To ask what the difference is between cocodamol and dihydrocoedine

[Confused1975]

I’ve been getting horrific leg and groin pain at night. Was prescribed cocodamol and yesterday they changed the prescription to dihydrocoedine saying it would maybe be more effective. However I woke in excruciating pain and think the dihydrocoedine did nothing whereas the cocodamol was at least taking the edge off. I don’t really understand why as they are both coedine and act in the same way?

Co-codamol contains a mixture of codeine (an opiate) and paracetamol.

Dihydrocodeine is just another form of codeine. When it's prescribed on its own the does of codeine is usually large than the dose of codeine you get in most co-codamol products. So it's more potent.

Dihydrocodeine is stronger than codeine and I’ve found it very effective in the past. Maybe a medic or pharmacist will be able to explain why it’s not working as well for you.

You might be missing the paracetamol.
Try taking the D with two paracetamol if you aren't taking it elsewhere.

Take the dihydrocodiene with paracetamol.

Cocodamol is codeine and paracetamol, dihydrocodiene is a type of codeine alone.

After my c sections I was given 1 or 2 30mg dihydrocodiene (2 at the start and went down to 1) and 2 paracetamol every 4/6 hours and ibuprofen every 6 hours.

Dont underestimate the value of the paracetamol. Together with the codeine it will have been helping, I would take both

Be careful with the dihydrocodeine, I was prescribed it after some minor surgery. I took two in the morning and was absolutely off my nut for most of the day.

Cocodamol has a much lower dose of codeine than dihydrocodiene. It's possible though that your body just reacts better to the pain relief offered by the paracetamol in cocodamol.

Please be aware - dihydrocodeine also sometimes comes in a tablet with paracetamol too (e.g. in Co-dydramol).

You need to be VERY careful with paracetamol doses - i.e. it is important not to take more than the maximum daily dose. So before thinking about taking addition paracetamol tablets need to check there isn't any paracetamol in the products you are already taking.

Thanks all! I had been taking paracetamol before being prescribed cocodamol and it was doing nothing so hadn’t thought that might be the missing element. I honestly don’t think the dihydrocoedine made any difference to my pain which surprised me as doctor had said it was more effective and seems to work for a lot of people.

They're different drugs. As others have said, co-codamol is paracetamol with codeine (in different doses depending on the preparation). Dihydrocodeine is just that, but does also come as a 'co' drug with paracetamol. Codeine and dihydrocodeine are not the same drug and some people get on much better with one rather than the other, both in terms of analgesia and side effects, for no particularly good reason. The pharmacology would suggest dihydrocodeine should be the better analgesic but that doesn't always seem to work out in real life.

If you're not taking paracetamol since stopping the co-codamol you could try adding that back in or maybe ask to go back to co-codamol if you found it better. Remember both are addictive and very constipation. Hope that helps. (Doi: anaesthetist)

The other possibility that occurs to me is that you may be a poor metaboliser of codeine - it has to be changed into an active form in the body and people vary in how much this happens. I've just checked that the same enzyme is responsible for doing this for dihydrocodeine.

So, make sure you're taking paracetamol appropriately, keep taking the new prescription and if you can manage over the weekend go back on Monday and discuss what has and hasn't worked again. It not working for you will be information to guide the next choices.

Thanks I hadn’t realised that from what I had read it seemed they both worked in a very similar way. Will need to try and change back then

I have horrific hip and leg/groin pain just now, cocodamol was doing nothing but when I took some dihydrocodeine along with paracetamol and aspirin for a migraine, the other pain completely vanished. I've yet to actually speak to a dr about it though, I'm prescribed the cocodamol for period pain and the dihydrocodeine for migraines but I only get 30 dihydrocodeine at a time so I don't want to use them too often.

@Glitterblue have you had a diagnosis for your pain? I’m getting frustrated as nobody seems able to tell me what the problem is despite seeing numerous doctors and physios

@Confused1975 no I haven't. It seemed to start as sciatica a few months ago and I mentioned it when I had my prescription review and the Dr said to self refer myself for physio but lockdown happened so I've just been struggling on. It's changed now though, it's both hips and goes down my thighs and my hips click and feel like they lock sometimes. It's agony.

The combination of paracetamol and codine together works very well. Your body probably reacted well and it helped with the pain much better than just codine

Sorry to hear that I’m so fed up of the pain but good the dihydrocoedine works for you. I’m starting to wonder if the coedine doesn’t do anything for me, the cocodamol stops the spasming but not much more and I still wake in a lot of pain whereas the dihydrocoedine did nothing and I woke in spasm and agony. Wondering if it’s the paracetamol element rather than the coedine

Would have expected a bit more pain relief to be honest

I’m so sorry to hear this. I just stumbled across this thread reading your symptoms, it sounds like it could be sacroiliac joint dysfunction - I have this and it took months for me to be diagnosed. Please look it up and if it sounds familiar, speak to your GP and try to find an Osteo / chiropractor who can manipulate the joints back into place. There is hope!