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Co-Codamol

Co-Codamol

Co-codamol is an analgesic (painkiller) that is available in several different strengths and is taken for mild to moderate acute pain when other painkillers have not been successful. It is a combination of both paracetamol and codeine (known as a compound painkiller). It comes in the form of tablets, capsules and effervescent tablets.  Co-codamol is used to relieve migraines, headaches, toothache, period pain, fever from bad colds and flu, injury pain, muscular pain, coughing, back pain and post-operative pain.  The strength of the paracetamol in co-codamol is always the same at 500 mg, while the strength of the codeine varies at 8 mg, 12.8 mg, 15 mg and 30 mg. The two lower doses are available for purchase over-the-counter whereas the higher strength of 15 mg and 30 mg doses must be prescribed by a doctor.  Paracetamol works to reduce fever as it affects an area of the brain that controls the temperature of the body. It also blocks pain signals to the brain. It reduces the production of prostaglandins, which the body makes naturally to heal injuries and tissue inflammation. Paracetamol does not heal the cause of the pain and does not work directly (locally) on the site of the pain.  Codeine copies the action of endorphins (natural painkillers in the body) that reduce and relieve pain. They do not heal the cause of the pain but lessen the feeling. Endorphins are chemicals the body produces when it is under stress or in pain and give a “high” feeling.   Codeine has a similar action to endorphins and is known as an opioid.   Opioids, in particular codeine, can be addictive if used long-term. This is why Co-codamol should only be used as a short-term painkiller unless your doctor recommends you take it for longer. It can become addictive and there can be withdrawal symptoms when stopping this medicine as the body becomes used to it. These withdrawal symptoms can include panic attacks, anxiety, sleeplessness, nervousness, shaking and agitation. If you suspect you may be suffering from withdrawal symptoms when stopping Co-codamol you should talk to your doctor.   The body also starts to tolerate codeine if you take it long-term and it does not work so well, meaning you would need to take a stronger dose to deal with the pain.  Because of the serious consequences of taking this painkiller, it is not recommended to take it for more than 3 continuous days unless your doctor prescribes it for longer. This medicine should be taken in the lowest dose possible for the shortest period of time.  If your doctor does prescribe it to you for longer than 3 days this is likely to be because you are in pain after an operation or serious injury. They should not prescribe it to you for more than a few weeks. 

Co-codamol is a strong painkiller that is a mix of the active ingredients paracetamol and codeine. It is used to treat pain when single painkillers have not worked. 

Co-codamol should only be used for a short period of time as it is possible to become addicted to codeine and/or experience withdrawal symptoms when stopping it.  

What is Co-Codamol? 

Co-codamol is an analgesic (painkiller) that is available in several different strengths and is taken for mild to moderate acute pain when other painkillers have not been successful. It is a combination of both paracetamol and codeine (known as a compound painkiller). It comes in the form of tablets, capsules and effervescent tablets. 

Co-codamol is used to relieve migraines, headaches, toothache, period pain, fever from bad colds and flu, injury pain, muscular pain, coughing, back pain and post-operative pain. 

The strength of the paracetamol in co-codamol is always the same at 500 mg, while the strength of the codeine varies at 8 mg, 12.8 mg, 15 mg and 30 mg. The two lower doses are available for purchase over-the-counter whereas the higher strength of 15 mg and 30 mg doses must be prescribed by a doctor. 

Paracetamol works to reduce fever as it affects an area of the brain that controls the temperature of the body. It also blocks pain signals to the brain. It reduces the production of prostaglandins, which the body makes naturally to heal injuries and tissue inflammation. Paracetamol does not heal the cause of the pain and does not work directly (locally) on the site of the pain. 

Codeine copies the action of endorphins (natural painkillers in the body) that reduce and relieve pain. They do not heal the cause of the pain but lessen the feeling. Endorphins are chemicals the body produces when it is under stress or in pain and give a “high” feeling.  

Codeine has a similar action to endorphins and is known as an opioid.  

Opioids, in particular codeine, can be addictive if used long-term. This is why Co-codamol should only be used as a short-term painkiller unless your doctor recommends you take it for longer. It can become addictive and there can be withdrawal symptoms when stopping this medicine as the body becomes used to it. These withdrawal symptoms can include panic attacks, anxiety, sleeplessness, nervousness, shaking and agitation. If you suspect you may be suffering from withdrawal symptoms when stopping Co-codamol you should talk to your doctor.  

The body also starts to tolerate codeine if you take it long-term and it does not work so well, meaning you would need to take a stronger dose to deal with the pain. 

Because of the serious consequences of taking this painkiller, it is not recommended to take it for more than 3 continuous days unless your doctor prescribes it for longer. This medicine should be taken in the lowest dose possible for the shortest period of time. 

If your doctor does prescribe it to you for longer than 3 days this is likely to be because you are in pain after an operation or serious injury. They should not prescribe it to you for more than a few weeks. 

When is Co-Codamol used? 

Co-codamol is used when other, milder painkillers, such as paracetamol, aspirin and ibuprofen have not worked. It should not be used long-term, for more than 3 consecutive days, unless your doctor advises differently. It is used for the treatment of: 

  • Flu symptoms; 
  • Coughing;  
  • Headache; 
  • Migraine; 
  • Muscular pain; 
  • Backache;  
  • Toothache;  
  • Rheumatic pain;   
  • Period pain;  
  • Sore throat;  
  • Sciatica. 

Co-codamol is especially good for treating the symptoms of coughing associated with heavy colds and flu. It can help stop coughing to help with sleep or when uncontrollable coughing occurs. 

How do you use Co-Codamol? 

You should Co-codamol tablets and capsules with a glass of water. The effervescent tablets should be completely dissolved in water before drinking the whole amount.  

Co-codamol can be taken before or after meals, however, it is better to take it after as you are less likely to feel sick if you are prone to this side effect. 

If you are taking Co-codamol you should not take any other medicine that contains paracetamol or codeine. This is because there is the risk of an overdose. Too much paracetamol can cause liver and kidney damage and too much codeine can cause breathing problems and loss of consciousness. 

Co-codamol usually takes up to an hour to start to work. It then works for approximately 5 hours. If the effects of taking Co-codamol wear off before 4 hours have passed you should not take another dose as this can be dangerous. 

This medicine should not be taken by children under 12 years of age. 

What dosages are there? 

Co-codamol is available in 4 strengths. It always contains 500 mg of paracetamol but the strength of the codeine differs. Co-codamol tablets can contain 8 mg, 12.8 mg, 15 mg and 30 mg of codeine.   The strength is written on the product and packaging with the quantity of codeine first, then the quantity of paracetamol, like this: 

  • 8/500 mg; 
  • 12.8/500 mg; 
  • 15/500 mg; 
  • 30/500 mg. 

The recommended doses are below, however, it is important to follow your doctor’s or pharmacist’s advice: 

  • Adults: 1-2 tablets every 4-6 hours, with a maximum of 8 tablets in 24 hours; 
  • Children over 12 years of age: 1 tablet every 6 hours, with a maximum of 8 tablets in 24 hours. 

If you forget to take a dose of Co-codamol you should not take another dose to make up for this, but wait until the next dose is due as taking too much can be dangerous. 

If your pain is severe you should not increase the dose but see a doctor. 

What are the side effects of Co-Codamol? 

As with all medicines, Co-codamol can cause side effects for some people. The common possible side effects are: 

  • Constipation; 
  • Feeling or being sick; 
  • Drowsiness; 
  • Headache; 
  • Dizziness. 

Co-codamol can cause headaches to get worse which is a condition known as medicine-induced headache. This is when you have a headache for at least 15 days a month. If this happens you should stop taking this medication immediately. The headaches are likely to get worse when you stop, but will then get better after about a week. You are then likely to suffer from headaches again so you should see your doctor about another form of treatment. 

When shouldn’t you use Co-Codamol? 

You should not use Co-codamol if you are allergic to any of its ingredients (see the package leaflet).  

Children under 12 years of age should not use Co-codamol. 

You should not take Co-codamol if you: 

  • Are taking any other medicines containing paracetamol; 
  • Are taking any other medicines containing codeine; 
  • Are pregnant, planning to become pregnant or breastfeeding; 
  • Have a problem with your liver or kidneys; 
  • Have prostate problems;  
  • Have difficulty passing urine;  
  • Have asthma, other breathing problems or chronic obstructive pulmonary disease (COPD); 
  • Suffer from epilepsy;  
  • Have gallstones or a problem with your gallbladder or bile duct;  
  • Have recently had a severe head injury;  
  • Suffer from any problems with your thyroid or adrenal glands;  
  • Have low blood pressure or an abnormal heart rhythm;  
  • Are dependent on drugs or alcohol;  
  • Have been constipated for more than a week or have inflammatory bowel syndrome (IBS). 

It is important to tell your doctor or pharmacist if you are taking any other medication before taking Co-codamol, including herbal medicines. 

Alcohol can interact with and increase the risk of the side effects Co-codamol so you should reduce or stop your alcohol intake while taking this medicine. 

If you feel dizzy or drowsy when you have taken Co-codamol you should not drive or operate machinery. 

Does Co-Codamol interact with other medication? 

Co-codamol can interact with other medication and can affect the way it works, and other medication can also affect the way Co-codamol works. 

It is important to tell your doctor if you are taking other medication, including: 

  • Blood-thinning medicines; 
  • Medicines to stop you feeling or being sick; 
  • Antidepressants; 
  • Medicines for epilepsy; 
  • Sleeping tablets or tranquillisers; 
  • Herbal medicines. 

You must not take Co-codamol if you are taking any other medicines containing paracetamol or codeine – check all the packaging and if you have any doubts talk to your doctor or pharmacist. Note that many cough and cold remedies you can buy over-the-counter contain these ingredients and should not be taken with Co-codamol. 

Co-codamol can sometimes temporarily reduce fertility in men and women. Taking this medication for a long period of time can also affect the possibility of conceiving. If you are concerned about your fertility while taking Co-codamol you should talk to your doctor. 

Where can you buy Co-Codamol? 

You can buy Co-codamol 8/500 mg and 12.8/500 mg over-the-counter. However, you need a prescription for the stronger versions of 15/500 mg and 30/500 mg. 

Can I get Co-Codamol without a prescription?  

You can only get the lower codeine doses of Co-codamol without a prescription: 8/500 mg and 12.8/500 mg. The higher codeine doses of 15/500 mg and 30/500 mg need a prescription from a doctor. 

Sources 

Co-codamol for adults. August 25, 2017. Retrieved 27 November, 2019 from https://www.nhs.uk/medicines/co-codamol-for-adults/ 

Marshall, H. February 5, 2019. Co-codamol dosage: How do you take co-codamol?  Retrieved 27 November, 2019 from https://www.netdoctor.co.uk/medicines/aches-pains/a26367/how-do-i-take-co-codamol-and-what-is-the-dose/ 

Package leaflet. PACKAGE LEAFLET: INFORMATION FOR THE USER Co-codamol 30mg/500mg Tablets Codeine Phosphate/Paracetamol. March, 2014. Retrieved 27 November, 2019 from https://s3-eu-west-1.amazonaws.com/docomimg2.s3.amazonaws.com/leaflets/en/patient_information_leaflet-2774-co-codamol-30,500-uk.pdf-1510756509.pdf 

Stewart, M. Co-codamol for pain relief. January 24, 2018. Retrieved 27 November, 2019 from https://patient.info/medicine/co-codamol-for-pain-relief#nav-3