What is Co-codamol?

• Co-codamol is a type of pain relief that contains both paracetamol and codeine
• It is sometimes prescribed when other pain relief like paracetamol alone or ibuprofen have not alleviated the pain
• Low dose co-codamol can be bought from pharmacies, but higher strength co-codamol can only be obtained if you have a prescription from a doctor or pharmacist
• The codeine in co-codamol can become addictive, so you should have your prescription reviewed by your doctor regularly
• Co-codamol is sometimes known by its brand names Solpadol, Kapake and Zapain
• It is important to read the patient leaflet for a full list of side effects and cautions.

How Does Co-codamol Work?

Co-codamol tablets contain both paracetamol and codeine.

Paracetamol works by blocking the chemical messengers of pain. This means that our sensation of pain is reduced.

Codeine is a form of opiate pain relief. Codeine blocks the signals of pain that would normally travel along nerve cells. This means that the pain messages do not reach the brain, further reducing our sensation of pain.

Taking two different types of pain relief medication can be a more effective way of managing pain. Combining the drugs in one tablet also minimises the number of medications you need to take each day.

How is Co-codamol Taken?

Co-codamol Tablets

Co-codamol is available as a tablet or capsule. These can be taken with or without food.

Co-codamol is sometimes prescribed as a soluble tablet which some people find easier to take.

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What is the dosage of Co-codamol?

Co-Codamol 30/500mg

There are three different strengths of co-codamol available. The amount of paracetamol in each preparation is the same, but the amount of codeine varies from 8mg to 30mg per tablet.

The following strengths of co-codamol tablets are available:

1. 8mg of codeine and 500mg of paracetamol per tablet
2. 15mg of codeine and 500mg of paracetamol per tablet
3. 30mg of codeine and 500mg of paracetamol per tablet.

The usual dose is 1 or 2 tablets of any strength up to 4 times daily. There should be 6 hours between each dose, and the maximum number of tablets you can take in a 24 hour period is 8.

It is common for 2 tablets to be taken at a time. This equals a dose of 1000mg (1 gram) of paracetamol, which is the maximum recommended amount of paracetamol per dose. You must therefore not take any other paracetamol containing medications whilst taking co-codamol.

Codeine can become additive when taken long term. Over a long period, some people can become dependent on codeine or experience symptoms of withdrawal when stopping it. Your prescriber will talk to you about your likely course of treatment and when you can expect to stop taking it to avoid dependence.

Are there any side effects to Co-Codamol?

Like all medications, co-codamol can have some side effects. The most common side effects include:

• Constipation
• Nausea and vomiting (feeling sick and being sick)
• Feeling sleepy
• Headache.

If these side effects are troublesome or do not settle, you should speak to a doctor for advice.

Occasionally, more serious side effects can occur when taking co-codamol. Serious side effects include:

• Skin rashes
• Change in your vision
• Feeling dizzy
• Difficulty passing urine (peeing).

You should speak to a doctor straight away if you notice one of these more serious side effects.

If you have a severe allergic reaction (anaphylaxis) including breathlessness, lip or tongue swelling, call 999 immediately.

What warnings come with Co-codamol?

Co-codamol may not be suitable for everyone. You should tell your doctor if you have:

• Lung problems or breathing difficulties including asthma
• Obstructive sleep apnoea
• Liver or kidney disease
• A head injury
• Seizures (fits)
• Problems with your adrenal glands
• Alcohol or drug addiction, or if you drink more than 14 units of alcohol each week.

Co-codamol may not be suitable if you are pregnant, trying to conceive, or breastfeeding.

Some medications can interact with co-codamol. You may be advised that co-codamol will not suit you if you already take:

• Another medication that contains paracetamol
• Another medication that contains codeine
• Anti-sickness medications
• Blood-thinners including warfarin or heparin
• Sleeping pills
• Benzodiazepines including diazepam
• Antidepressants
• Certain antibiotics
• Medications for epilepsy.

You should also tell your prescriber about any herbal remedies or supplements you take. This will allow your prescriber to check that co-codamol will not interact with them.

It is important that your doctor checks that co-codamol will suit you. Your doctor should complete a thorough health questionnaire and review your current medications before prescribing this medication.

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