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See also Opioid receptor agonists
Dihydrocodeine is an opioid analgesic related to codeine, in which the double bond in the seventh position is saturated. It is about one-tenth as potent as morphine and 2–3 times more potent than codeine. It is similar to codeine in other respects. The most common adverse reactions are nausea, vomiting, and drowsiness [ , ].
In a randomized, double-blind comparison of the antitussive effect of dihydrocodeine 10 mg tds with levodropropizine 75 mg tds in 140 adults with primary lung cancer or metastatic cancer there was no significant difference between the two drugs as far as cough severity and the numbers of night wakings were concerned, both drugs leading to significant improvement [ ]. However, dihydrocodeine caused significantly more somnolence, which was reported by 11% and in some cases was continuous. Other adverse effects reported by those taking dihydrocodeine included erythema of the abdomen and epigastric pain, although constipation, a potential adverse effect of codeine derivatives, was not reported.
Dihydrocodeine has been compared with nabilone, a synthetic cannabinoid, in the treatment of chronic neuropathic pain [ ]. Dihydrocodeine provided better pain relief and was associated with fewer adverse effects. Only tiredness and nightmares were more frequent with dihydrocodeine.
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