A strong opioid painkiller (combined with cyclizine as Diconal)
Dipipanone
A strong opioid painkiller for moderate to severe pain, available combined with cyclizine as Diconal.
What is Dipipanone?
Dipipanone is a strong opioid painkiller used for moderate to severe pain. In the UK it is available combined with the anti-sickness medicine cyclizine in a product called Diconal. Like other strong opioids, its most important risks are slowed or shallow breathing (respiratory depression), dependence and sedation, and it is a controlled drug because of the risk of misuse. It is taken by mouth and used at the lowest effective amount for the shortest suitable time, under close medical supervision.
Education and reference only. This is a plain-language guide to Dipipanone — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Dipipanone is a strong opioid painkiller used to relieve moderate to severe pain. In the UK it is usually found combined with cyclizine, an anti-sickness medicine, in a product called Diconal; the cyclizine is included to help counter the nausea that opioids can cause. As a strong opioid, dipipanone is a controlled drug, meaning its prescribing and supply are tightly regulated because of the risk of dependence and misuse. It is taken by mouth and is used under careful medical supervision, usually when other painkillers have not given enough relief.
How it works
Dipipanone works on opioid receptors in the brain and spinal cord, the body's own pain-control system, to reduce the sensation of pain. By acting on these receptors it dampens pain signals and changes how pain is perceived. The same action on the brain explains its main risks: it can slow breathing, cause drowsiness and, with repeated use, lead to tolerance (needing more for the same effect) and dependence. Because of this, it is used at the lowest helpful amount for the shortest suitable time, with regular review of whether it is still needed.
Company & origin
Originated / developed by: Generic (long-established).
A strong opioid painkiller used in the UK for moderate to severe pain, available combined with the anti-sickness medicine cyclizine as Diconal.
Practical use
How to take Dipipanone
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it exactly as prescribed, using the lowest amount that controls your pain for the shortest suitable time.
- Do not drink alcohol or take other sedating medicines with it, as this increases the risk of dangerously slowed breathing.
- Do not drive or use machinery until you know how it affects you, as it commonly causes drowsiness.
- Do not stop it suddenly after regular use; your prescriber will reduce the dose gradually to avoid withdrawal.
- Expect constipation and ask your prescriber about a laxative, and store it securely as it is a controlled drug.
Weighing it up
Advantages & disadvantages of Dipipanone
Advantages
- An effective option for relieving moderate to severe pain.
- Taken by mouth, and combined with cyclizine to help reduce opioid-related nausea.
- A long-established strong painkiller for when weaker painkillers are not enough.
Disadvantages
- Can cause dangerously slowed or shallow breathing, especially with alcohol or other sedatives.
- Causes drowsiness and constipation, and can lead to tolerance and dependence.
- A controlled drug with a risk of misuse, so it must be prescribed and stored carefully.
Practical use
Good to know
The most important safety point with dipipanone, as with all strong opioids, is that it can slow or shallow your breathing (respiratory depression), which can be dangerous, especially if the amount is too high, if it is combined with alcohol or other sedating medicines, or in people with breathing problems. It also commonly causes drowsiness, so do not drive or use machinery until you know how it affects you, and avoid alcohol. With regular use the body becomes used to it, so tolerance and dependence can develop, and it should not be stopped suddenly after prolonged use because of withdrawal symptoms; doses are reduced gradually under guidance. Constipation is very common, and a laxative is often needed. Because it is a controlled drug with a risk of misuse, it is prescribed carefully and stored securely. The cyclizine in Diconal helps with nausea but adds its own drowsiness.
Who should not take it / use with caution
- People who have had a serious allergic reaction to dipipanone or cyclizine should not take it.
- It should be avoided in people with significant breathing problems or where breathing is already depressed.
- It is used with great caution in older or frail people and those with liver or kidney problems.
- It is used with care in people with a history of substance misuse, given the risk of dependence.
Monitoring
- Reviewing how well pain is controlled against side effects such as drowsiness and constipation.
- Watching for signs of slowed breathing, especially when starting or increasing the dose.
- Reviewing the ongoing need for treatment and watching for tolerance or dependence.
Side effects
- Drowsiness, dizziness and constipation.
- Nausea and vomiting, which the cyclizine in Diconal helps to reduce.
- Slowed or shallow breathing (respiratory depression), which can be serious and needs urgent help.
- With regular use, tolerance and dependence, and withdrawal symptoms if stopped suddenly.
Key interactions
- Alcohol and other sedating medicines, such as benzodiazepines and sleeping tablets, add to the risk of dangerously slowed breathing.
- Other medicines that cause drowsiness or affect the brain increase sedation when taken with it.
- The cyclizine part can add anticholinergic effects, such as dry mouth and constipation, especially with similar medicines.
Available as: Tablets taken by mouth (combined with cyclizine as Diconal).
Answers
Dipipanone: frequently asked questions
What is dipipanone used for?
It is a strong opioid painkiller used for moderate to severe pain, available in the UK combined with the anti-sickness medicine cyclizine as Diconal.
Why is it combined with cyclizine?
The cyclizine is included to help reduce the nausea and vomiting that strong opioids can cause, though it adds its own drowsiness.
Is it addictive?
Like other strong opioids it can lead to tolerance and dependence with regular use, which is why it is used carefully and is a controlled drug.
Can I drink alcohol with it?
No. Alcohol adds to the risk of dangerously slowed breathing and extra drowsiness, so it should be avoided while taking dipipanone.
Can I stop it suddenly?
Not after regular use; stopping suddenly can cause withdrawal symptoms, so your prescriber will reduce the dose gradually.
The wider class
About Strong opioid painkiller (controlled drug)
Dipipanone belongs to the strong opioid painkiller (controlled drug) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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