihydrocodeine is differ by person, because 5-10% of white people and some more percentage of Asian people has low metabolism in CYP2D6. [13] Because CYP2D6 metabolism is almost everything of this drug’s effect, CYP2D6 inhibitors such as Fluoxetin, Paroxetine, Bupropion, Quinidine makes dihydrocodeine’s effect weaker. [14]
Different routes of taking dihydrocodeine
Medical Use
Substance Effects
Desired Effects
Side Effects
Harm, Tocity, social problem of Dihydrocodeine
Combinations with other substances
Good Combinations
Bad Combinations
Legal status by each country
History
References
- ↑ Stolerman, I. P. (Ed.). (2010). *Encyclopedia of Psychopharmacology*. Springer-Verlag Berlin Heidelberg.
- ↑ Sobczak, Ł., & Goryński, K. (2020). Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse. *Table 2.3*. PMC7504308
- ↑ Leppert, W. (2010). Dihydrocodeine as an opioid analgesic for the treatment of moderate to severe chronic pain. *Current Drug Metabolism*, 11(6), pp. 515-520. PMID: 20540693
- ↑ 약학정보원. (n.d.). drug_cd=A11A0410A0051 디코데서방정 의약품 정보. 약학정보원 의약품상세정보.
- ↑ 약학정보원. (n.d.). 코푸정 의약품 정보. 약학정보원 의약품상세정보, Medication information of SS Bron from Japan.
- ↑ photo of the chemical structure is from wikipedia, [1]
- ↑ Rowell, F. J., Seymour, R. A., & Rawlins, M. D. (1983). Pharmacokinetics of intravenous and oral dihydrocodeine and its acid metabolites. *European Journal of Clinical Pharmacology*, 25(3), pp. 419–424.
- ↑ Rowell, F. J., Seymour, R. A., & Rawlins, M. D. (1983). Pharmacokinetics of intravenous and oral dihydrocodeine and its acid metabolites. *European Journal of Clinical Pharmacology*, 25(3), 419–424.
- ↑ Sobczak, Ł., & Goryński, K. (2020). Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse. *Table 2.1*. PMC7504308
- ↑ Leppert, W. (2010). Dihydrocodeine as an opioid analgesic for the treatment of moderate to severe chronic pain. *Current Drug Metabolism*, 11(6), pp. 515-520. PMID: 20540693
- ↑ Webb, J. A., Rostami-Hodjegan, A., Abdul-Manap, R., Hofmann, U., Mikus, G., & Kamali, F. (2001). Contribution of dihydrocodeine and dihydromorphine to analgesia following dihydrocodeine administration in man: a PK–PD modelling analysis. *British Journal of Clinical Pharmacology*, 52(6), pp. 619–628. DOI: 10.1046/j.0306-5251.2001.01414.x
- ↑ Wilder-Smith, C. H., Hufschmid, E., & Thormann, W. (1998). The visceral and somatic antinociceptive effects of dihydrocodeine and its metabolite, dihydromorphine. A cross-over study with extensive and quinidine-induced poor metabolizers. *British Journal of Clinical Pharmacology*, 45(6), 575–581. PMC1873649
- ↑ Wilder-Smith, C. H., Hufschmid, E., & Thormann, W. (1998). The visceral and somatic antinociceptive effects of dihydrocodeine and its metabolite, dihydromorphine. A cross-over study with extensive and quinidine-induced poor metabolizers. British Journal of Clinical Pharmacology, 45(6), pp. 575–581 PMC1873649
- ↑ Wilder-Smith, C. H., Hufschmid, E., & Thormann, W. (1998). The visceral and somatic antinociceptive effects of dihydrocodeine and its metabolite, dihydromorphine. A cross-over study with extensive and quinidine-induced poor metabolizers. British Journal of Clinical Pharmacology, 45(6), 575–581. PMC1873649