Codeine ? What’s the difference?

[JJSS123]

Posting for traffic very sorry!
What’s the difference between codeine 30mg and dihydracodeine? Sorry if that’s spelt wrong.
Thank you

Not a lot in effect. Why?

Dihydracodeine is prescription only, cocodamol is available over the counter. Presume Dihydracodeine is stronger?

In terms of the effects the difference is little. They are both opioid or narcotic drugs.
Technically: codiene is derived from a natural source whilst dihydracodiene is synthetically produced.
Some people find one works better than the other in controlling pain for them.

Codeine 30mg is not co codamol so is prescription only. Dihydrocodeine comes in different strengths. Are these prescribed for you and you need advice.

Yep not much depending on dosage. It all turns into morphine inside the body. Codeine is prescription only except very low dose combined with paracetamol or ibuprofen.

Codiene is not the same as coCodamol.
Both codiene and dihydracodiene are explicitly prescription only drugs.

Cocodamol over counter is usually 8mg codeine and 500mg paracetamol.

Cocodamol is paracetamol and codeine combined. You can get over the counter but also higher strength on prescription. Higher strength is usually 30/500 so 30g codeine and 500g paracetamol

It might be helpful to know why you’re asking.

They are both opioid-based painkillers and on the ladder of pain relief.

Technically, one is an opiate and one is an opioid. Opiates are opioids, not all opioids are opiates. One is, I think, synthetic and one derived from natural products.

If you are asking to find out which one is 'stronger', you've not given the strength of the DHC to which you are comparing the 30mg codeine to be able to give an indicative comparison between the two.

In practice, a surprising amount of pain relief is in the user's head so different people find different pain killers more effective. Although there is a general 'ladder of pain relief' most people react individually so it's not usually the case to say one is stronger.

@GlamGiraffe I think you’re confused.
Co-codamol IS codeine, just with paracetamol too. So codeine is available without prescription.

I have been on both op. I have fibromyalgia and sciatica and am in constant agony.

My doctor told me that dihydrocodeine is stronger and I completely agree. I’ve been taking it for around 5 years and it’s the best painkiller I’ve had. Tramadol is much “stronger” but I didn’t like it at all, pain relief wasn’t great and it made me feel sick.

Dihydrocodeine is very good but is addictive, as is codeine/co-codamol.

Sorry should of added more. I have fibromyalgia and arthritis and the pain is just getting worse. I am on codeine 30mg 4 times a day and pregablin. They have offered me tramadol and I am not sure weather to go down that route. I was just wondering if the dihydra was better than the codeine. I was on cocodamol 30mg but they changed it to codeine as it was cheaper to prescribe and asked me to buy my own paracetamol which was fine but just doesn’t have the same effect I think. I’m getting desperate now I have days where I can’t move my legs and I’m under 25 I have a young baby and I can’t carry on like this it’ll only get worse. Thanks for your replies x

Have you tried amitryptilne?

OP, you'll want to take the advice of your HCP. (and now I'll add a couple of things for your awareness, not as a recommendation).

1. I might have misread your most recent post but please don't discount paracetamol as a housekeeping painkiller. Don't exceed the dose and don't take if contraindicated but I've seen many people stop taking it because it's not 'strong' and they've been been prescribed opiates and paracetamol is available OTC 'so can't be effective' but when it's added back in to the mix with 'stronger' pain killers, they've said the reintroduction of the paracetamol transformed their subjective feelings of pain.

2. Putting aside the issues of dependency, for some people long term use of opioids can be counter-productive with longer-term/escalating use and poorly controlled pain. If pregabelin didn't have the effect, it might be an idea to discuss other neural-based pain relief. I've seen at least one person for whom pregabelin had little to no effect but ametryptyline was transformative, even though pregabelin is generally regarded as 'stronger'.

Sorry to hear you're struggling with uncontrolled pain and good luck.

Ok I totally get what you mean. I was lucky that my pain started later at 27 and I’m now 42 and it’s relentless. I have chronic insomnia and have anxiety. I also have OCD and ADD too so quite a cocktail of drugs.

I had to stop talking Pregablin as for me they were horrendous for weight gain which of course puts more pressure on the joints, same with Gabapentin and I’m already overweight as it is.

Have you been referred to a specialist pain
clinic op?

Codiene and separate paracetamol is the same as Co-codamol and I’ve also tried that way too. Tramadol is a horrible drug and my doctor thinks it’s best for acute pain like after an operation. I can handle painkillers but they were horrendous.

Please ask your doctor for dihydrocodeine as you will see a difference in pain relief.
I’ve tried many combinations and for me they are the best and combined with an anti inflammatory such as Naproxen enable me to live a pretty normal life and can cope with the pain most of the time.

Zilla I completely agree with your point 1 over the paracetamol. Used with dihydrocodeine it’s really very good.
If it was my only pain relief I would be in a bad state but combined it’s brilliant and very underrated.

Glad to hear things seem better for you, Curious. Idiot that I am, I forgot to mention an anti-inflammatory like Naproxen which many can tolerate more than ibuprofen. It's a shame there's not more explanation about the different families of pain relief and how best to combine them though the patient is usually in difficult circumstances when they've uncontrolled pain. I see gabapentin and pregabelin weren't helpful for you. Did you try amatryptiline before you settled on your current regime? I hope your pain stays controlled-enough to give you quality of life.

Thanks so much for your informative responses. I think I Will ask for the D one sorry settling the baby so trying to be quick. I try to take paracetamol every other codeine dose as I am conscious of prolonged use. Was on amitriptyline before I was pregnant and that was good but made me so sleepy which isn’t great with a baby who doesn’t sleep. I suffer most when I have a period and I get insomnia when ever I have a period so I am on a pill now which has stopped them luckily x

At the minute I have awful nerve pain well I say nerve pain it’s like tingling on my skin on my left leg all the way down I normally get it when I’m on my period so haven’t had that for a long time but god it is sore nothing helps it. It’s sore to touch. I’ve been having a fibro flare on and off for a month now

I use a cocktail of gabapentin, dihydracodeine / paracetamol, and amitriptyline to control my fibromyalgia. It isn’t perfect, but it’s the best combo I’ve found. Definitely speak to the doc about adjusting your meds if you’re struggling. I know mine need it every so often if my symptoms really flare up.
It’s so hard, and especially with a baby. x

Zilla I take Nortryptyline which is in the same “family” as my doctor said it’s both a good painkiller and sedative to help me sleep. To be honest, absolutely nothing works for my insomnia, I’ve tried Zopiclone/Zolpidem etc and I can get asleep like always but I’m awake by 1-2am. They are good for pain relief so I’m giving them a chance. I’m very in tune with my body and if something isn’t working for me then I see my doctor and reduce and eventually stop. For now I’m quite happy with what I’m taking but know the best thing for me would be to lose weight and reduce the strain on my legs where my worst pain is.

Op I really hope you manage to get the D from your doctor. Chronic pain is horrific and affects every area if your life. Don’t suffer any more

Sorry you're struggling to control your pain, it's no fun.

Just waved to stars the obvious on case... codeine alone, not co-codamol so much (don't know about dihydrocodeine) has caused me the most horrendous constipation. The 'I'm going to pass out' type pain, and is the only time I have ever faced the dilemma of gloving up or calling 999! Tmi I know, but gets the point across! Ishould never want anyone to go through that.

If you do take them ask gp/ chemist for laxative sachets...long term user of OTC ones not advised as they are strong, designed for one offs and can stop the bowel working effectively if taken too often. The gp ones you take a few times a day and they are milder. Lecture over xx

Hope you get some relief soon, it's not easy xx

I have Fibromyalgia & ME/CFS, plus arthritis & peripheral neuropathy, I take Dihydracodeine, Naproxen & I have Mirtazapine for sleep & to help my depression, I also use CBD to keep my levels of opioids down, it helps with sleep & muscle spasms as well. I have had gabapentin, pregabalin & amitriptyline but I didn't get on with any of them.

Curious, never easy to lose weight at the best of times, even without pain and the conditions that are causing the pain in the first place. try not to feel bad about something that someone without those problems may sometimes find easier to control (and many don't - the world's not short of overweight people who don't have to manage with what you have).