These opioids have low potency but can be a useful second step for patients with moderate pain.
It is seldom useful to change from one weak opioid preparation to another (unless to alter side effects). If regular doses do not provide adequate analgesia, move up the ladder to step 3.
Compound preparations of paracetamol and weak opioids may be useful.
Only preparations with higher doses of opioids (codeine 30mg, dihydrocodeine 20-30mg) should be used, as the lower strength preparations produce opioid side effects with little analgesia.