lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: capsule, oral solution, solution for
injection, powder for solution for injection
Tablet
CAUTIONARY AND ADVISORY LABELS 2
▶Diamorphine hydrochloride (Non-proprietary)
Diamorphine hydrochloride 10 mgDiamorphine 10 mg tablets|
100 tabletP£ 33. 75 DT = £ 33. 75 b
Powder for solution for injection
▶Diamorphine hydrochloride (Non-proprietary)
Diamorphine hydrochloride 5 mgDiamorphine 5 mg powder for
solution for injection ampoules| 5 ampouleP£ 11. 36 DT =
£ 11. 36 b
Diamorphine hydrochloride 10 mgDiamorphine 10 mg powder for
solution for injection ampoules| 5 ampouleP£ 12. 95 – £ 16. 56 DT =
£ 12. 95 b
Diamorphine hydrochloride 30 mgDiamorphine 30 mg powder for
solution for injection ampoules| 5 ampouleP£ 13. 80 – £ 16. 52 DT =
£ 11. 22 b
Diamorphine hydrochloride 100 mgDiamorphine 100 mg powder
for solution for injection ampoules| 5 ampouleP£ 42. 39 DT =
£ 42. 39 b
Diamorphine hydrochloride 500 mgDiamorphine 500 mg powder
for solution for injection ampoules| 5 ampouleP£ 187. 70 DT =
£ 187. 70 b
Spray
EXCIPIENTS:May contain Benzalkonium chloride, disodium edetate
▶Ayendi(Wockhardt UK Ltd)
Diamorphine (as Diamorphine hydrochloride) 720 microgram per
1 doseAyendi 720 micrograms/actuation nasal spray| 68 doseP
£ 107. 90 (Hospital only)b| 160 doseP£ 112. 50 (Hospital
only)b
Diamorphine (as Diamorphine hydrochloride) 1.6 mg per
1 doseAyendi 1600 micrograms/actuation nasal spray|
68 doseP£ 113. 52 (Hospital only)b| 160 doseP£ 123. 75
(Hospital only)beiiiiF 273Dihydrocodeine tartrate
lINDICATIONS AND DOSE
Moderate to severe pain
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 1–3 years: 500 micrograms/kg every 4 – 6 hours
▶Child 4–11 years: 0. 5 – 1 mg/kg every 4 – 6 hours (max. per
dose 30 mg)
▶Child 12–17 years: 30 mg every 4 – 6 hours
▶BY INTRAMUSCULAR INJECTION, OR BY SUBCUTANEOUS
INJECTION
▶Child 1–3 years: 500 micrograms/kg every 4 – 6 hours
▶Child 4–11 years: 0. 5 – 1 mg/kg every 4 – 6 hours (max. per
dose 30 mg)
▶Child 12–17 years: 30 mg every 4 – 6 hours (max. per dose
50 mg)
Chronic severe pain
▶BY MOUTH USING MODIFIED-RELEASE MEDICINES
▶Child 12–17 years: 60 – 120 mg every 12 hours
DF118 FORTE®
Severe pain
▶BY MOUTH
▶Child 12–17 years: 40 – 80 mg 3 times a day; maximum
240 mg per daylUNLICENSED USEMost preparations not licensed for use in
children under 4 years.
lCAUTIONSPancreatitis.severe cor pulmonale
lINTERACTIONS→Appendix 1 : opioids
lSIDE-EFFECTS
Biliary spasm.bronchospasm.dysuria.hypothermia.
mood altered.postural hypotension.sexual dysfunction.
ureteral spasmlBREAST FEEDINGUse only if potential benefit outweighs
risk.
lRENAL IMPAIRMENTAvoid use or reduce dose; opioid
effects increased and prolonged and increased cerebral
sensitivity occurs.
lPROFESSION SPECIFIC INFORMATION
Dental practitioners’formulary
Dihydrocodeine tablets 30 mg may be prescribed.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution
Modified-release tablet
CAUTIONARY AND ADVISORY LABELS2, 25
▶DHC Continus(Napp Pharmaceuticals Ltd)
Dihydrocodeine tartrate 60 mgDHC Continus 60 mg tablets|
56 tabletP£ 5. 20 DT = £ 5. 20 m
Dihydrocodeine tartrate 90 mgDHC Continus 90 mg tablets|
56 tabletP£ 8. 66 DT = £ 8. 66 m
Dihydrocodeine tartrate 120 mgDHC Continus 120 mg tablets|
56 tabletP£ 10. 95 DT = £ 10. 95 m
Tablet
CAUTIONARY AND ADVISORY LABELS 2
▶Dihydrocodeine tartrate (Non-proprietary)
Dihydrocodeine tartrate 30 mgDihydrocodeine 30 mg tablets|
28 tabletP£ 1. 09 DT = £ 0. 72 m| 30 tabletP£ 0. 77 –
£ 1. 56 m| 100 tabletP£ 3. 89 DT = £ 2. 57 m|
500 tabletP£ 12. 85 m
▶DF 118 (Martindale Pharmaceuticals Ltd)
Dihydrocodeine tartrate 40 mgDF 118 Forte 40 mg tablets|
100 tabletP£ 11. 51 DT = £ 11. 51 m
Solution for injection
▶Dihydrocodeine tartrate (Non-proprietary)
Dihydrocodeine tartrate 50 mg per 1 mlDihydrocodeine 50 mg/ 1 ml
solution for injection ampoules| 10 ampouleP£ 105. 27 DT =
£ 105. 27 b
Oral solution
CAUTIONARY AND ADVISORY LABELS 2
▶Dihydrocodeine tartrate (Non-proprietary)
Dihydrocodeine tartrate 2 mg per 1 mlDihydrocodeine 10 mg/ 5 ml
oral solution| 150 mlP£ 8. 94 DT = £ 8. 94 mDihydrocodeine with paracetamol
18-Jan-2018The properties listed below are those particular to the
combination only. For the properties of the components
please consider, dihydrocodeine above, paracetamol p. 271.lINDICATIONS AND DOSE
Mild to moderate pain (using 10 / 500 preparations only)
▶BY MOUTH
▶Child 12–17 years: 10 / 500 – 20 / 1000 mg every 4 – 6 hours
as required; maximum 80 / 4000 mg per day
Severe pain (using 20 / 500 preparations only)
▶BY MOUTH
▶Child 12–17 years: 20 / 500 – 40 / 1000 mg every 4 – 6 hours
as required; maximum 160 / 4000 mg per day
Severe pain (using 30 / 500 preparations only)
▶BY MOUTH
▶Child 12–17 years: 30 / 500 – 60 / 1000 mg every 4 – 6 hours
as required; maximum 240 / 4000 mg per day
DOSE EQUIVALENCE AND CONVERSION
▶A mixture of dihydrocodeine tartrate and paracetamol;
the proportions are expressed in the form x/y, where x278 Pain BNFC 2018 – 2019
Nervous system4