Can I take Codeine and Paracetamol together?

Why this happens

These medicines work in different ways to stop pain. Paracetamol works mainly in the central nervous system to reduce pain signals and lower fevers, while codeine is an opioid that changes how your brain and nervous system respond to pain. Because they use different pathways, their effects are 'additive', meaning they provide a stronger combined effect.

What you should do

It is safe to take these together, provided you do not exceed the maximum dose for either medicine. Always check the labels of other cold and flu remedies or 'plus' painkillers to ensure they do not already contain paracetamol or codeine, as taking too much paracetamol can cause serious liver damage.

Important precautions

Liver disease or heavy alcohol consumption

Taking paracetamol if you have liver problems or drink more than 14 units of alcohol per week significantly increases the risk of life-threatening liver damage, even at standard doses.

Asthma or breathing problems

Codeine can dangerously slow your breathing. You must not take it if you have severe asthma or chronic obstructive pulmonary disease (COPD), as it can lead to respiratory failure.

Opioid addiction or long-term use

Codeine is highly addictive. Using it for more than 3 days can lead to physical dependence and withdrawal symptoms; it should only be used for short-term pain relief.

Food and drink warnings

Alcohol

You must avoid drinking alcohol while taking codeine. Alcohol increases the sedative effects of codeine, which can lead to extreme sleepiness, breathing difficulties, and a higher risk of overdose.

Caffeine (Coffee, tea, energy drinks)

Be cautious with caffeine if you are taking 'co-codamol' (a combination of codeine and paracetamol) that already contains caffeine. Too much caffeine can cause tremors, a racing heart, and difficulty sleeping. If your medicine does not already contain caffeine, normal intake is usually fine.

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.