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Co-codamol

Co-codamol is taken for the relief of short-term moderate pain cause by conditions such as headache, migraine, painful periods, neuralgia, tooth ache and dental work, rheumatism and muscle ache. It may also be used to lower body temperature.

Can I buy Kapake or Co-codamol online?

The Online Clinic can prescribe Co-codamol generically or we can prescribe under the brand name Kapake if you prefer. Please just complete a short online consultation questionnaire so that we can make an assessment.

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What is Co-codamol?

Co-codamol contains two active medicines, codeine phosphate and paracetamol, which are both analgesics (painkillers). Paracetamol is also an antipyretic, i.e., it reduces your body temperature. Codeine is an opioid which works by being converted to morphine that, by acting on the nervous system, gives pain relief. Paracetamol is believed to prevent chemicals called prostaglandins being released, which dampens down the feeling of pain, and also acts on the brain region controlling body temperature.

How to use Co-codamol

This medicine is available in tablet, effervescent tablet, and capsule form. One or 2 Co-codamol tablets/capsules are usually taken every 6 hours, if required, but no more than 8 are permitted within a 24-hour period. They should not be used for longer than 3 days. Tablets and capsules are swallowed whole with water; effervescent tablets are dissolved in a large glass of water. Your doctor will confirm how you should take this medicine and for how long. Consult your doctor or get medical advice immediately if either you need pain relief for longer (because the codeine ingredient in this medicine is an opioid and can lead to addiction and withdrawal symptoms) or you take too many tablets (as it can cause liver damage at a later date). Do not double up on the dose if you forget to take Co-codamol; take it at the next scheduled time. You must not drink alcohol while taking this medicine.

Who can use Co-codamol?

Children 12 years of age and older and adults can use this medicine for moderate pain that is not alleviated by a painkiller such as ibuprofen, aspirin, or paracetamol alone.

You should avoid taking Co-codamol if you have an allergy to any of its ingredients, have severe diarrhoea/bloody diarrhoea, rapidly break down codeine to morphine, if you have lung disease or breathing difficulties, or you are breastfeeding or pregnant. Children and adolescents (18 years or younger) should not take Co-codamol after they have had their tonsils or adenoids removed because of obstructive sleep apnoea syndrome. Mention to the doctor if you have had recent surgery, or problems with your liver or kidneys, gall stones, inflammatory bowel disease, Addison's disease, underactive thyroid gland, enlarged prostate, passing urine, muscle weakness, low blood pressure, epilepsy, a head injury, or have/have had problems with mental illness, or alcohol or drug abuse.

Co-codamol can interact with many different medicines, so it is very important to inform your doctors about all your current medicines including those recently taken and those bought from the chemist. These include medicines known as monoamine oxidase inhibitors (e.g., moclobemide), blood thinners (e.g., warfarin), oral contraceptives (e.g., ‘the pill’), anticholinergics (e.g., atropine), muscle relaxants, barbiturates (e.g., phenobarbital), anaesthetics, and opioid antagonists (e.g., naltrexone); medicines used in the treatment of vomiting (e.g., metoclopramide or domperidone), diarrhoea (e.g., loperamide), stomach ulcers (e.g., cimetidine), high blood pressure (e.g., furosemide and guanethidine), high cholesterol levels (e.g., colestyramine), an irregular heartbeat (e.g., mexiletine), Parkinson's disease (e.g., selegiline), epilepsy (e.g., phenytoin), depression (e.g., amitriptyline), and mental illness; and medicines affectng the liver (e.g. rifampicin), and the nervous system (e.g., sleeping pills and diazepam).

Co-codamol Side Effects

In the liver, an enzyme breaks down codeine to morphine that gives us relief from pain. The amount of morphine produced can vary between individuals so some people produce too much morphine (causing serious side effects) while others produce too little (causing insufficient pain relief). Stop taking Co-codamol and seek immediate medical attention if your breathing becomes slow or shallow, or you become confused, sleepy, feel/are sick, constipated, not hungry, and have small pupils. You can become tolerant to, i.e., the medicine has less effect and you need to take it more often or for a longer time period, or dependent on, i.e., you have withdrawal symptoms when stopping the medicine (e.g. tremor, sleep disturbances, sweating, increased heart and breathing rate) this medicine. Taken frequently over the longer term, taking Co-codamol for headache can worsen the headaches. However, if you take Co-codamol exactly as you have been advised by your doctor then these circumstances are unlikely to occur.

Co-codamol can cause allergic reactions such as skin rash/itch, breathing difficulty, increased sweating and fever, facial flushing, and mouth ulcers. It can also cause problems with your digestive system (e.g., poor appetite, nausea, vomiting, stomach ache, and constipation), heart (e.g., slow heart rate or palpitations and low blood pressure), blood (causing more nose bleeds, bruising, or infections), ‘water works’ (e.g., passing urine), nervous system (e.g., confusion, sleepiness/sleep disturbances, dizziness, fluctuating moods, depression, restlessness, and headache), and eyes (small pupils, and blurred or double vision). Additionally, it can cause trembling, weakness, and a drop in body temperature. If you have any of these symptoms then stop the medicine now and contact your doctor immediately.

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