Co-dydramol
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| Combination of | |
|---|---|
| Dihydrocodeine | Opioid analgesic |
| Paracetamol | Non-opioid analgesic |
| Clinical data | |
| Routes of administration |
Oral |
| Legal status | |
| Legal status |
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| (verify) | |
Co-dydramol (BAN) is a non-proprietary name used to denote a particular compound analgesic, a combination of dihydrocodeine tartrate and paracetamol. Co-dydramol tablets are used for the relief of moderate pain. Co-dydramol is part of a series of combination drugs available in the UK and other countries including co-codaprin (aspirin and codeine).
Contents
Formulations[edit]
All formulations of co-dydramol contain 500 mg of paracetamol per tablet and may only be sold at a pharmacy as an over-the-counter item without prescription (a P medicine) if containing less than 7.5 mg of dihydrocodeine per tablet. Higher strengths are prescription only medicines. There are no GSL formulations of co-dydramol, as it is a Schedule 5 controlled drug. Four strengths of dihydrocodeine tartrate in each tablet are available:
- 7.46 mg dihydrocodeine as co-dydramol 7.46/500 (e.g. in the branded product Paramol).
- 10 mg dihydrocodeine as co-dydramol 10/500, this is also the preparation to be dispensed if no strength is specified on a prescription.
- 20 mg dihydrocodeine as co-dydramol 20/500 (e.g. branded products Paracod 500/20 and Remedeine).
- 30 mg dihydrocodeine as co-dydramol 30/500 (e.g. branded products Paracod 500/30 and Remedeine Forte).
Metabolism[edit]
Dihydrocodeine is metabolised by the CYP450 system isoenzyme 2D6 to dihydromorphine, which mediates the majority of its analgesic effects. Owing to the low oral bioavailibility of dihydrocodeine (20%), and its subsequent metabolism to active compounds, it is likely that doses below 30mg are sub therapeutic for analgesia.
Possible Side Effects[edit]
- Allergic reactions - skin rash or itchy skin, difficulty breathing, increased sweating, redness or flushed face, mucosal lesions (such as mouth ulcers), drug fever.
- Abdominal pain - may be caused by spasm of the bile ducts and inflammation of the liver or pancreas.
- Gastrointestinal system - stomach irritation (mild stomach pain, heartburn and feeling sick), constipation, feeling or being sick, loss of appetite, dry mouth, difficulty in passage of food through the gut.
- Blood - anaemia, changes in numbers and types of blood cells, nose bleeds, increased risk of infection, bruising.
- Urinary system - pain or difficulty in passing urine.
- Nervous system - confusion, drowsiness, dizziness, 'spinning' sensation, mood changes, depression, hallucinations, restlessness, excitation, fits, increased pressure in the skull (painful eyes, changes in vision), headache, difficulty sleeping, nightmares, reduced alertness. Tolerance or dependence.
- Eyes - blurred or double vision, extremely small pupils.
- Other - trembling, unusual tiredness or weakness, malaise, low body temperature, breathing difficulties, muscle stiffness, changes in sex drive
References[edit]
- British National Formulary 2004
- Merck Index 13th Edition
- Oxford textbook of clinical pharmacology Second Edition (09. October 1992)
- Martindale: The complete drug reference 35th Edition (2007)
- Goodman & Gilman's The Pharmacological Basis of Therapeutics, 11th Edition
- Information on the packaging leaflet in Co-dydramol from Hammed
