From the Research
No, dihydrocodeine is not a metabolic product of hydrocodone. These are two distinct opioid medications with different metabolic pathways. Hydrocodone is primarily metabolized in the liver by CYP2D6 enzymes to hydromorphone and by CYP3A4 to norhydrocodone. Dihydrocodeine, on the other hand, is a semi-synthetic opioid that is metabolized to dihydromorphine through CYP2D6, as shown in a study published in 2002 1.
The metabolic pathways of hydrocodone and dihydrocodeine are distinct, with hydrocodone being metabolized to hydromorphone and norhydrocodone, and dihydrocodeine being metabolized to dihydromorphine, as supported by a study in 2013 2. This distinction is important for understanding potential drug interactions, individual patient responses based on metabolizer status, and interpreting drug screening results where these compounds might need to be distinguished from one another.
Key points to consider:
- Hydrocodone and dihydrocodeine have separate chemical structures and metabolic pathways.
- Dihydrocodeine is metabolized to dihydromorphine through CYP2D6, as demonstrated in a study published in 1995 3.
- The pharmacokinetics of dihydrocodeine and its active metabolite dihydromorphine are linear in extensive metabolizers of CYP2D6, as shown in a study published in 1999 4.
- Understanding the metabolic pathways of these opioids is crucial for clinical practice, particularly in managing pain and interpreting drug screening results.
In clinical practice, it is essential to recognize the distinct metabolic pathways of hydrocodone and dihydrocodeine to ensure proper pain management and to minimize potential drug interactions. The most recent and highest quality study, published in 2013 2, supports the conclusion that dihydrocodeine is not a metabolic product of hydrocodone.