Co-codamol (paracetamol and codeine) is a compound analgesic which contains both paracetamol and codeine. It is typically taken as-needed to treat mild to moderate acute pain when paracetamol alone is insufficient.

This combination of drugs is widely used around the world and generally considered safe as long as it is not taken in large doses or for long periods of time.

Pain Relief When you Need It

Like most acute pain treatments, co-codamol is taken as-needed. It is commonly used to manage pain from:

• Toothache or dental procedures
• Menstrual cramps
• Headaches, including migraines
• Muscle cramps, sprains or other injuries
• Minor medical procedures
• Wounds or broken bones

In patients 12 years old and up, administration is straightforward:

• Take 1 to 2 tablets as-needed every 4 to 6 hours.
• The initial dose is ideally taken at the first symptoms of pain.
• Taking with food and water is optional.
• Do not exceed 8 tablets (4000 mg paracetamol) in 24 hours.

Length of treatment can vary; it may be taken just once or twice a month for conditions such as headaches; in other cases it may be taken for days straight to manage more persistent pain, as from toothache. When taken consecutively, most doctors do not advise using the medication for longer than three days, for a few reasons:

• The longer it is taken the greater the chances of developing side effects;
• Taking codeine long-term may lead to tolerance, in which the medication no longer works as well at lower doses;
• Codeine can be habit-forming if used often, leading to irritability and anxiety when treatment ends.

If pain treatment is needed for longer than three days, staggering co-codamol with another painkiller will likely avert all three issues.

Other Considerations

Too much paracetamol can cause serious liver damage; be careful to not take more than the recommended dose of co-codamol. Also note that a great many other products, including over-the-counter treatments, contain paracetamol; read labels carefully before taking additional medications.

The medication should not be given to children under age 12 without doctor approval; dosage strength will likely be determined by weight. Too much codeine can produce serious, even life-threatening adverse reactions in young patients. Codeine is known to pass through breast milk; mothers who are breast-feeding should not take co-codamol.

Patients with any serious preexisting conditions should speak with a doctor about risks before using codeine products, particularly those with any sort of breathing disorder--opiates are known to depress breathing in patients with asthma, sleep apnea, and similar conditions.

Speak with a doctor if taking any other medications; co-codamol may interfere with their effectiveness or cause unanticipated side effects.

Because codeine often produces feelings of euphoria or well-being, it is a widely-abused drug. For this reason there may be regulations regarding its purchase or possession in some areas; clients are responsible for complying with any such applicable regulations.

If addiction does occur, treatment may be gradually tapered off. It is unlikely to produce physical withdrawal symptoms unless it has been used in very high doses for months or longer. A doctor can provide more advice for quitting codeine.

Co-Codamol Side Effects

Most side effects from co-codamol are rare, and not cause for concern unless persistent or severe:

• Nausea
• Dry mouth
• Light-headedness
• Constipation
• Euphoria
• Drowsiness

Symptoms of more serious reactions call for immediate medical attention:

• Difficulty breathing
• Severe stomach pain, especially if it radiates to the back
• Symptoms of jaundice (yellowing eyes or skin)
• Difficult or painful urination
• Allergic reactions (hives, itching, swelling of lips, tongue, or throat)
• Slowed heart rate
• Extreme confusion

Codeine makes many patients drowsy; use caution performing complex or dangerous tasks until the medication's effect is known.