Can I take Co-codamol and Hydroxocobalamin (Vitamin B12) together?
Drug interaction guide
Originally published 25 Jan 2026
Meets Patient’s editorial guidelines
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There are no known interactions between co-codamol and hydroxocobalamin. It is generally safe to take these two medications together.
Why this happens
Co-codamol (a combination of paracetamol and codeine) and hydroxocobalamin (Vitamin B12) are processed by the body through different pathways. They do not interfere with each other's absorption, metabolism, or effectiveness.
What you should do
You can continue to take both medications as prescribed by your doctor. Always follow the dosage instructions on the packaging for co-codamol, as it contains codeine which can be addictive if used for more than three days without medical advice.
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.
Hypokalaemia (low potassium)
When starting treatment for severe vitamin B12 deficiency, your potassium levels can drop rapidly as your body produces new red blood cells. Your doctor may need to monitor your blood potassium levels closely during the start of treatment.
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.
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.
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Article history
The information on this page is written and peer reviewed by qualified clinicians.
Article also available in English, German, Spanish, French, Italian, Portuguese, Hindi, Hebrew, Arabic, and Swedish.
25 Jan 2026 | Originally published

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