Co-codamol for pain relief

About co-codamol

What is co-codamol used for?

Co-codamol is a type of painkiller that contains paracetamol and codeine. It is given to relieve short-lasting painful conditions where paracetamol alone is not sufficient.

There are three different strengths of co-codamol available, one of which can be bought without a prescription at a pharmacy. The amount of paracetamol in the three different strengths is the same (500 mg), but the amount of codeine differs and this determines the strength of the preparation.

The three main tablet strengths are: 8 mg/500 mg, 15 mg/500 mg, and 30 mg/500 mg, where the first number relates to how much codeine is in the tablet, and the second is the amount of paracetamol present.

Combination painkillers like co-codamol can reduce how many tablets you take, but they may not give the best pain relief. It’s harder to adjust the dose without increasing side effects, so many doctors prefer not to prescribe them.

Side effects of co-codamol

Common side effects of co-codamol are:

• Feeling sick (nausea).

• Being sick (vomiting).

• Constipation.

• Feeling sleepy or drowsy.

• Dry mouth.

• Sweating.

• Stomach pain.

You will find a full list in the manufacturer's information leaflet supplied with your medicine.

The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any side effects continue or become troublesome.

How to manage co-codamol side effects

If you experience any other symptoms which you think may be due to the medicine, discuss them with your doctor or pharmacist for further advice.

Who should not take co-codamol?

Some medicines aren’t safe for people with certain health conditions, or may need to be used with extra care. So before you start taking co-codamol, make sure your doctor or pharmacist knows:

• If you are pregnant or breastfeeding.

• If you have a problem with the way your liver works, or a problem with the way your kidneys work.

• If you have prostate problems or any difficulties passing urine.

• If you have any breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD).

• If you have been told you have low blood pressure or an abnormal heart rhythm.

• If you have any problems with your thyroid or adrenal glands.

• If you have epilepsy.

• If you have gallstones or a problem with your gallbladder or bile duct.

• If you have been constipated for more than a week or have an inflammatory bowel problem.

• If you have a condition causing muscle weakness, called myasthenia gravis.

• If you have recently had a severe head injury.

• If you have ever been dependent on drugs or alcohol.

• If you have ever had an allergic reaction to a medicine.

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

How to take co-codamol

• Read the information leaflet in the pack before you start. It explains how co-codamol works and lists possible side effects.

• Take co-codamol exactly as advised by your doctor or pharmacist. Adults usually take 1-2 tablets every 4-6 hours if needed.

  • Leave at least 4 hours between doses.

  • Don’t take more than 2 tablets at once or 8 tablets in 24 hours.

• Swallow tablets/capsules with water. If you have effervescent tablets, dissolve them in a small glass of water first.

• You can take co-codamol with or without food, but taking it after food may help prevent feeling sick.

• If you miss a dose, just take one when you next need it. Do not double up to make up for a missed dose.

Getting the most from your treatment

• You can take over-the-counter co-codamol for up to 3 days. If your pain continues or the medicine doesn’t help, speak to a doctor or pharmacist.

• Using co-codamol often for headaches can actually cause more headaches (medication-overuse headaches), even at normal doses. Do not use painkillers for headaches for more than 2 days in a row or 2 days a week. Get advice if you’re worried about this.

• Do not take any other paracetamol-containing medicines while using co-codamol. Check labels or ask a pharmacist to be safe.

• Avoid alcohol while taking co-codamol, as codeine increases the risk of alcohol-related side effects.

• Co-codamol is usually only given for short-term use because stopping it after long-term use can cause withdrawal symptoms (for example, restlessness, irritability). If you’ve been taking it for a while, your doctor may reduce your dose gradually.

• Long-term use of codeine can lead to tolerance, meaning it becomes less effective.

• Never take more than the recommended dose. If you think you or someone else has taken too much, go to A&E immediately, even if you feel fine, because an overdose can seriously harm the liver. Bring the medicine container with you.

• Tell your doctor, dentist, or surgeon that you are taking co-codamol if you are having any operation or dental treatment.

• When buying any new medicines, always check with a pharmacist that they are safe to take with co-codamol.

How to store co-codamol

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

Frequently asked questions

How long does it take for co-codamol to work?

Co-codamol usually starts to work within 30 to 60 minutes. Once it starts working, co-codamol can provide pain relief for around 4 to 6 hours.

Can you drink alcohol on co-codamol?

No, you should not drink alcohol while taking co-codamol. Mixing alcohol with co-codamol can increase drowsiness, slow your reactions, and make you feel very unwell.

You should wait until the co-codamol is fully out of your system - usually at least 24 hours after your last dose - before having alcohol.

Is it safe to take co-codamol during pregnancy?

Co-codamol is not usually recommended during pregnancy because it contains codeine, which may affect your baby’s breathing or cause withdrawal symptoms if used regularly or late in pregnancy.

Can you take co-codamol with ibuprofen?

Yes, it is generally safe to take co-codamol with ibuprofen. They work in different ways, so taking them together can provide better pain relief. Always take co-codamol as directed and take ibuprofen with food or water to reduce stomach upset.

Can you buy co-codamol over the counter?

Yes, you can buy low-strength co-codamol (8/500 mg) over the counter in the UK. Stronger doses require a prescription from a doctor.