Last update Aug. 16, 2022

Dihydrocodeine

Low Risk

Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

It is an opioid analgesic related to codeine, with similar analgesic activity. It is used for the relief of moderate to severe pain, often in combination preparations with acetaminophen. It has also been used as a cough suppressant. Oral, subcutaneous or intramuscular administration three to four times a day. The enzyme cytochrome P450-CYP2D6 catalyzes its metabolization into dehydromorphine.

Since the last update we have not found published data on its excretion in breastmilk.

A two-day-old newborn, whose mother was taking dihydrocodeine for a cough, developed respiratory depression that required hospitalization. (Eleftheriou 2014)

Codeine is excreted into breast milk in non-significant amount, however, serious health problems have appeared among off-spring of mothers who are rapid metabolizers from Codeine to Morphine.

Discontinue if excessive sedation appears in mother or infant, and, do not administer if such a background in mother or family is present, as there are between 1% and 29% of people who are rapid metabolizers from codeine to morphine with an excess of the gene linked to enzyme P450-CYP2D6.

Ibuprofen is more effective than dihydocodeine for pain relief. (Edwards 2000)


See below the information of this related product:

  • Codeine ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)

Alternatives

  • Butorphanol Tartrate ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Dextromethorphan ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Ibuprofen ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Morphine (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Paracetamol ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Dihydrocodeine is also known as


Dihydrocodeine in other languages or writings:

Groups

Dihydrocodeine belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Dihydrocodeine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 20 %
Molecular weight 452 daltons
pKa 14.15 -
Tmax 1.2 - 1.8 hours
3.5 - 5 hours

References

  1. Eleftheriou G, Butera R, Davanzo F, Farina ML. Dihydrocodeine and breast feeding: a case report. Birth Defects Res Clin Mol Teratol. 2014;100:540. (Abstract 43) In: Meeting Abstracts The 2nd International OTIS-ENTIS Conference at The Hospital for Sick Children, Toronto, Canada September 19–21, 2014
  2. Edwards JE, McQuay HJ, Moore RA. Single dose dihydrocodeine for acute postoperative pain. Cochrane Database Syst Rev. 2000 Abstract
  3. Rowell FJ, Seymour RA, Rawlins MD. Pharmacokinetics of intravenous and oral dihydrocodeine and its acid metabolites. Eur J Clin Pharmacol. 1983 Abstract

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