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Morphine Derivatives

Codeine

Codeine sulfate is a form of this drug that is commonly used. It is available in tablet form [FDA label] and indicated for the relief of mild to moderately severe pain, where the use of an opioid analgesic is appropriate [FDA label]. The solution form is used by itself or combined in a syrup with other drugs and is used as a cough suppressant in adults aged 18 and above [L5521], [L5524].

Hydromorphone

Hydromorphone is indicated for the management of moderate to severe acute pain and severe chronic pain. Due to its addictive potential and overdose risk, hydromorphone is only prescribed when other first-line treatments have failed.[A176468] The WHO has proposed a three-step ladder for the management of pain in which it is suggested to start with a non-opioid medication followed by addition of weak opioids to the non-opioid treatment for moderate pain and finishing in the use of strong opioids such as hydromorphone along with the existing regimen for cases of severe pain.[A176471] Off-label, hydromorphone can be administered for the suppression of refractory cough.

Oxycodone

For the treatment of diarrhoea, pulmonary oedema and for the relief of moderate to moderately severe pain.

Hydrocodone

For relief of moderate to moderately severe pain. Also used for the symptomatic relief of nonproductive cough, alone or in combination with other antitussives or expectorants.

Oxymorphone

For the treatment of moderate-to-severe pain.

5-Methoxy-N,N-diisopropyltryptamine

Not Available

Diamorphine

Diamorphine, as a prescription medication in the United Kingdom, is indicated for use in the treatment of severe pain associated with surgical procedures, myocardial infarction or pain in the terminally ill and for the relief of dyspnoea in acute pulmonary edema [L4999].

Ethylmorphine

Ethylmorphine is an analgesic used for pain relief.

Desomorphine

Not Available

Drotebanol

Not Available

Dihydrocodeine

Dihydrocodeine is used for the treatment of moderate to severe pain, including post-operative and dental pain [2]. It can also be used to treat chronic pain [1], breathlessness and coughing. In heroin addicts, dihydrocodeine has been used as a substitute drug, in doses up to 2500mg/day to treat addiction.

Dihydromorphine

Dihydromorphine is an opioid analgesic used for moderate to severe pain relief.

Pholcodine

Pholcodine is indicated as a cough suppressant for the temporary relief of non-productive dry cough. It is stated to present a required label indication of “temporary relief of dry cough.”[L1200] Cough is the respiratory movement that occurs after an irritation signal is transmitted to the central nervous system and further stimulates the medulla oblongata. This stimulation causes a motor output that is sent through motoneurons to the respiratory muscles. A non-productive cough is a type of cough characterized by the absence of sputum, and it has a large inspiration that will cause continuous coughing.

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