caffeine + codeine + paracetamol at a glance
Medicine class
Combination analgesic containing paracetamol, an opioid and caffeine.
Usual role
Short-term treatment of acute moderate pain not adequately relieved by appropriate non-opioid painkillers alone.
Important check
Check all pain, migraine, cold and flu products to avoid additional paracetamol or codeine.
Dependence risk
Repeated codeine use can cause tolerance, dependence and opioid use disorder.
What is caffeine + codeine + paracetamol used for?
Selected products are licensed for short-term relief of acute moderate pain when appropriate painkillers used alone have not worked adequately.
Headache and migraine
Toothache and neuralgia
Period pain
Rheumatic pain
Muscular pain and backache where represented by the selected capsule product
How does caffeine + codeine + paracetamol work?
Paracetamol reduces pain signalling in the central nervous system. Codeine is converted partly to morphine, which activates opioid receptors and reduces pain perception; genetic differences in CYP2D6 make its effects and toxicity variable. Caffeine stimulates the central nervous system and can enhance paracetamol's analgesic effect.
How to take caffeine + codeine + paracetamol
Follow the pack leaflet or prescriber's directions and do not exceed the labelled amount.
Swallow capsules whole with water.
Dissolve soluble tablets fully in a glass of water before drinking.
Take with or without food; food may help if nausea occurs.
Do not take another product containing paracetamol or codeine unless specifically directed by a clinician.
Seek pharmacist or prescriber advice if pain persists, worsens or repeatedly returns.
caffeine + codeine + paracetamol side effects
Common or expected effects
- Constipation
- Nausea or vomiting
- Drowsiness or dizziness
- Headache
- Indigestion or abdominal discomfort
- Nervousness, tremor, sleeplessness or palpitations from caffeine
Get urgent medical advice
- Slow or shallow breathing, profound sleepiness, confusion or pinpoint pupils
- Severe allergic reaction with facial or throat swelling or breathing difficulty
- Severe or blistering skin reaction
- Severe abdominal pain spreading to the back, which may indicate pancreatitis
- Unusual bruising or recurrent infections suggesting a blood disorder
- Signs of dependence, withdrawal or escalating use
caffeine + codeine + paracetamol in pregnancy
Do not self-treat with this combination during pregnancy. The selected Boots capsule is contraindicated in pregnancy, while broader codeine evidence supports use only after individual clinician-led assessment when pain relief is necessary. Exposure near delivery or repeated exposure can cause neonatal respiratory depression, drowsiness or withdrawal.
caffeine + codeine + paracetamol while breastfeeding
Do not use this combination while breastfeeding. Codeine and its active metabolite can enter breast milk and may cause dangerous sedation or breathing problems in the infant. Caffeine-containing combinations are also best avoided, particularly with newborn or young infants.
caffeine + codeine + paracetamol interactions
Check prescribed, pharmacy and shop-bought products before use. Important interactions include:
Other paracetamol- or codeine-containing products
Combining them can cause accidental paracetamol overdose or excessive opioid effects.
Alcohol, benzodiazepines, sleeping medicines and other sedatives
Sedation and respiratory depression may increase, potentially causing coma or death.
Gabapentin or pregabalin
Combined central nervous system depression increases the risk of profound sedation and breathing difficulty.
Common questions about caffeine + codeine + paracetamol
Answers are fully visible for fast scanning and source review.
Can it be taken with ordinary paracetamol?
No, unless a clinician has specifically instructed this. The combination already contains paracetamol, and duplication can cause serious liver injury.
Can it be taken with food?
Yes. It may be taken with or without food; food may help if it causes nausea.
Can it make me sleepy?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.