1. Name of the medicinal product
DHC CONTINUS 60 mg, 90 mg and 120 mg prolonged release tablets. Where and how can I buy Dihydrocodeine Continus 30mg, 60mg, 90mg, 120mg tablets online over the counter without prescription in uk next day delivery.
2. Qualitative and quantitative composition
Each 60 mg tablet contains dihydrocodeine tartrate 60 mg. Each 90 mg tablet contains dihydrocodeine tartrate 90 mg. Each 120 mg tablet contains dihydrocodeine tartrate 120 mg. Excipient with known effect: Each 60 mg tablet contains lactose anhydrous 58.4 mg. Each 90 mg tablet contains lactose anhydrous 40.5 mg. Each 120 mg tablet contains lactose anhydrous 54 mg. For the full list of excipients, see section 6.1.
3. Pharmaceutical form
Prolonged release tablet.
White capsule-shaped tablet. 60 mg tablets are marked DHC 60, 90 mg tablets are marked DHC 90 and 120 mg tablets are marked DHC 120. Where and how can I buy Dihydrocodeine Continus 30mg, 60mg, 90mg, 120mg tablets online over the counter without prescription in uk next day delivery.
4.1. Therapeutic indications
For the relief of severe pain in cancer and other chronic conditions. DHC CONTINUS tablets are indicated for use in adults and children over 12 years of age.
4.2. Posology and method of administration
Posology
Adults and children over 12 years:
60 mg: One or two tablets 12-hourly. 90 mg and 120 mg: The usual dose is one tablet 12-hourly.
Elderly:
Dosage should be reduced
Prior to starting treatment with opioids, a discussion should be held with patients to put in place a strategy for ending treatment with dihydrocodeine in order to minimise the risk of addiction and drug withdrawal syndrome (see section 4.4). Where and how can I buy Dihydrocodeine Continus 30mg, 60mg, 90mg, 120mg tablets online over the counter without prescription in uk next day delivery.
Paediatric population
Children 12 years or under: Not recommended.
Method of administration
Oral.
4.3. Contraindications
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1; severe respiratory depression with hypoxia; severe chronic obstructive lung disease; severe cor pulmonale; severe bronchial asthma; paralytic ileus; acute alcoholism. As dihydrocodeine may cause the release of histamine, it should not be given during an asthma attack.
Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine. Where and how can I buy Dihydrocodeine Continus 30mg, 60mg, 90mg, 120mg tablets online over the counter without prescription in uk next day delivery.
4.4. Special warnings and precautions for use
Dihydrocodeine should be administered with caution to the elderly or patients with:
• a history of opioid abuse or dependence
• raised intracranial pressure, intracranial lesions or head injury
• reduced level of consciousness of uncertain origin
• biliary tract disorders
• prostatic hypertrophy
• pancreatitis
• impairment of hepatic function
• severe renal dysfunction
• constipation
• an obstructive bowel disorder
• respiratory depression with hypoxia
• chronic obstructive pulmonary disease
• cor pulmonale
• bronchial asthma
• hypothyroidism
• sleep apnoea
The primary risk of opioid excess is respiratory depression.
Overdose
Acute overdosage with dihydrocodeine can be manifested by somnolence progressing to stupor or coma, miotic pupils, rhabdomyolysis, non-cardiac pulmonary oedema, bradycardia, hypotension and respiratory depression or apnoea, which may in severe cases result in a fatal outcome. Where and how can I buy Dihydrocodeine Continus 30mg, 60mg, 90mg, 120mg tablets online over the counter without prescription in uk next day delivery.
Patients should be informed of the signs and symptoms of overdose and to ensure that family and friends are also aware of these signs and to seek immediate medical help if they occur.
Primary attention should be given to the establishment of a patent airway and institution of assisted or controlled ventilation.
In the case of massive overdosage, administer naloxone intravenously (0.4 to 2 mg for an adult and 0.01 mg/kg body weight for children) if the patient is in a coma or respiratory depression is present. Repeat the dose at 2 minute intervals if there is no response, or by an infusion. An infusion of 60% of the initial dose per hour is a useful starting point. A solution of 10 mg made up in 50 ml dextrose will produce 200 micrograms/ml for infusion using an IV pump (dose adjusted to the clinical response). Infusions are not a substitute for frequent review of the patient’s clinical state. Intramuscular naloxone is an alternative in the event that IV access is not possible. Where and how can I buy Dihydrocodeine Continus 30mg, 60mg, 90mg, 120mg tablets online over the counter without prescription in uk next day delivery.
As the duration of action of naloxone is relatively short, the patient must be carefully monitored until spontaneous respiration is reliably re-established. Naloxone is a competitive antagonist and large doses (4 mg) may be required in seriously poisoned patients. For less severe overdosage, administer naloxone 0.2 mg intravenously followed by increments of 0.1 mg every 2 minutes if required.
Naloxone should not be administered in the absence of clinically significant respiratory or circulatory depression secondary to dihydrocodeine overdosage. Naloxone should be administered cautiously to persons who are known, or suspected, to be physically dependent on dihydrocodeine. In such cases, an abrupt or complete reversal of opioid effects may precipitate pain and an acute withdrawal syndrome. Where and how can I buy Dihydrocodeine Continus 30mg, 60mg, 90mg, 120mg tablets online over the counter without prescription in uk next day delivery.
Additional/other considerations:
• Consider activated charcoal (50 g for adults, 10-15 g for children), if a substantial amount has been ingested within 1 hour, provided the airway can be protected. It may be reasonable to assume that late administration of activated charcoal may be beneficial for prolonged release preparations but there is no evidence to support this.
DHC CONTINUS tablets will continue to release and add to the dihydrocodeine load for up to 12 hours after administration and the management of overdosage should be modified accordingly. Gastric contents may therefore need to be emptied, as this can be useful in removing unabsorbed drug, particularly when a prolonged release formulation has been taken. Where and how can I buy Dihydrocodeine Continus 30mg, 60mg, 90mg, 120mg tablets online over the counter without prescription in uk next day delivery.
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