Can I take Co-codamol and Clopidogrel together?

Why this happens

Clopidogrel needs to be broken down by the body to start working. Codeine (in co-codamol) can slow down the movement of your gut and interfere with how clopidogrel is absorbed and processed, meaning there is less of the active medicine in your bloodstream to thin your blood.

What you should do

You should speak to your doctor or pharmacist before taking these together. They may suggest an alternative painkiller that does not interfere with your heart medication, such as paracetamol on its own. If you must take both, your doctor may need to monitor you more closely.

Important precautions

Paracetamol overdose

Co-codamol contains paracetamol. Do not take it with any other paracetamol-containing products (such as cold and flu remedies), as this can lead to fatal liver damage.

Opioid addiction and withdrawal

Co-codamol contains codeine, which can cause addiction if used for more than 3 days. Stopping suddenly after long-term use can cause withdrawal symptoms.

Breathing difficulties

Do not take co-codamol if you have severe asthma or breathing problems, as the codeine can dangerously slow your breathing.

Active bleeding

Do not take clopidogrel if you have an active bleeding site, such as a stomach ulcer or bleeding in the brain, as it prevents blood clotting and will worsen the condition.

Upcoming surgery or dental work

You must tell your surgeon or dentist you are taking clopidogrel at least 7 days before any planned procedure, as it increases your risk of bleeding and may need to be stopped temporarily.

Food and drink warnings

Alcohol

You must avoid drinking alcohol while taking co-codamol. Combining alcohol with codeine increases the risk of serious side effects, such as extreme sleepiness, breathing difficulties, and loss of consciousness. Additionally, both alcohol and paracetamol can affect the liver; combining them regularly increases the risk of liver damage.

It is best to avoid or strictly limit alcohol while taking clopidogrel. Both alcohol and clopidogrel can irritate the stomach lining and increase the risk of internal bleeding, particularly in the stomach and intestines.

Grapefruit juice

Grapefruit juice can interfere with how your body processes codeine, potentially making the medicine less effective or increasing the risk of side effects. It is best to avoid grapefruit juice while taking this medicine.

Grapefruit juice can reduce the effectiveness of clopidogrel, making it less likely to prevent blood clots. It is best to avoid drinking grapefruit juice or eating grapefruit while taking this medicine.

Caffeine

Some versions of co-codamol already contain caffeine. If you consume extra caffeine from coffee, tea, or energy drinks, it may make you feel shaky, anxious, or cause a racing heart.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.