Dihydrocodeine
Dihydrocodeine is a semi-synthetic opioid analgesic used to treat moderate to severe pain. It works by binding to opioid receptors in the brain and nervous system to reduce the perception of pain. This medication is typically prescribed when non-opioid pain relievers are insufficient.
Dihydrocodeine is an opioid pain medication for moderate to severe pain.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- N02AA08
- RxNorm
- 23088
- Generic
- Dihydrocodeine
- Class
- atc-n02
- Brands
- Trezix
- Availability
- rx
- Pregnancy
- C
- Lactation
- caution
- Routes
- oral
- Forms
- capsule, tablet, solution
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 30mg every 4-6 hours as needed
- Maximum
- consult physician
- Frequency
- every 4-6 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- Not recommended under 12 years
- Maximum
- consult physician
- Frequency
- N/A
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 30mg every 6-8 hours
- Maximum
- consult physician
- Frequency
- every 6-8 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
10 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks, use lowest effective dose for shortest duration
regular fetal monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
third trimesteravoid if possible
avoid use near delivery due to risk of neonatal respiratory depression and withdrawal
close fetal monitoring, assess for neonatal abstinence syndrome
Use of this medication in this population requires careful consideration of risks and benefits.
lactation
breastfeedingavoid
dihydrocodeine is excreted in breast milk, avoid breastfeeding during treatment
monitor infant for excessive sleepiness, breathing difficulties, or feeding problems
Use of this medication in this population requires careful consideration of risks and benefits.
geriatric
elderlyreduce initial dose by 25-50%, increase slowly
use with caution due to increased sensitivity, start with low doses, monitor for adverse effects
regular assessment of pain control, respiratory status, and cognitive function
Use with caution and monitor for adverse effects.
pediatric_age
under 12 yearsnot recommended
do not use in children under 12 years due to risk of severe respiratory depression
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
pediatric_age
adolescents 12 to 18use with caution, consider weight-based dosing
use only if benefits outweigh risks, monitor closely for respiratory depression
close monitoring for signs of respiratory depression and sedation
Use with caution and monitor for adverse effects.
renal_impairment
mild to moderatereduce dose by 25-50%
use with caution, adjust dosing interval, monitor for accumulation
monitor renal function, assess for opioid toxicity
Use with caution and monitor for adverse effects.
renal_impairment
severeavoid or use with significant dose reduction
use only if benefits clearly outweigh risks, consider alternative analgesics
frequent monitoring of drug levels and renal function
Use of this medication in this population requires careful consideration of risks and benefits.
hepatic_impairment
mild to moderatereduce dose by 25-50%
use with caution, impaired hepatic metabolism may alter drug effects
monitor liver function and opioid response
Use with caution and monitor for adverse effects.
hepatic_impairment
severeavoid
avoid use in severe hepatic impairment due to unpredictable metabolism
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
Statistics and clinical data
Commonly prescribed since
General prescribing information for dihydrocodeine products
Drug class
WHO ATC Classification System - Opioid analgesics
Common uses
Common therapeutic uses for dihydrocodeine
Potency relative to codeine
Pharmacological potency comparison
Treatment of moderate to severe pain, including postoperative pain, trauma pain, and pain from conditions such as cancer or musculoskeletal disorders. May also be used as a cough suppressant at lower doses.
Acts on mu-opioid receptors in the central nervous system to alter pain perception and emotional response to pain. Produces analgesia, sedation, and respiratory depression similar to other opioid medications.
Carries risk of dependence, tolerance, and addiction with prolonged use. Common side effects include drowsiness, constipation, nausea, and respiratory depression. Should be used with caution in patients with respiratory conditions, liver or kidney impairment, and should not be combined with alcohol or other CNS depressants.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 24, 2026. · Read our editorial policy