Paracetamol and codeine are the active ingredient of Co-Codamol, Dolorol Forte, Nitrocod, Painamol Plus, Paincodein, Panado-Co, Kodapon, Napacod and Infapain.
The combination of paracetamol and codeine relieves pain and reduces fever.
It is indicated for the relief of mild to moderate pain and fever, such as headaches, toothache and pain associated with colds and flu.
Paracetamol is the analgesic of choice for mild to moderate pain and to reduce fever. It is suited for both adults and children and, as it does not cause stomach irritation, it is safe for those who suffer from peptic ulcers and those who cannot take aspirin.
When taken by mouth it is rapidly absorbed into the body, and will be effective within 30 minutes. Paracetamol is safe for occasional use by those being treated with anticoagulants.
Codeine is most often prescribed to treat mild to severe pain, but is also effective in treating irritating, dry coughs, and diarrhoea. It should be used with caution by patients with a history of alcohol or drug abuse as risk of dependency does exist.
Neither paracetamol nor codeine cures the underlying condition responsible for pain, fever or inflammation, but keeps the symptoms under control.
How does the combination work?
Paracetamol blocks the production of chemicals responsible for pain, fever, swelling and inflammation.
Codeine exerts its effect by acting on parts of the central nervous system which process pain signals or the cough reflex.
Drug schedule: Schedule 2
Available as: Tablets and syrup
What does it do? The paracetamol-codeine combination relieves pain and fever.
Overdose risk: High
Dependence risk: Medium
Available as a generic? Yes
Available on prescription only ? No
Onset of effect: Within 30 minutes
Duration of action: Up to 6 hours
Dietary advice: Alcohol in combination with paracetamol may substantially increase the risk of liver damage and sedation
Stopping: It can be safely stopped when no longer needed
Prolonged use: The likelihood of adverse effects increases with prolonged use. Dependence is a possible risk of long-term use. Your doctor may perform periodic liver and kidney function tests, while also examining you for possible gastrointestinal damage.
Consult your doctor before using this drug if:
- You have asthma,
- you have kidney or liver disease,
- you have a bleeding disorder or if you are taking blood thinning medication,
- you have a head injury,
- you have a thyroid disorder,
- you have epilepsy,
- you have difficulty urinating, or
- You are taking other medication.
Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.
Porphyria: This medication is safe to use.
Infants and children: This medication is safe for use in children at the recommended dose.
Elderly: Caution is advised in the elderly as side effects may be more likely. The dose may need to be adjusted.
Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness, sedation and light-headedness. Avoid until you know how it affects you.
Alcohol: Avoid concomitant use of alcohol with this medication as it may worsen stomach irritation and sedative effects.
Possible side effects
Consult your doctor
Only if severe
In all cases
Drowsiness/ dizziness/ light-headedness
Change in mood
Rash/ itchy skin
Yellow-tinged skin and eyes
Blood pressure medication
Reduced pressure lowering effect
Increased risk of liver damage
Risk of bleeding
Atropine and related drugs
Increased risk of constipation, urinary retention, etc.
Increased risk of carbamazepine toxicity
Reduced effect of paracetamol
Drugs that may cause sedation
Increased risk of sedation
Drugs for treating diarrhoea
Risk of severe constipation
Monoamine oxidase inhibitors
Increase risk of low blood pressure
Increase painkilling effect
Risk of paracetamol toxicity; Therapeutic doses may not be safe
Risk of paracetamol toxicity
Reduced paracetamol effect
Consult your doctor before using this drug if y ou have asthma, kidney or liver disease, a bleeding disorder, a head injury, a thyroid disorder, epilepsy or if you have difficulty urinating.
A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention.
Dosage should not exceed that recommended for each individual agent
This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.