Nicodicodine

Nicodicodine is an opioid analgesic and cough suppressant, an analogue of codeine, which was developed in the early 20th century in Germany. It is not commonly used in most countries, but has activity similar to other opioids. Nicodicodine is metabolised in the liver by demethylation to produce 6-nicotinoyldihydromorphine, and subsequently further metabolised to dihydromorphine. Side effects are similar to those of other opioids and include itching, nausea and respiratory depression.

Chemistry

Nicodicodine is part of a series of dihydrocodeine, hydrocodone, and hydromorphone. Each of these three compounds is used as an antitussive and analgesic. Nicodicodine is approximately the same strength as hydrocodone; it is equivalent to dihydrocodeine and weaker than hydromorphone.

Pharmacology

Nicodicodine is metabolised in the liver by demethylation to produce 6-nicotinoyldihydromorphine, and subsequently further metabolised to dihydromorphine. This is then metabolised further to produce hydromorphone. The conversion from dihydromorphine to hydromorphone is catalysed by the enzyme dihydrodiol dehydrogenase.

Side effects

Side effects are similar to those of other opioids and include itching, nausea and respiratory depression. Because of the latter, this drug is not recommended for use in patients with respiratory insufficiency.

Legal status

Nicodicodine is currently a Schedule I/Narcotic controlled substance in the United States with an ACSCN of 9307 and a zero annual manufacturing quota as of 2014. The salts in use are hydroiodide (free base conversion ratio 0.805), hydrobromide (0.736), hydrochloride (0.870), and sulphate (0.632). The free base conversion ratios for the salts hydroiodide, hydrobromide, hydrochloride, and sulphate are 0.805, 0.736, 0.870, and 0.632, respectively.

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