PARACODINA ® - Dihydrocodeine

PARACODINA ® is a medicinal product based on dihydrocodeine rhodanate

THERAPEUTIC GROUP: Antitussives, excluding associations with expectorants.

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications PARACODINA ® - Dihydrocodeine

PARACODINA ® is used in the clinical setting as a cough suppressant.

Mechanism of action PARACODINA ® - Dihydrocodeine

PARACODINA ® is a medicinal product based on Dihydrocodeine, an alkaloid derived from Codeine, able, once taken orally, absorbed from the gastro-enteric tract, metabolised at the hepatic level into active metabolites such as dihydromorgine, to reach the nerve center of cough, located at the level of the bulb, inhibiting its activation and consequently reducing the frequency and intensity of this reflection.

Despite the contiguity between the nervous center of the cough and the respiratory one, the Dihydrocodeine is able to exert a selective inhibitory action on the cough center, without compromising the respiratory capacities, and thus allowing the maintenance of adequate ventilatory capacities.

Following an intense hepatic metabolism, mostly supported by the cytochrome CYP2D6, the codeine derivatives are eliminated mainly via the kidney.

Studies carried out and clinical efficacy

DIIDROCODEINE IN ADDICTION TO ALCOHOL

Front Psychiatry. 2012 Mar 23; 3: 21. doi: 10.3389 / fpsyt.2012.00021. eCollection 2012.

Interesting study that tries to treat alcohol dependence with new therapeutic approaches such as dihydrocodeine. In this work a clear and stable improvement was observed in over ¼ of the patients treated.

DIIDROCODEINE IN PAIN CONTROL

Pharmacol Rep. 2012; 64 (1): 84-93.

Work using Diidrocodeine with released control, in the analgesia of cancer patients with constant pain. However, this activity appears to be associated more with the active metabolites of dihydrocodeine than with the same active ingredient.

DIIDROCODEINE MULTIFORM ERITEMA

Clin Exp Dermatol. 2010 Aug; 35 (6): 673-4. doi: 10.1111 / j.1365-2230.2010.03798.x. Epub 2010 Mar 19.

Clinical case that reports the appearance of erythema multiforme associated with the administration of dihydrocodeine phosphate, thus reiterating the importance of assessing the individual susceptibility to such treatment.

Method of use and dosage

PARACODINA ®

10.25 mg drops of dihydrocodeine rhodanate per 1 ml of product;

200 mg syrup of dihydrocodeine bitartrate for 100 g of solution.

Dosage and method of use should be defined by the doctor after assessing the patient's general health status and the severity of his / her clinical picture.

In general it is recommended in adults to take 25-30 drops 3-4 times a day, preferably on a full stomach, or 1-2 teaspoons several times a day.

An adjustment of the dosages is evidently necessary in pediatric, elderly or affected patients with particular pathologies.

Warnings PARACODINA ® - Dihydrocodeine

The use of PARACODINA ® must be carried out with particular caution considering the risk of addiction, associated with prolonged use of the product, and must necessarily be supervised by medical personnel.

Particular caution in the use of this drug should be reserved for categories of patients at risk, such as the elderly, nephropaths and liver disease.

Known the hepatic metabolism of Dihydrocodeine, and the numerous polymorphisms associated to the gene coding for the enzyme CYP2D6, responsible for the activation of the active principle, it would be possible to find the possible presence of significant variations in the biological efficacy of this drug.

It is also important to consider the presence of sucrose in PARACODINA ®, potentially contraindicated in patients with hereditary fructose intolerance, glucose / galactose malabsorption syndrome and sucrase-isomaltase enzyme deficiency.

It is recommended to keep the medicine out of the reach of children.

PREGNANCY AND BREASTFEEDING

The ability of opioids to cross the placental barrier, reaching the fetus, and to concentrate in pharmacologically active doses in breast milk, extends the contraindications to the use of PARACODINA ® also to pregnancy and the subsequent period of breastfeeding.

Interactions

The patient on PARACODINA ® therapy should avoid the simultaneous intake of drugs active on the central nervous system, antihistamines and alcohol.

It would also be advisable to consider how the simultaneous assumption of inhibitory or inducing active principles of the cytochromial system, can determine a significant variation in the efficacy and safety profile of Dihydrocodeine.

Contraindications PARACODINA ® - Dihydrocodeine

The use of PARACODINA ® is contraindicated in patients with active substance hypersensitivity or to one of its excipients, liver failure, respiratory failure, constipation, in children under two years of age and during pregnancy and lactation.

Undesirable effects - Side effects

The use of PARACODINA ®, especially if continued for a long time, could determine the appearance of side effects such as sedation, drowsiness, gastrointestinal disorders, nausea, vomiting, constipation, headache, dizziness and asthenia.

Fortunately, the appearance of respiratory and cardiovascular deficits is rarer. serious ascoluses.