Can I take Co-codamol and Sukkarto together?

Why this happens

Co-codamol (a combination of paracetamol and codeine) and Sukkarto (metformin) are processed by the body through different pathways. Co-codamol works on pain receptors in the brain and spinal cord, while Sukkarto works on how the liver produces glucose and how cells respond to insulin. They do not interfere with each other's absorption or metabolism.

It is generally safe to take these two medicines together. Ensure you follow the prescribed doses for both. Because co-codamol can cause constipation and Sukkarto can sometimes cause an upset stomach, drink plenty of water and monitor for any digestive discomfort. If you feel very unwell or experience severe stomach pain, contact your GP.

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.

Lactic acidosis risk (Dehydration)

If you develop severe vomiting, diarrhoea, or a high fever, stop taking metformin and contact a doctor immediately. These conditions can lead to severe dehydration, which significantly increases the risk of a rare but life-threatening build-up of acid in the blood (lactic acidosis).

Contrast dye scans (e.g., CT or X-ray)

You must tell your doctor you take metformin if you are having a scan involving an injection of 'contrast dye'. You will usually need to stop taking metformin 48 hours before and after the procedure to prevent kidney damage.

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 metformin. Drinking alcohol with this medicine increases the risk of a rare but serious condition called lactic acidosis (a build-up of lactic acid in the blood). It also increases the risk of low blood sugar (hypoglycaemia).

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.

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.

Vitamin B12 absorption

Long-term use of metformin can prevent your body from absorbing enough vitamin B12 from your food. You may need to have your B12 levels checked by your doctor or take a supplement if you develop symptoms like extreme tiredness or a sore tongue.

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.