confused

[momander]

I have just had my co codamol 30/500 changed to dihydrocodeine 30mg along with paracetamol. My GP said to take them exactly the same way as I took my co codamol, 2 tablets 4 times a day, and also paracetamol 2 tablets 4 times a day. I was doing this for just over a week when my sisster said she thought the GP was wrong as the max daily dose for dihydrocodeine is 180mg a day (up to 6 tablets), and I had been taking 8 tablets a day ( 240mg)?? I phoned my GP surgery to check, and had a phone back advising that the GP had said it is perfectly safe to take 8 tablets a day, (240mg).

The patient information leaflet says a max of 6 tablets a day, (180 mg)??

I have googled this and cannot find anywhere at all that says you can take 240mg of the 30mg tablets per day??

On the printed instructions on the box it also says take up to 8 tablets per day, max of 240mg??

I am confused and am none the wiser? I'm not really sure what I should do?

Is anyone else on this medication? and if so, what dose have you been advised to take?

[Bananas5]

Take what your GP tells you not Dr google

x

[momander in reply to Bananas5]

Thank you. I would never take Dr google's advice!! I think you may have misunderstood? What I meant was that I could not find anything on google that agreed with my GP.

[Bananas5 in reply to momander]

Sorry but I did understand.!!!!!

x

[Bevvy]

I also take dihydrocodeine and paracetamol tablets. I have just checked instructions and can take up to 4x a day, 2 tablets. Every 4-6 hours which equals 8a day. I TRY to take less than that but depends on how bad pain is. I even have occasions where I do not need the medication for a few weeks, but then pain breaks through again ☹️

I have had this medication for years on repeat prescription and even with yearly medication checks have not had it queried.

So that would suggest your gp is correct but if you want further clarity speak to your pharmacist.

[momander in reply to Bevvy]

Hi Bevvy,

Can you please tell me what instructions you are referring to? The patient information leaflet states no more than 6 x 30mg tablets in a day, and a max of 180mg.

[Bevvy in reply to momander]

I am reading the instructions from gp on the outside of the box. This is same amount been prescribed for a number of years and never queried by pharmacist.

As said previously am comfortable with instructions from gp (and had several). If you are unsure speak to your pharmacist. Although you said you have queried it with gp and their response was that you are safe with amount prescribed. At end of day it is up to you whose advice you take. Gp has said what you can take. If you are uncomfortable then either query or take 6 a day instead of 8….

However I am not taking additional paracetamol to this which I think you are doing?? If so that is a lot of paracetamol. I AM currently taking Naproxen in addition but again this is with gp knowledge and is to assist me during a severe pain flare up and not long term.

[weathervane]

I’ve always found my pharmacist really helpful if im unsure about meds .

[momander in reply to weathervane]

yes you are right. I have asked and he agreed that or os best to fillow the P.I.L. which says noore than 6 a day , max of 180mg

[etheral]

The danger here is the amount of acetominophen you are taking. This could have potentially irreversible effects on your liver. If you are taking 6 grams from the the dihrdro odeine/paracetamol mixture plus extra paracetamol you are far exceeding the reccomended daily maximum dose. Taking the exra dihydrocodiene will only increase your difficulty in stopping the drug because of withdrawal effects. Dangerous narcotic effects such as respiratory depression should not be a problem at this dose as long as you are not mixing the drug with other potentially respiratory depressants such as alcohol or benzodiazipines. I would get liver function tests done and stop the extra paracetamol. Best, etheral

[momander in reply to etheral]

my goodness!! Are you a scientist, chemist, GP or consultant??? Thats a pretty damning response. When I took co codamol it was 30/500 strength, so30mg codeine and 500 paracetamol. The dihydracodeine is 30mg. My GP prescribed parparacetamol 500mg to be taken with each dihydracodeine tablet.

[etheral]

I'm a retired Emergency Department ( a +e ) physician. I live in Maine, US

[happytulip in reply to etheral]

the paracetamol dose is fine. Her GP has advised her to take 2 tablets (1g) 4 times a day which is the maximum amount of paracetamol allowed in 24 hrs as stated on the box.

The question here is about the dihydrocodiene dose. I would advice following the advice of the GP and pharmacist if the dose has been queried and confirmed.

I too worked in ED and saw individual patients on higher doses of meds than is typically prescribed.

[etheral]

If your dihydrocodiene pill does not contain paracetamol you should be OK. Anything more than 4grams a days of paracetamol isnot recomeded.

[momander in reply to etheral]

I am NOT taking more than I should of paracetamol. I am taking 8x509mg tablets a day max which here in the uk is fine.

[etheral in reply to momander]

That dose should be fine. I was under the impression that the narcotics you were talking also contained paracetamol. Hope you find a way to get decent painrelief.

[momander in reply to etheral]

No no, just sihydracodeibe in its own, then a aeparate prescription of paracetamol.

[Angelicscripts6]

im on 8 a day +if pain becomes intolerable i can take more & once under control i drop back down . Paracetamol works well with said pain medicine ...drink lots of fluids so that your not constipated.

[momander in reply to Angelicscripts6]

Thank you!! At last!! Someone who is not preaching!!! I am 63!! Not a child!! Phew!! Honestly!!! The constipation is not pleadamt and I drink upwards of 2 ltres of water a day. I was fine on co codamol!? No constipation!!??

[Angelicscripts6 in reply to momander]

ive been on said medication for over 20yrs & have been prescribed varies nerve/pain medication to which some have had a negative effect. Said medication also comes in 120mg which is slow release, see if your gp will trial this with you, it may also combat constipation your experienceing. Know its not good when your of an age & know your own mind & more importantly your own body to have some Condisending health professionals tell you otherwise.

[momander in reply to Angelicscripts6]

thank you. Unfortunately slow release disagrees with me!! Strange isnt it!? It makes me feel really sick amd the pain relief isnt as good.

[Angelicscripts6 in reply to momander]

I couldnt tolerate slow release either ... we all have differant physiology so trying to cram everybody into the same box is not possible, Even though the Health Professionals try to do this, it doesn't work...hope you find a happy balance with your self.

[momander in reply to Angelicscripts6]

thank you so much

[NaturesArtist]

Your GP is able to change the recommendations by the drugs company. That’s quite within his remit.

When I was on Dihydrocodeine 30mg tablets, I was prescribed 2 x 30 mg tablets up to 4 times per 24 hour period. I was also prescribed paracetamol as a separate prescription. This way I had more control over my pain meds … which can be quite liberating. If you’re so unsure or not confident in your current GP, ask to see a different one!

You can get more information from your local pharmacist.

It might benefit you to see the pain clinic. I’d ask for a referral if you still feeling unsure or you want people that specialise in pain management!

Just remember though you will always have some pain. It isn’t possible to remove every last bit of it. I was told that years ago. By taking the edge off your chronic pain you will be able to carry on doing some of things you enjoyed

[happytulip in reply to NaturesArtist]

very well said.

[momander in reply to happytulip]

I agree!!

[momander in reply to NaturesArtist]

Thank you. I have no reson to ask to see another GP. I have a very good relationship with mine. I have already been to.the pain clinic for something else so cannot go again. My pharmacist advised to stick to the P.I.L. The dihydracodeine IS syringer than co codamol and urs, I agree it does not eliminate pain!! Nothing does!! Apart from sleep!!

[Kinga2500]

hi I’m using same medicine. Is safe to do 8 tablets. Is like u have to take no more than 6 tablets but they leaving space for extra two if u need. By the way on my dihydrocodeine says max 8 tablets so is nothing worried about. Obviously if is included paracetamol can’t take it much often that 4 hours gap. If u taking paracetamol separately u can get this like after 3 hours to make sure u not in pain if that’s make sense?

[momander in reply to Kinga2500]

thank you. My instructions say no.more than 6 dihydracodeine a day, a max of 180mg a day? Im wondering what insyructions you have? I take paracetamol separately. Im allowed 8 a day max.

[Kinga2500 in reply to momander]

I have 2 tablets 4 times a day. Which give 240 dose of dihydrocodein NHS says no more than 240 mg

Maybe your doc think u don’t need more doses but if u felling like u need just tell him but yes is safe to take 8 tablets a day

I been confused like u on beginning but in hospital they explain is always safe to take one or two more as label saying if needed but isnt recommend

[momander in reply to Kinga2500]

ok thank you. NHS says no more than 180mg!! Its ok to take 240mg if you ate o 40mg tablets. I am in 30mg tablets.

[Kinga2500 in reply to momander]

just I’ve check on NHS website. ..says 240 and I’m on 30 mg tablets too…

[momander in reply to Kinga2500]

Hi, Im not sure what website your looking at? Im in scotland amd the NHS website here says no more than 6 tablets in a 24 hour period ( of 30 mg)

[Kinga2500]

best consult with doc. Just I had quick look on NHS.

[RT2826]

My take on this would be to listen to your Doctor. I've been on meds like this for over 25 years and rarely follow the advice in the patient leaflet. This is written for general use but your Doctor knows your circumstances. I hope you get some relief.

[momander in reply to RT2826]

thank you so much. I guess im just anxious incase I overdose!?

[momander]

tomcotton,

Is this some kind of advert or are you promoting a product??? I am sure we are ALL aware that everyone feels pain from time to time, and off the reasons.

your post is completely irrelevant to my original post

[Kinga2500]

I had the same situation. In the hospital, they explained to me. That is safe to take up to 8 tablets. The box says 6 tablets a day but is that just for safety reasons to make people not get more without consulting with doc Becouse always is a risc. Any painkillers have a gap for extra two emergency dosages. U can take extra two tablets a day after taking with GP, if that’s not helping they switch to something else or higher strength this isn’t my opinion is just what they told me