Co-codamol at a glance
Medicine class
Paracetamol combined with a weak opioid analgesic.
Administration
Swallow standard tablets or capsules with water. Dissolve effervescent tablets in water. It can be taken with or without food.
Important check
Do not combine it with another paracetamol-containing medicine unless specifically directed by a healthcare professional.
What is Co-codamol used for?
Licensed indications differ between products. Selected UK products cover:
Acute moderate pain not adequately relieved by paracetamol, ibuprofen or aspirin alone.
Conditions including headache or migraine, neuralgia, toothache, period pain and rheumatic pain.
Some painful or feverish symptoms associated with sore throat, colds or influenza.
Migraleve Yellow, within the Migraleve range, for migraine attacks including associated nausea and vomiting.
Severe pain for the selected capsule product.
How does Co-codamol work?
Paracetamol reduces pain signalling, probably mainly through central prostaglandin pathways. Codeine is partly converted into morphine, which acts at opioid receptors to reduce pain transmission. CYP2D6 differences mean codeine may be ineffective in some people and unexpectedly toxic in ultra-rapid metabolisers.
Co-codamol preparations and strengths
Capsule
Route: Oral
Strengths: 15 mg + 500 mg, 30 mg + 500 mg
Tablet
Route: Oral
Strengths: 15 mg + 500 mg, 30 mg + 500 mg
How to take Co-codamol
Follow the pack label or prescriber's instructions and check the formulation before use.
Swallow ordinary tablets or capsules with water.
Dissolve effervescent tablets fully in a glass of water before drinking; do not swallow them whole.
It may be taken with or without food. Taking it with or just after food may help nausea.
Check painkillers, migraine remedies and cold or flu products for paracetamol before combining them.
Do not stop suddenly without prescriber advice after prolonged regular use, because withdrawal can occur.
Co-codamol side effects
Common or expected effects
- Constipation
- Feeling or being sick
- Sleepiness
- Dizziness
- Headache
Get urgent medical advice
- Slow, shallow or difficult breathing
- Seizure
- Severe allergic reaction, including swelling of the mouth, tongue or throat
- A blistering, peeling or otherwise severe skin reaction
- Marked confusion, extreme drowsiness, collapse or inability to wake
- Difficulty passing urine
Co-codamol in pregnancy
Paracetamol can be used during pregnancy, but codeine requires an individual prescriber assessment. Repeated codeine exposure may cause fetal dependence and neonatal withdrawal; use near delivery may cause newborn drowsiness, feeding difficulty or respiratory depression. Discuss pregnancy, planned pregnancy or regular codeine use with the prescriber rather than changing treatment abruptly.
Co-codamol while breastfeeding
Codeine phosphate + paracetamol should not be used while breastfeeding. Morphine formed from codeine can enter breast milk and may cause dangerous sedation or respiratory depression in the infant. Paracetamol alone is generally compatible with breastfeeding.
Co-codamol interactions
Important interactions include:
Other paracetamol-containing medicines
Combining products can cause an unrecognised paracetamol overdose and serious liver damage.
Benzodiazepines, sleeping medicines, sedating antihistamines, antipsychotics and other opioids
Additive sedation can lead to respiratory depression, coma or death.
Alcohol
Increases sleepiness and the risk of severe respiratory and central nervous system depression.
Common questions about Co-codamol
Answers are fully visible for fast scanning and source review.
Is this the same as co-codamol?
Yes. Co-codamol is the usual UK name for a medicine containing paracetamol and codeine phosphate.
Can I take paracetamol with it?
Do not add another paracetamol-containing medicine unless specifically told to by a healthcare professional. Duplication can cause overdose.
Can I drink alcohol while taking it?
Alcohol is not recommended because it increases drowsiness and can contribute to dangerous respiratory depression.
Can it make me sleepy?
Yes. Do not drive, cycle or operate machinery if sleepy or dizzy.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.