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  • BDD Moderators: Keif’ Richards | negrogesic

Does dihydrocodeine have a ceiling dose?

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pally pete

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I recently read that Codeiene has a ceilng des af around 400mg, (eg, taking any more is pointless)

And i know there a very dimilar sustance but does DHC (Dihydrocodeine) also have a ceiling dose and if so what is i?

Help much appreciated, Thanks.
 
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Thanks a lot for your reply, much appreciate it.

I do try and do as much research as possibly beore coming on here but i get a lot of it conlicting evidence.

So i eventually to turn to bluelight.


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"Where is the information about codeine's ceiling dose coming from? It would be nice to at least see a reference if claims like this, along with calculations supporting them, are going to be made. Just read the wiki article and you'll see that the ceiling dose effect contradicts other facts mentioned in the article. At the start of the pharmacology section, there is mention that 70% of codeine is metabolized to codeine-6-glucuronide (C6G). Codeine is metabolized to C6G by uridine diphosphate glucuronosyl transferase (UGT) 2B7. Only about 5% of codeine is metabolized by CYP 2D6 (Armstrong and Cozza, 2003). The article cited states that C6G is responsible for codeine analgesia, not morphine via 2D6. The pharmacology section is directly contradicting itself. The claims I have ever seen about the codeine "ceiling effect" have not been backed up by evidence: they seem to lie on the assumption that codeine analgesia is due to CYP2D6 producing morphine, which is being refuted. I have never seen any good evidence to suggest that codeine has a ceiling effect and some who use codeine recreationally will tell you that their experience contradicts it. I suggest removing this nonsense from the article.
Armstrong SC and Cozza KL. (2003) Pharmacokinetic drug interactions of morphine, codeine, and their derivatives: theory and clinical reality, Part II. Psychosomatics. 44: 515 - 520."

Not sure about DHC to be honest, but the codeine ceiling dose not mean effects wont be increased by upping the dosage, however the dose response range will drop.
 
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Re Tripman's post....

Other then extensive (personally, professionally and via friends/acquaintances) anecdotal evidence*, I have read papers describing and studying this (I'll try to find references), I'm quite confident that the codeine ceiling dose (regarding analgesic or euphoric effects) does exist.

Having said this however, I would hazard a guess that the reason why it's not really often/well studied is that, in terms of analgesic properties, codeine sucks! lol. Plus if used, doses very rarely exceed ~200mg.

Additionally, once this upper limit is reached, I've personally found the negative (specifically extreme dissociative) effects become more pronounced.

To the OP, regarding codeine's ceiling dose, check out the Codeine and CWE Megathread. However with DHC, not entirely sure (well not confident enough to comment just yet tbh).
 
If your doses have never exceeded 200mg then how can you possible comment on the ceiling dosage?

I have anecdotal evidence from myself and other prominent BL'ers such as ex Smod, and current AusDD mods Drug_Mentor and Mr.Blonde who have taken doses anywhere from 800-1800mg.

I promise you that while the liver can only turn so much codeine into morphine, the ceiling dose only effects the dose response range, you still get higher just at a lesser rate per quantity of codeine used.
 
Tripman said:
If your doses have never exceeded 200mg then how can you possible comment on the ceiling dosage?
Click to expand...

Haha, sorry, I didn't quite explain myself there. What I meant was if given by a health professional (EN/RN/GP/etc), very rarely are codeine doses exceed 200mg. Me, personally, has most definitely exceeded doses beyond that!!

Tripman said:
I have anecdotal evidence from myself and other prominent BL'ers such as ex Smod, and current AusDD mods Drug_Mentor and Mr.Blonde who have taken doses anywhere from 800-1800mg.
Click to expand...

I've spoken with these (particularly d_m and M_B off from BL) also regarding this topic. Along with multiple GP, Anaesthetists, RN/ENs, etc.

Clearly above said ceiling dose this doesn't imply "nothing" is felt, it's more-so the positive effects which are diminished!! Surely you've viewed the Codeine Megathread? I post very regularly there and have explained/discussed this in depth many times.

Tripman said:
I promise you that while the liver can only turn so much codeine into morphine, the ceiling dose only effects the dose response range, you still get higher just at a lesser rate per quantity of codeine used.
Click to expand...

Preaching to the choir brother ;) :P Basic physiology and codeine -dynamics/-kinetics really aren't pass me. :)
 
i quite often cwe codeine & i do it really well. get almost every last drop of water i originally add in what i end up with. so i dose around 400mg each time. when i have dosed higher ime it's stronger.

I've made a thread before about ceiling dose of codeine. & referenced that wiki site.

I dunno about dhc. ive only had small amounts of the cough syrup rikodeine which contains sorbitol too so ya cant have much
 
Dosed over a gram of DHC...I got more analgesia/side effects but there wasn't much euphoria... which is totally gone at any dose now :(

So pretty much what tripman said about slower conversion to morphine.

If like me you're taking more than 800mg DHC and not getting much outta it then its time to call it a day really as further dosing is a waste for me.

*Reminisces on 120mg opiate naive doses <3*
 
The reason codeine has a ceiling dose is because it Is inactive until converted into morphine within the body, this is done by your liver using a group of enzymes called p450.

Ironically codeine also inhibits this group of enzymes so if enough codeine is taken all p450 enzymes will be inhibited and therefore no more codeine will be converted within the body.

Because dihydrocodeine does not require to be converted within the body in order to become active it does not have a ceiling dose.
 
crepsirezzell said:
the reason codeine has a ceiling dose is because it is inactive until converted into morphine within the body, this is done by your liver using a group of enzymes called p450.

Ironically codeine also inhibits this group of enzymes so if enough codeine is taken all p450 enzymes will be inhibited and therefore no more codeine will be converted within the body.

Because dihydrocodeine does not require to be converted within the body in order to become active it does not have a ceiling dose.
Click to expand...

no.
 
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