Co-codamol
Co-codamol is the name given to the combination medicine which contains paracetamol and codeine. It is available in several strengths:
Co-codamol 8/500 - codeine 8mg and paracetamol 500mg Co-codamol 15/500 - codeine 15mg and paracetamol 500mg Co-codamol 30/500 - codeine 30mg and paracetamol 500mg
Co-codamol 8/500 may be bought from a pharmacy. Co-codamol 15/500 and 30/500 are only available on prescription. The drug should only be taken for short term pain relief of up to 3 days, unless prescribed by a doctor. What can co-codamol be used for? Co-codamol can be used for mild to moderate pain. For example, backache, migraine, period pain, and toothache. Use in children Co-codamol 8/500 may be taken by children from 6 years old. How does co-codamol work? Paracetamol blocks the production of chemicals called prostaglandins. These are released in your body in response to illness and injury, and cause pain and fever. Codeine is a slightly stronger painkiller than paracetamol. It is from a group of medicines called opioids and is a weak relative of morphine. It mimics the action of chemicals in the body called endorphins which are the bodys natural painkillers. Co-codamol begins to ease pain about 20-30 minutes after a dose is taken. It usually lasts for about 4 hours. When shouldnt you take co-codamol? You should not take co-codamol if you are:
allergic to codeine or paracetamol, taking other paracetamol containing medicines (for example, codydramol, Tramacet and some cough and cold remedies), because of the risk of overdosing with paracetamol, taking other codeine containing medicines (for example co-codaprin, dihydrocodeine and some cough and cold remedies), or
taking a mono-amine oxidase inhibitor (MAOI) antidepressant. For example, isocarboxazid, moclobemide, phenelzine, tranylcypromine or taken a MAOI within the last 2 weeks.
You should use co-codamol with caution if you have:
Liver problems - speak to your doctor before taking if you have severe liver problems. Kidney problems - speak to your doctor before taking if you have severe kidney problems.
Can co-codamol be taken if you are pregnant or breastfeeding? Paracetamol is the first choice of pain killer when pregnant or breastfeeding. Pregnancy Co-codamol should not be taken during pregnancy unless advised to by a doctor. Breastfeeding Co-codamol should not be taken when breastfeeding unless advised to by a doctor. What are the possible side effects? Codeine Side effects from codeine include:
blurred vision, constipation, drowsiness, feeling light headed or having a spinning sensation, inability to think clearly, nausea (feeling sick), and rash.
Taking codeine regularly for a long time may lead to dependence which may cause you to feel restless and irritable when you stop taking the tablets. Paracetamol Side effects from paracetamol are rare but include:
rash, and liver and kidney damage - when taken at higher than recommended doses.
Does co-codamol affect your ability to drive? Co-codamol may cause drowsiness, blurred vision or make it hard to think clearly. You should not drive if you experience any of these. Is co-codamol safe to take with other medicines? When two or more medicines are taken at the same time, the effects of the medicines are sometimes different to when they are taken separately. This is known as an interaction. If you want to check that co-codamol is safe to take with your other medicines, you should ask your doctor or pharmacist (chemist) or read the patient information leaflet that comes with your medicine. Mono-amine oxidase inhibitor (MAOIs) antidepressant Mono-amine oxidase inhibitor (MAOIs) antidepressants include isocarboxazid, moclobemide, phenelzine and tranylcypromine. Avoid taking co-codamol if you are taking an MAOI as it might cause large and serious drops in blood pressure. Other paracetamol containing medicines You should not take co-codamol with other paracetamol containing medicines (for example, co-dydramol, Tramacet, and some cough and cold remedies), because of the risk of overdosing on paracetamol. Other codeine containing medicines You should not take co-codamol with other codeine containing medicines (for example co-codaprin, dihydrocodeine, Tramacet, and some cough and cold remedies), because of the increased risk of side effects from codeine. Warfarin Avoid taking co-codamol if taking warfarin. Paracetamol is the recommended painkiller for people taking warfarin. Can you drink alcohol? You should not drink alcohol when taking co-codamol because of the increased risk of side effects from co-codamol particularly confusion, drowsiness and impaired breathing. Are there any interactions with food? There are no known interactions with food. What if you forget to take a dose?
If you forget to take your dose of co-codamol, the general advice is: If the dose is less than 2 hours late - take the dose as soon as you remember and then the next dose at least 4 hours after the missed dose. Doses of co-codamol must be at least 4 hours apart. If the dose is more than 2 hours late take the dose as soon as you remember and then the next dose at least 4 hours after the missed dose. Doses of co-codamol should be at least 4 hours apart. Do not take more than eight tablets in 24 hours (not more than 4G paracetamol in 24 hours). Check the patient information leaflet that comes with your medicine as this should give you advice about what to do. What if you accidentally take an extra dose? If you accidentally take an extra dose of co-codamol dont take the next dose so that you do not take more than eight tablets in 24 hours and then carry on as normal. If you feel unwell or are concerned, call NHS Direct on 0845 4647 or contact your GP. If you have taken more than the recommended total daily dose of cocodamol - seek advice immediately. Call NHS Direct on 0845 4647, contact your GP or go to your nearest accident and emergency department (A&E).
