Publications
Partners
Paracetamol and codeine are the active ingredient of Co-Codamol, Dolorol Forte, Nitrocod, Painamol Plus, Paincodein, Panado-Co, Kodapon, Napacod and Infapain.
General information
The combination of paracetamol and codeine relieves pain and reduces fever.
It is indicated for the relief of mild to moderate pain and fever, such as headaches, toothache and pain associated with colds and flu.
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, it is safe for those who suffer from peptic ulcers and 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, and diarrhoea. It should be used with caution by patients with a history of alcohol or drug abuse as risk of dependency does exist.
Neither paracetamol nor codeine cures the underlying condition responsible for pain, fever or inflammation, but keeps the symptoms under control.
How does the combination work?
Paracetamol blocks the production of chemicals 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: Schedule 2
Available as: Tablets and syrup
What does it do? The paracetamol-codeine combination relieves pain and fever.
Overdose risk: High
Dependence risk: Medium
Available as a generic? Yes
Available on prescription only ? No
User information
Onset of effect: Within 30 minutes
Duration of action: Up to 6 hours
Dietary advice: Alcohol in combination with paracetamol may substantially increase the risk of liver damage and sedation
Stopping: It can be safely stopped when no longer needed
Prolonged use: The likelihood of adverse effects increases with prolonged use. Dependence is a possible risk of long-term use. Your doctor may perform periodic 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 kidney or liver disease,
- you have a bleeding disorder or if you are taking blood thinning medication,
- you have a head injury,
- you have a thyroid disorder,
- you have epilepsy,
- you have difficulty urinating, or
- 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 to use.
Infants and children: This medication is safe for use in children at the recommended dose.
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 until you know how it 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 | |
Constipation | x | x | ||
Nausea/ vomiting | x | x | ||
Drowsiness/ dizziness/ light-headedness | x | x | ||
Headache | x | x | ||
Euphoria | x | x | ||
Change in mood | x | x | ||
Rash/ itchy skin | x | x | ||
Slurred speech | x | x | ||
Difficulty breathing | x | x | ||
Seizures | x | x | ||
Yellow-tinged skin and eyes | x | x | ||
Interactions:
Drug interactions:
Blood pressure medication | Reduced pressure lowering effect |
Alcohol | Increased risk of liver damage |
Warfarin | Risk of bleeding |
Atropine and related drugs | Increased risk of constipation, urinary retention, etc. |
Carbamazepine | Increased risk of carbamazepine toxicity |
Cholestyramine | Reduced effect of paracetamol |
Drugs that may cause sedation | Increased risk of sedation |
Drugs for treating diarrhoea | Risk of severe constipation |
Monoamine oxidase inhibitors | Increase risk of low blood pressure |
Chlorpromazine | Increase painkilling effect |
Isoniazid | Risk of paracetamol toxicity; Therapeutic doses may not be safe |
Metoclopramide, Domperidone | Risk of paracetamol toxicity |
Oral contraceptives | Reduced paracetamol effect |
Disease interactions
Consult your doctor before using this drug if y ou have asthma, kidney or liver disease, a bleeding disorder, a head injury, a thyroid disorder, epilepsy or if you have difficulty urinating.
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.
