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Updated 11 February 2013

The combination of ibuprofen, paracetamol and codeine

The combination of ibuprofen, paracetamol and codeine relieves pain and reduces inflammation and fever.

3

Ibuprofen, paracetamol and codeine are the active ingredients of Dentopain Forte, Gen-Payne, Ibupain Forte, Mybulen, Myprodol and Mybucod.

General information

The combination of ibuprofen, paracetamol and codeine relieves pain and reduces inflammation and fever.

It is indicated for the relief of headache from musculo-skeletal origin, feverishness, muscular, menstrual and dental pain.

Ibuprofen is a non-steroidal anti-inflammatory medication. It is an effective painkiller and is prescribed in higher doses to relieve inflammation, swelling and stiffness. It is often used to provide pain relief in a wide range of conditions ranging from menstrual and dental pain to post-operative pain. It is effective in reducing fever and is also prescribed for the treatment of arthritic conditions such as rheumatoid- and osteoarthritis, muscle injury, acute attacks of gout.

Paracetamol is the analgesic of choice for mild to moderate pain and to reduce fever. It is suited for both adults and children and, as it does not cause stomach irritation, and it is safe for use by those who suffer from peptic ulcers as well as those who cannot take aspirin.

When taken by mouth it is rapidly absorbed into the body and will be effective within 30 minutes. Paracetamol is safe for occasional use by those being treated with anticoagulants.

Codeine is most often prescribed to treat mild to severe pain, but is also effective in treating irritating, dry coughs as well as diarrhoea. It should be used with caution in those patients with a history of alcohol or drug abuse as definitive risk of dependency does exist.

Neither paracetamol, ibuprofen nor codeine cures the underlying condition responsible for pain, fever or inflammation, but simply keeps the symptoms under control.

How does the combination of i buprofen, paracetamol and codeine work?

The combination of ibuprofen and paracetamol blocks the production of chemicals in the body that are responsible for pain, fever, swelling and inflammation.

Codeine exerts its effect by acting on parts of the central nervous system which process pain signals or the cough reflex.

Fast facts

Drug schedule: schedule3

Available as: this combination is available as tablets, capsules and as syrup

What does it do? The combination of ibuprofen, paracetamol and codeine relieves pain and reduces inflammation and fever.

Overdose risk: high

Dependence risk: medium

Is this combination available as a generic? yes

Is this combination available on prescription only ? yes

User information

Onset of effect: within 30 minutes

Duration of action: up to 8 hours

Dietary advice: The combination of ibuprofen, paracetamol and codeine should be taken with a meal to minimise gastrointestinal irritation.

Stopping this medicine: The combination of ibuprofen, paracetamol and codeine can be safely stopped when no longer needed.

Prolonged use: the likelihood of adverse effects increase with prolonged use. Dependence is another possible risk of long-term use. Your doctor may perform period liver and kidney function tests, while also examining you for possible gastrointestinal damage.

Special precautions

Consult your doctor before using this drug if:

  • you have asthma
  • you have a stomach ulcer
  • you have a bleeding disorder
  • you are taking blood thinning medication
  • you are allergic to aspirin or any other medication
  • you have a head injury
  • you have a thyroid disorder
  • you have epilepsy
  • you have difficulty urinating
  • you are taking other medication

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: this medication is safe for use.

Infants and children: this medication is safe for use in children at the recommended dose.

The elderly: caution is advised in the elderly as side effects may be more likely. The dose may need to be adjusted.

Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, sedation and light-headedness. Avoid such activities until you know how this medication affects you.

Alcohol: avoid concomitant use of alcohol with this medication as it may worsen stomach irritation and sedative effects.

Possible side effects

Interactions

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

gastrointestinal disorders

x

x

headache

x

x

nausea/vomiting

constipation/ dry mouth

x

x

dizziness

x

x

drowsiness/ confusion

x

x

depression/ change of mood

x

x

sweating

x

x

palpitations

x

x

swelling (feet/ ankles)

x

x

rash/ itch

x

x

difficulty breathing

x

x

blood in vomit

x

dark tarry stools

x

yellow-tinged skin and eyes

x

x

Interactions:

Drug interactions:

blood pressure medication

reduced pressure lowering effect

alcohol

potential gastrointestinal symptoms

warfarin

risk of bleeding

asthma medication

reduced effect of asthma medication; risk of asthma attack

cardiac glycosides, digoxin

risk that heart failure may be more severe

cholestyramine

reduced effect of paracetamol

corticosteroids

potential gastrointestinal symptoms

ciclosporin

potential ibuprofen toxicity

drugs for treating diarrhoea

risk of severe constipation

methotrexate

potential methotrexate toxicity

diuretics

potential risk of kidney damage

blood-glucose lowering drugs

risk of prolonged low blood sugar

isoniazid

risk of paracetamol toxicity; therapeutic doses may not be safe

metoclopramide, domperidone

risk of paracetamol toxicity

oral contraceptives

reduced paracetamol effect

baclofen

potential baclofen toxicity

other NSAIDs

potential risk of gastrointestinal bleeding

probenecid

risk of ibuprofen toxicity

quionolone antibiotics

risk of seizures

Tacrolimus

increased risk of kidney damage

Zidovudine

increased risk of zidovudine toxicity

Disease interactions

Consult your doctor before using this drug if you have asthma, a stomach ulcer, thyroid disease, bleeding disorder, a head injury, epilepsy, if you have difficulty urinating, you are taking blood thinning medication, or if you are allergic to aspirin or any other medication.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage

Dosage should not exceed that recommended for each individual agent.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
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