DHC Continus (Dihydrocodeine tartrate)

DHC Continus 60 mg, 90 mg and 120 mg prolonged-release tablets. Dihydrocodeine tartrate

What DHC Continus tablets are and what they are used for

These tablets have been prescribed for you to relieve severe pain over a period of 12 hours. They contain the active ingredient dihydrocodeine which belongs to a group of medicines called strong analgesics or ‘painkillers’.

Before you take DHC Continus tablets

Do not take DHC Continus tablets if you:

• are allergic (hypersensitive) to dihydrocodeine or any of the other ingredients of the tablets;
• have breathing problems, such as obstructive airways disease or respiratory depression. Your doctor will have told you if you have these conditions. Symptoms may include breathlessness, coughing or breathing more slowly or weakly than expected;
• are having an asthma attack;
• have a condition where the small bowel (part of your gut) does not work properly (paralyticileus);
• have a severe headache or feel sick due to a head injury or increased pressure in your skull (for instance due to brain disease). This is because the tablets may make these symptoms worse or hide the extent of a head injury;
• are addicted to alcohol;
• have an intolerance to some sugars;
• are under 12 years of age.

Take special care with DHC Continus tablets

Before treatment with these tablets tell your doctor or pharmacist if you:

• have asthma;
• have an under-active thyroid gland (hypothyroidism);
• have kidney or long-term liver problems;
• have constipation or obstructive bowel disorders;
• have inflammation of the pancreas (which causes severe pain in the abdomen and back);
• have problems with your gall bladder;
• have prostate problems;
• have a severe heart problem after long-term lung disease (severe cor pulmonale);
• are or have ever been addicted to drugs.

Taking other medicines

Tell your doctor or pharmacist if you are taking:

• medicines to help you sleep (for example tranquillisers, hypnotics or sedatives);
• medicines to treat psychiatric or mental disorders (such as phenothiazines);
• a type of medicine known as a monoamine oxidase inhibitor (examples include tranylcypromide, phenelzine, isocarboxazid, moclobemide and linezolid), or you have taken this type of medicine in the last two weeks.

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. If you take these tablets with some other medicines, the effect of these tablets or the other medicine may be changed.

Taking DHC Continus tablets with alcohol

Drinking alcohol during your treatment with these tablets may make you sleepy. If you are affected you should avoid drinking alcohol.

Pregnancy and breast-feeding

Do not take these tablets if you are pregnant or likely to become pregnant. If you are breastfeeding do not take these tablets until you have spoken to your doctor.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines

These tablets may cause a number of side effects such as drowsiness which could affect your ability to drive or use machinery. These are usually most noticeable when you first start taking the tablets or when changing to a higher dose.    If you are affected you should not drive or use machinery.

Important information about some of the ingredients of DHC Continus tablets

These tablets contain lactose which is a form of sugar. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking these tablets.

How to take DHC Continus tablets

Always take these tablets exactly as your doctor has told you. The label on your medicine will tell you how many tablets to take and how often. Do not take for longer than directed by your doctor.

Swallow your tablets whole with a glass of water. Do not break, crush or chew them.

DHC Continus tablets are designed to work properly over 12 hours when swallowed whole. If a tablet is broken, crushed or chewed, the entire 12-hour dose may be absorbed rapidly into your body. This can be dangerous, causing serious problems such as an overdose, which may be fatal.

You should take your tablets every 12 hours. For instance, if you take a tablet at 8 o’clock in the morning, you should take your next tablet at 8 o’clock in the evening.

Adults and children over 12 years of age

The usual starting dose is 60 mg to 120 mg every 12 hours. If you are elderly your doctor may suggest a lower starting dose. Your doctor will prescribe the dose required to treat your pain. If you find that you are still in pain whilst taking these tablets discuss this with your doctor.

Children under 12 years of age

Children under 12 years of age should not take the tablets.

If you take more DHC Continus tablets than you should or if someone accidentally swallows your tablets

Call your doctor or hospital straight away. People who have taken an overdose may feel very sleepy, sick or dizzy. They may also have breathing difficulties leading to unconsciousness or even death and may need emergency treatment in hospital. When seeking medical attention make sure that you take this leaflet and any remaining tablets with you to show the doctor.

If you forget to take DHC Continus tablets

If you remember within 4 hours of the time your tablet was due, take your tablet straight away. Take your next tablet at your normal time. If you are more than 4 hours late, please call your doctor or pharmacist for advice. Do not take a double dose to make up for a forgotten tablet.

If you stop taking DHC Continus tablets

You should not suddenly stop taking these tablets unless your doctor tells you to. If you want to stop taking your tablets, discuss this with your doctor first. They will tell you how to do this, usually by reducing the dose gradually so you do not experience unpleasant effects. Withdrawal symptoms such as agitation, anxiety, shaking or sweating may occur if you suddenly stop taking these tablets.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Possible side effects

Like all medicines, these tablets can cause side effects, although not everybody gets them.

All medicines can cause allergic reactions, although serious allergic reactions are uncommon. Tell your doctor immediately if you get swelling of the face or throat.

The most serious side effect is a condition where you breathe more slowly or weakly than expected (respiratory depression).

As with all strong painkillers, there is a risk you may become addicted or reliant on these tablets.

Taking a painkiller for headaches too often or for too long can make your headaches worse.

Common side effects

(Probably affecting more than 1 in 100 people taking these tablets)

• Constipation (your doctor can prescribe a laxative to overcome this problem).
• Feeling or being sick (this should normally wear off after a few days, however your doctor can prescribe an anti-sickness medicine if it continues to be a problem).
• Drowsiness (this is most likely when you start taking your tablets or when your dose is increased, but it should wear off after a few days).
• Dry mouth, abdominal pain or discomfort.

Uncommon side effects

(Probably affecting fewer than 1 in 100 people taking these tablets)

• Diarrhoea, a condition where the bowel does not work properly (paralytic ileus).
• Mood changes.
• Headache, confusion, a feeling of unusual weakness.
• Hallucinations.
• Blurred vision.
• A feeling of dizziness or ‘spinning’, seizures, fits or convulsions.
• Tingling or numbness.
• Low blood pressure.
• Decreased sexual drive.
• Difficulty in passing urine.
• Flushing of the skin.
• Rash or itchy skin.
• Shortness of breath.
• Sweating.
• A need to take increasingly higher doses to obtain the same level of pain relief (tolerance).
• A worsening in liver function tests (seen in a blood test).

If any of the side effects become serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

How to store DHC Continus tablets

Keep out of the reach and sight of children.

Do not use any tablets after the expiry date which is stated on the label and carton. EXP 08 2010 means that you should not take the tablets after the last day of that month i.e. August 2010.

Do not store your tablets above 25°C.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

Further information

What DHC Continus tablets contain

The active ingredient is dihydrocodeine tartrate. Each tablet contains 60 mg, 90 mg or 120 mg of dihydrocodeine tartrate.

The other ingredients are:

• Lactose
• Hydroxyethylcellulose
• Cetostearyl alcohol
• Magnesium stearate
• Talc

What DHC Continus tablets look like and the contents of the pack

The tablets are white, capsule shaped and marked DHC followed by the strength (e.g. 60, 90 etc.).

In each bottle there are 56 tablets.