paracetamol and dihydrocodeine

CLINICAL USE


Analgesic

DOSE IN NORMAL RENAL FUNCTION

1–2 tablets up to 4 times a day

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Paracetamol: 151.2; dihydrocodeine: 451.5 (as tartrate)
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Paracetamol: 20–30; dihydrocodeine: –
  • %Excreted unchanged in urine &nbsp &nbsp : Paracetamol: <5; dihydrocodeine: 13–22
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :Paracetamol: 1–2; dihydrocodeine: 1.1
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :Paracetamol: 1–4/Unchanged; dihydrocodeine: 3.5–5/6+

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : 50–100% of dose every 6 hours
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : 50–100% of dose every 6–8 hours

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL/min

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugsNone known

    ADMINISTRATION

    Reconstition

    Route

    Oral

    Rate of Administration

    Comments

    OTHER INFORMATION

    Active metabolites of dihydrocodeine accumulate in renal impairment (drowsiness/lightheadedness/constipation). Increased cerebral sensitivity in patients with renal failureCo-dydramol