{"id":3910,"date":"2025-03-31T18:11:52","date_gmt":"2025-03-31T18:11:52","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/diamorphine-hydrochloride-txt\/"},"modified":"2025-03-31T18:11:52","modified_gmt":"2025-03-31T18:11:52","slug":"diamorphine-hydrochloride-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/diamorphine-hydrochloride-txt\/","title":{"rendered":"Diamorphine hydrochloride.txt"},"content":{"rendered":"

Diamorphine hydrochloride<\/h1>\n

CLINICAL USE <\/H3>
\nOpiate analgesic:Control of severe pain Pain relief in myocardial infarction (MI) Acute pulmonary oedema

DOSE IN NORMAL RENAL FUNCTION <\/H3>Severe pain: Oral\/SC\/IM: 5\u201310 mg 4 hourly, increasing dose as necessaryAcute MI, pulmonary oedema: IV: 2.5\u20135 mg. Elderly patients \u2013 reduce dose by half

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :423.9<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :35<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 0.1<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :40\u201350 litres<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :1.7\u20135.3 minutes\/\u2013

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Use small doses, e.g. 2.5 mg SC\/IM approx 6 hourly and titrate to response
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Use small doses, e.g. 2.5 mg SC\/IM approx 8 hourly and titrate to response

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • HDF\/high flux &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR 10 to 20 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugsAnti-arrhythmics: delayed absorption of mexiletineAntidepressants: possible CNS excitation or depression with MAOIs \u2013 avoid concomitant use and for 2 weeks after stopping MAOI; possible CNS excitation or depression with moclobemide; increased sedative effects with tricyclicsAntipsychotics: enhanced sedative and hypotensive effectSodium oxybate: enhanced effect of sodium oxybate \u2013 avoid concomitant use

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>1 mL water for injection or sodium chloride 0.9% (less may be used, e.g. for SC injection use 0.1 mL for 10 mg)

    Route <\/H4>IV, IM, SC, oral

    Rate of Administration <\/H4>IV: 1 mg\/minute

    Comments<\/H4>Monitor BP and respiratory rates

    OTHER INFORMATION <\/H4>Increased cerebral sensitivity in renal impairment which can result in excessive sedation and serious respiratory depression necessitating ventilationMore rapid onset and shorter duration of action than morphineExtreme caution with regular dosing \u2013 accumulation of active metabolites may occurNaloxone must be readily available for reversal if required
    \n","protected":false},"excerpt":{"rendered":"

    Diamorphine hydrochloride CLINICAL USE Opiate analgesic:Control of severe pain Pain<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-3910","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3910","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=3910"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3910\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=3910"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=3910"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=3910"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}