DHC CONTINUS 60mg Tablets/Prolonged Release

What is DHC CONTINUS 60mg

DHC CONTINUS 60mg is a prolonged-release oral tablet formulation containing dihydrocodeine tartrate, an opioid analgesic used primarily for the treatment of moderate to severe chronic pain. This formulation allows for controlled release over a 12-hour period, offering sustained pain relief with fewer daily doses.

• Form: Prolonged-release tablet
• Strength: 60mg per tablet
• Pack Size: 56 tablets per plastic bottle
• Generic Name: Dihydrocodeine Tartrate
• Therapeutic Class: Opioid analgesic

It is prescribed in conditions such as osteoarthritis, cancer pain, postoperative pain, or other chronic painful conditions where non-opioid analgesics are insufficient. Due to its opioid nature, DHC CONTINUS is typically reserved for cases requiring long-term pain management and where the benefit outweighs the risk of dependency or side effects.

How to use DHC CONTINUS 60mg

Proper administration of DHC CONTINUS is essential to achieve effective pain control while minimizing side effects and the risk of dependence. The tablets are designed for prolonged release and must be taken as prescribed by a healthcare provider.

• Route: Oral
• Frequency: Typically every 12 hours
• Swallow whole: Do not crush, chew, or split tablets to avoid rapid release of the drug and potential overdose.
• With or without food: Can be taken with food to reduce gastrointestinal discomfort.
• Missed dose: Take as soon as remembered unless it is close to the next dose. Do not double the dose.

Patients must follow the prescribed dosage schedule exactly. Self-adjustment of the dose or stopping the medication abruptly can lead to withdrawal symptoms or reduced pain control. If switching from another opioid, a conversion and tapering plan should be followed under medical supervision.

Mode of Action DHC CONTINUS 60mg

Dihydrocodeine acts as an opioid agonist, primarily interacting with the μ-opioid receptors located in the central nervous system (CNS). The prolonged-release formulation of DHC CONTINUS ensures sustained activation of these receptors over a longer duration.

• Central action: Alters perception of pain and emotional response to it by inhibiting ascending pain pathways in the spinal cord and brain.
• Suppresses cough reflex: Though not its primary use, it may suppress cough due to its opioid action in the medulla.
• Gastrointestinal motility: Slows down peristalsis, which may contribute to constipation.
• Sustained release: The prolonged-release matrix gradually releases the drug over approximately 12 hours, reducing dosing frequency and improving adherence.

Unlike some other opioids, dihydrocodeine has moderate potency and a lower abuse potential when used as directed. However, the mechanism of tolerance and dependence remains similar to other opioid agonists, necessitating cautious long-term use.

DHC CONTINUS 60mg Interactions DHC CONTINUS 60mg

Drug interactions with DHC CONTINUS can significantly impact its safety and efficacy. Co-administration with certain agents may lead to enhanced sedation, respiratory depression, or altered metabolism of the drug.

• CNS depressants: Alcohol, benzodiazepines (e.g., diazepam), antihistamines, antipsychotics, and other opioids may enhance sedative and respiratory depressant effects.
• MAO inhibitors: Concurrent use or recent use within 14 days can lead to severe reactions such as serotonin syndrome or CNS excitation.
• CYP2D6 inhibitors: Drugs like fluoxetine or paroxetine may reduce the conversion of dihydrocodeine to its active metabolites, potentially reducing analgesic effects.
• Serotonergic drugs: SSRIs, SNRIs, and triptans may increase the risk of serotonin syndrome when combined.
• Enzyme inducers: Rifampicin and carbamazepine may reduce plasma levels, decreasing effectiveness.

Patients should inform healthcare providers of all medications, including herbal supplements, to avoid serious interactions. Careful monitoring or dose adjustments may be needed when combining DHC CONTINUS with other drugs.

Dosage of DHC CONTINUS 60mg

Dosing of DHC CONTINUS should be individualized based on the patient's clinical condition, previous opioid exposure, and response to treatment. The goal is to achieve adequate pain control with the lowest effective dose.

• Typical adult dose: 60 mg every 12 hours
• Titration: Dosage may be increased in 60 mg increments every few days depending on pain relief and tolerability.
• Maximum dose: No fixed maximum; guided by patient response and tolerance under physician supervision.
• Opioid-naive patients: Start with lower doses to assess tolerance.
• Renal or hepatic impairment: Use caution; dose adjustments may be necessary.

In all cases, DHC CONTINUS should not be abruptly discontinued after prolonged use. A gradual tapering schedule is recommended to avoid withdrawal symptoms.

Possible side effects of DHC CONTINUS 60mg

Like all opioid medications, DHC CONTINUS 60mg may cause a range of side effects. While many are mild and transient, others may require medical intervention or dose adjustment.

• Common: Constipation, nausea, dry mouth, dizziness, drowsiness, and vomiting
• Less common: Sweating, headache, mood changes, and confusion
• Serious: Respiratory depression, bradycardia, hypotension, allergic reactions (e.g., rash, urticaria)
• Long-term use: May lead to tolerance, dependence, and withdrawal symptoms upon discontinuation
• Rare: Seizures, hallucinations, or serotonin syndrome (especially with interacting drugs)

Patients should report persistent or severe side effects to a healthcare provider. Constipation is a particularly common issue with opioid use and may require preventative laxatives.

DHC CONTINUS 60mg Contraindications DHC CONTINUS 60mg

DHC CONTINUS is contraindicated in several clinical scenarios due to the risk of serious adverse effects, especially involving the respiratory and CNS systems.

• Hypersensitivity: Known allergy to dihydrocodeine or other opioids
• Respiratory depression: Including acute or severe bronchial asthma
• Acute alcoholism or delirium tremens
• Paralytic ileus or gastrointestinal obstruction
• Coma or head injury: Increased risk of intracranial pressure
• Concurrent use of MAO inhibitors: Within the past 14 days

In such cases, alternative pain management therapies should be explored. The medication must be used only under medical supervision with careful consideration of benefit-risk balance.

Storage of DHC CONTINUS 60mg

Proper storage is critical to maintain the stability, effectiveness, and safety of DHC CONTINUS. Being a controlled substance, it must also be kept out of reach of unauthorized individuals.

• Temperature: Store below 25°C (77°F) in a dry place, away from heat and direct sunlight
• Container: Keep in original plastic bottle with child-resistant cap
• Avoid moisture: Do not store in bathrooms or other damp environments
• Keep out of reach of children and pets
• Disposal: Unused or expired tablets should be returned to a pharmacy or disposed of according to local regulations for controlled substances

Improper storage may lead to loss of potency or misuse. Patients should always check the expiry date before use and avoid sharing their medication with others.