What is
Co-codamol?
- Co-codamol is a mixture of 2 different painkillers – paracetamol and codeine.
- It’s used to treat aches and pains including headaches, muscle pain, migraines and toothache.
- It may help to take co-codamol if everyday painkillers, such as ibuprofen, aspirin or paracetamol on its own, have not worked.
- This medicine comes as tablets and capsules, including soluble tablets that you dissolve in water.
- Co-codamol tablets and capsules come in 3 strengths. You can buy the lowest strength from pharmacies but the higher strengths are only available on prescription.
- For children and young people under 18 years old, read our information on co-codamol for children.
Key facts
- Co-codamol takes up to 1 hour to work. It keeps on working for about 5 hours.
- The most common side effects of co-codamol are constipation, feeling sick (nausea) or feeling sleepy.
- Taking too much co-codamol can be harmful. Do not increase the dose, even if your pain is very bad.
- It’s possible to become addicted to the codeine in co-codamol, but your doctor will explain how to reduce the risks of becoming addicted.
- If you need to take co-codamol for more than a few weeks, your treatment plan may include details of how and when to stop taking this medicine.
Who can and cannot take co-codamol
Most adults can take co-codamol.
Most children and young people aged from 12 to 17 years old can take it but it’s only recommended if other painkillers have not worked.
Who may not be able to take co-codamol.
Co-codamol is not suitable for some people. To make sure it’s safe for you, tell your doctor before starting to take it if you:
- have lung problems or breathing difficulties
- have a head injury
- have adrenal gland problems
- have a condition that causes fits or seizures
- regularly drink more than the maximum recommended amount of alcohol (14 units a week)
- are trying to get pregnant, are already pregnant or are breastfeeding
- have liver problems – you may need to take a lower dose
- are under 18 years old and have had your tonsils or adenoids removed because of a sleep problem called sleep apnea
How and when to take
co-codamol?
It’s important to take co-codamol as your doctor has asked you to. This is particularly important because co-codamol can be addictive.
Different co-codamol strengths
Co-codamol tablets and capsules come in 3 different strengths, containing 8mg, 15mg or 30mg of codeine.
All 3 strengths contain 500mg of paracetamol – the same as in a standard paracetamol tablet or capsule.
The strength of co-codamol appears as 2 numbers on the packet. For example, 8/500 means each tablet or capsule contains 8mg of codeine and 500mg of paracetamol.
You can buy the lowest strength of co-codamol (8/500) without a prescription but only from a pharmacy. The higher strengths (15/500 and 30/500) are only available on prescription from a doctor.
Dosage
Adults can take 1 or 2 tablets (of any strength) up to 4 times in 24 hours. It’s important to leave a gap of at least 4 to 6 hours between doses of co-codamol.
The maximum dose is 8 co-codamol tablets in 24 hours.
Taking too much co-codamol can be very dangerous. That’s because the paracetamol in it can cause liver damage.
Do not increase the dose of co-codamol or take more than 2 tablets at once, even if your pain is very bad. Talk to a pharmacist or doctor if you think the dose is not enough to help your pain.
Side effects of
co-codamol
Like all medicines, co-codamol can cause side effects, although not everyone gets them. Many people have no side effects or only minor ones.
You’re more likely to have side effects if you take the higher strengths of co-codamol.
Common side effects
These common side effects of co-codamol happen in more than 1 in 100 people. There are things you can do to help cope with them:
- Constipation
- Feeling or being sick (nausea or vomiting)
- Feeling dizzy
- Feeling sleepy
- Headaches
Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Serious side effects
Serious side effects are rare and happen in less than 1 in 100 people.
Call a doctor now if you have:
- a skin rash
- difficulty peeing
- changes in your eyesight
- muscle stiffness
- symptoms of low blood pressure, which include feeling dizzy and tired
Serious allergic reaction
In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to co-codamol.
Long-term side effects
If you’ve bought co-codamol from a pharmacy, do not use it for more than 3 days. If your pain has not gone away, talk to a pharmacist or doctor.
If you need to take co-codamol for a long time, your body can become tolerant to the codeine in it. That means you need higher doses to control your pain over time.
Some people can become more sensitive to pain (hyperalgesia). If this happens, your doctor will reduce your dose gradually to help these symptoms.
It’s possible to become addicted to the codeine in co-codamol. For this reason, your dose will be reviewed to make sure you’re only taking the amount you need to control your pain.
Your treatment plan may include details of how and when you’ll stop taking co-codamol.
If you’re having treatment for cancer pain or other severe pain, your pain control will be carefully monitored. Speak to your doctor if you’re worried about tolerance, hyperalgesia or becoming addicted.
Other side effects
These are not all the side effects of co-codamol. For a full list, see the leaflet inside your medicine packet.
Pregnancy, breastfeeding and fertility while taking co-codamol?
Co-codamol and pregnancy
Co-codamol can be taken in pregnancy, although taking it long-term is not recommended.
Co-codamol contains paracetamol and codeine. Paracetamol is safe to take in pregnancy, but codeine can affect your baby.
If you take codeine at the end of pregnancy then there’s a risk that your baby may become used to having codeine. They may be drowsy or have withdrawal symptoms after they’re born. If this happens, your baby may need extra time in hospital for observation.
It’s important to treat pain in pregnancy. If you have severe pain, co-codamol might sometimes be the best option. Your doctor can help you decide what’s right for you and your baby.
Co-codamol and breastfeeding
Do not take co-codamol if you’re breastfeeding.
Small amounts of the codeine in co-codamol get into breast milk. This could harm your baby, for example by causing breathing problems.
Paracetamol is the best painkiller to take if you’re breastfeeding.
If you’re breastfeeding and think you need co-codamol, discuss this with your doctor first. They can advise you on other pain relief options.
Co-codamol and fertility
Taking co-codamol for a short time at normal doses is unlikely to affect fertility in either men or women.
However, if you’ve been taking it for a long time or you’re having difficulty in trying for a baby, speak to a pharmacist or doctor.
Co-codamol with other medicines
Cautions with other medicines
Some medicines affect the way co-codamol works. Co-codamol can also stop some medicines working as well as they should.
Tell your doctor if you’re taking:
- sleeping pills or tranquillisers – particularly benzodiazepines such as diazepam, temazepam or lorazepam
- antidepressants – some types do not mix with co-codamol
- medicines to stop you feeling or being sick such as domperidone or metoclopramide
- medicines that help to prevent blood clots (anticoagulants) such as warfarin
- medicines to treat infections, particularly rifampicin or ciprofloxacin
epilepsy medicines
Taking co-codamol with other painkillers
It’s safe to take co-codamol with ibuprofen and aspirin.
Do not take co-codamol with paracetamol, or other medicines that contain paracetamol, unless you’ve been advised to by a doctor. Co-codamol already contains paracetamol so you could be at risk of paracetamol overdose.
Medicines that have paracetamol in them include painkillers like Tramacet and co-dydramol, migraine remedies, and some cough and cold remedies like Lemsip and Night Nurse.
Mixing co-codamol with herbal remedies and supplements
There’s not enough information to say that complementary medicines, herbal remedies and supplements are safe to take with co-codamol.
They’re not tested in the same way as pharmacy and prescription medicines. They’re generally not tested for the effect they have on other medicines.
