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  • BDD Moderators: Keif’ Richards

Codeine vs Dihydrocodiene?

K

Klaha

Greenlighter
Joined
Nov 18, 2006
Messages
18
Hi - I recently came in to possession of a box of 100 Dihydrocodeine after leaving hospital due to 5 surgeries in the same place thus year along with other things. I normally use Codeine.

I did a bit of research - but know that the buffs here would probably be even better to ask. How does 30mg dihydrocodeine equate to 30mg of normal codeine? Is it stronger? Weaker? Different? If I normally take say...8 pills of codeine for example, what you would the equivalent? Do they -feel- the same, or is there a difference and what about lingering how fast until they are out of your system? Thank you so much for any help at all on this matter.
 
Dihydrocodeine is stronger, on average about twice as strong as codeine. The effects of dihydrocodeine should last longer, maybe around 2 hrs longer - like if the main effects of codeine normally last around 4 hrs, DHC should last around 6 hrs. Codeine usually takes around 15 hrs to be pretty much out of your system, whereas DHC takes around 20 hrs - how long a drug is in your body is different from the duration of noticeable effects of course.

If you normally take 30mg of codeine I would go with 15mg of DHC. I have no idea what "8 pills of codeine" means, there are different sizes of codeine pills. You need to say how many mg that is :). If you mean 8 x 30mg pills, for a total of 240mg, I would start with less than half of that in DHC to be on the safe side since everyone's different.
 
I am prescribed both these medications monthly and without a doubt I find dihydrocodeine is stronger then codeine. About 2x more potent ime although it may be different for you. Codeine gives me more of an initial histemic rush, ie. tingling extremities and that warmth in the torso. But it fades off after an hour or so and is not really noticeable after a couple of hours. Dihydrocodeine for me, starts slow and is actually a bit like a stimulant for the first hour or so and after that first hour becomes more if a classic opiate with sedating 'noddy' rushes that continue for about 6 hrs. The dihydrocodeine high for me is nothing at all like the codeine high. Its alot smoother and seems to have more 'depth' (you will see what I mean when you try it.lol), its a completly different animal to codeine and I actually prefer it to morphine which makes me unbelievably sick. If your doing around 250mg of code oine at a time then I would start at no more then 120mg dihydrocodeine or maybe even 90mg to be safe. Remember, unlike codeine you can effectively redose on dihydro' every couple of hours and theres no ceiling dose unlike codeine so take it slow and you will really enjoy it.
 
Yeah, DHC is about twice as strong. Although I've noticed differences in how opiates feel, I'd say codeine & DHC feel pretty much the same.
 
I think at least in my case, comparing dhc and codeine is like comparing a bottle of well aged single malt whiskey to a bad moonshine. They both do the same thing but the malt is a more enjoyable experience all-round.lol but maybe im just strange as I do enjoy dhc more then morphine.
 
Serotonin101 said:
does DHC have the ceiling that codeine does?
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That is a good question. Some say yes, some say no.

Wikipedia claims (uncited mind you) there is no ceiling and that the dose is limited by factors like APAP etc added to pills, adverse side effects with too high a dose, etc instead. But I read a product insert for DHC that said there was a ceiling at 240mg. Still other sources list the maximum daily dose anywhere from 240-720mg.
 
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I was just curious of the ceiling effect as I have known people to try to taper off opis with codeine but due to tolerance hit the ceiling effect and experienced little relief. dhc could be a good bridge to taper down with until one can make the switch to codeine. I'm suprised docs haven't looked into maintenance with dhc for mid level addiction that methadone just seems to large for the habit. maybe its the half life. but I would rather detox from dhc over bupe anyday as well as over methadone.

maybe as I further my career into learning about addiction (I am a recovering heroin addict) I could look into transitional tapering. start with methadone, taper down til one could use dhc to bridge to bupe, then taper down on bupe, then transition to a shorter halflife drug that could be used to "hop off" if you will. though I know they're investigating using morphine and hydromorphone as a maintenance drug in extended release pill form. I like the use of hydromorphone maintenance as its short half life could allow patience to taper down and when its time to hop off they could do a short "detox" if needed like a one or two day stay while the withdrawals hit their peak.

sorry for derailing the thread, just pondering...
 
Serotonin101 said:
does DHC have the ceiling that codeine does?
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nah, even the ceiling dose for codeine is debatable and seems to be disproved. i can take many more times the ceiling dose commonly said to be 400mg and only get increased effects, occasionally the histamine release will get a little fierce but nothing an anti-histamine doesn't take care of usually.

swimmingdancer said:
Still other sources list the maximum daily dose anywhere from 240-720mg. DHC can be toxic to the liver in high doses though.
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i haven't read that before. have you got the article handy?
 
tentram said:
nah, even the ceiling dose for codeine is debatable and seems to be disproved. i can take many more times the ceiling dose commonly said to be 400mg and only get increased effects, occasionally the histamine release will get a little fierce but nothing an anti-histamine doesn't take care of usually.
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It's weird, for both codeine and DHC some people swear there is a ceiling, while others say they've taken doses way above the supposed ceiling and the effects increase dose-proportionally like they normally would. Maybe it depends on the person? Or people swearing there is a ceiling are just repeating wheat they've read? I don't know myself, I could never take that much as side effects are way too great for me, I think I have a codeine sensitivity.
tentram said:
i haven't read that before. have you got the article handy?
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Honestly, I don't remember where I read it and I shouldn't have repeated it as though it were fact. It might not even be true - it's possible they might have been confused because of formulations that come with APAP. One thing that is interesting though is that the lethal dose for DHC in animals is very low compared to other opioids.
Here is a post I made in a different thread:

Swimmingdancer said:
Going by the LD50s (median lethal dose) in animals (which can not be used to assume safe human doses but can often be used to estimate a comparison of relative toxicity between 2 substances):
LD50 of oral oxycodone is: 920 mg/kg (rat) (source)
LD50 of oral dihydrocodeine is: 240mg/kg (rat) (source)

So that would lead me to think dihydrocodeine is a lot more toxic than oxycodone (especially since oxy is like 5-15 times stronger depending on the source).

I am not sure what a safe dose of dihydrocodeine is, especially for chronic use. It is often the toxicity of other ingredients that are often found in combination with dihydrocodeine (APAP, aspirin, etc) and/or the histamine-related side effects that limit the dose. Whether or not it has a ceiling dose is unclear. Some sources say dihydrocodeine is possibly unlike codeine in that dhc may lack a theoretical ceiling dose, codeine on the other hand after a certain dose (the exact amount seems to depend on the person) taking a higher dose will not produce more effects. However, a different source, states that dihydrocodeine does have a ceiling and the maximum recommended dose is 240mg daily since higher doses do not provide any further analgesic effect.

Different sources list the maximum daily dose for dihydrocodeine as being anywhere from 250-750 mg, but I have no idea what they're basing that off. I have certainly heard of people taking a lot more than 240mg and saying it still gave them increased effects. Don't know how safe it is though.
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But I am actually having trouble finding good sources on DHC side effects and toxicity. Perhaps because it's not widely used in the US?

There is one article that says it can cause kidney failure:

Two patients who developed severe narcosis and acute renal failure following therapeutic doses of dihydrocodeine are reported. The administration of naloxone produced an increase in respiratory minute volume and an improved level of consciousness. In addition, there was evidence of reversal of their renal failure with an increased urine output and creatinine clearance during the period of naloxone administration. Although the antidiuretic effect of opioids is well documented, opioids have not previously been incriminated in the aetiology of renal failure. The possible mechanism for this is discussed and the risks associated with the administration of dihydrocodeine to patients with renal failure or the elderly are emphasized. [source]
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I will look for some more info. I'm going to retract the liver toxicity statement for now.
 
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no worries, thanks for going to the effort. pethadine has a toxic metabolite and can some harm so i thought you may have it crossed with that, possibly. but that info regarding about it being in combination for apap could also be another reason there's mention of toxicity.

there's a hell of a lot of talk of the ceiling dose of codeine right here on bluelight. it was a hot topic at one stage when i was moderating OD and there were articles posted that argued against a ceiling dose for codeine as far as i can remember. i can't really recall why and what thread it was in (different computer, no bookmarks from that time-period) but it may be in the CWE thread. i'm sure a search would bring it up reasonably easy. effects definitely only increase with me. i've taken up to 3g and was as lit as you could get from shooting heroin.

it's not used very widely here apart from the cough syrup it comes in OTC, really. it's used fairly often in the UK as a Pain Management medication so i'd say most literature is bound to come from that way. i might have a look for it myself shortly and see what i can't find.

that's pretty interesting how the rat LD50 for oxy is 3 times higher that of the DHC as well. they'd probably like the oxy a lot more as well;)
 
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That same data sheet where I got the LD50 lists the following as side effects of DHC (in addition to normal opioid side effects and histamine-related effects): convulsions, biliary colic, hepatic enzymes increased. Not sure if these can occur with all opioids?
 
Serotonin101, dhc was used years ago, before the widespread use of methadone, as a tapering and maintenance treatment for opiate addiction but was succeeded by methadone mainly due to half-life of dhc being lower and more doses being needed to maintain the user over time as apposed to methadone with its massive halflife. one of the other reasons that dhc was dropped (according to my doctor) is this capacity is because in alot of users it produces a fair level of euphoria and created as much addiction as it treated. Although I think there would be merit in investigating it for addictions to moderate range opiates and opioids such as tramadol or hydrocodone, maybe even low level oxy habits. Not sure about the oxys, never tried them myself.
 
bunge said:
Serotonin101, dhc was used years ago, before the widespread use of methadone, as a tapering and maintenance treatment for opiate addiction but was succeeded by methadone mainly due to half-life of dhc being lower and more doses being needed to maintain the user over time as apposed to methadone with its massive halflife. one of the other reasons that dhc was dropped (according to my doctor) is this capacity is because in alot of users it produces a fair level of euphoria and created as much addiction as it treated. Although I think there would be merit in investigating it for addictions to moderate range opiates and opioids such as tramadol or hydrocodone, maybe even low level oxy habits. Not sure about the oxys, never tried them myself.
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good deal, thanks for the info. everytime I get a "great idea" it seems to already been thought up :(
 
never got to try dhc as I'm in the states. I despise codeine though cuz I get massive histamine release from it... makin me itch just thinking of it.
 
bunge said:
Serotonin101, dhc was used years ago, before the widespread use of methadone, as a tapering and maintenance treatment for opiate addiction but was succeeded by methadone mainly due to half-life of dhc being lower and more doses being needed to maintain the user over time as apposed to methadone with its massive halflife. one of the other reasons that dhc was dropped (according to my doctor) is this capacity is because in alot of users it produces a fair level of euphoria and created as much addiction as it treated. Although I think there would be merit in investigating it for addictions to moderate range opiates and opioids such as tramadol or hydrocodone, maybe even low level oxy habits. Not sure about the oxys, never tried them myself.
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I have an on/off high-dose Oxy addiction.

I use DHC to help me through the rough times, withdrawals etc quite successfully.

Somebody off this board suggested a DHC tapering regimen which works very well as they are time released 120mg tablets that i use.

I wait for anywhere between 36-48 hours (when the withdrawals from the oxy begin to kick in for me) i then dose 240mg DHC in the morning and then approximately 12 hours later dose the other 240mg DHC. Continue this for 1 or 2 days and then slowly begin to taper by reducing my dose by 60mg per day starting with the morning dose and then the next day cutting another 60mg from my evening dose and so on and so forth ( I sometimes taper at an even faster rate) and im usually done within a week or so with very little discomfort compared to all the times in the past when i just used to cold turkey off the Oxy and then go through a 7-10 day hell!
 
Pegasus said:
Does anyone like codeine more than DHC?
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I do; I seem to get more unpleasant side-effects from DHC than codeine.
I find DHC more stimulating, less dreamy and barely consider it worthwhile recreationally. That said I'd be pleased to have a box of 100 to play with!
As others have suggested start with half your codeine dose.
 
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