K čemu se používá Co-Codamol (Paracetamol/Codeine)?

Co-Codamol is a combination analgesic containing paracetamol and codeine phosphate. It is used for the short-term treatment of moderate pain that has not responded adequately to paracetamol or ibuprofen alone, including headaches, dental pain, musculoskeletal pain, and post-operative pain.

Is Co-Codamol stronger than paracetamol alone?

Yes. The addition of codeine — a mild opioid analgesic — to paracetamol provides enhanced pain relief for moderate pain that does not respond sufficiently to paracetamol on its own. Clinical evidence supports the combination being more effective for moderate pain than either ingredient alone at standard doses.

Jaké jsou nejčastější vedlejší účinky?

Common side effects include constipation, nausea, dizziness, drowsiness, and headache. The codeine component carries a risk of dependence with prolonged use, which is why it should only be used for short durations and under medical supervision.

Can Co-Codamol be habit forming?

Yes. Codeine is an opioid and carries a risk of psychological and physical dependence, particularly with prolonged use or higher doses. Co-Codamol is intended for short-term use only, and patients should not use it for longer than three days without medical guidance.

Co-Codamol (Paracetamol/Codeine) Online Evropa — Posouzení lékařem z EU

Co je Co-Codamol (Paracetamol/Codeine)?

Co-Codamol is a combination prescription analgesic containing two active ingredients: paracetamol and codeine phosphate. It provides stronger pain relief than paracetamol alone and is indicated for the short-term treatment of moderate pain in adults and adolescents aged 12 and over. Higher-strength formulations (30/500 mg) are prescription-only medicines across the European Union.

Jak funguje Co-Codamol (Paracetamol/Codeine)?

Co-Codamol achieves its analgesic effect through two complementary mechanisms:

Paracetamol component: Paracetamol (also known as acetaminophen) works centrally in the brain to inhibit the synthesis of prostaglandins involved in pain signalling and temperature regulation. It does not significantly reduce inflammation at peripheral sites of injury.
Codeine component: Codeine is a prodrug that is metabolised in the liver to morphine, a potent opioid analgesic. Morphine binds to mu-opioid receptors in the central and peripheral nervous system, inhibiting the transmission of pain signals and altering the perception of pain. Codeine also has antitussive (cough-suppressing) and antidiarrhoeal properties.
Synergistic effect: The combination of a centrally acting analgesic (paracetamol) and an opioid (codeine) produces additive or synergistic pain relief at lower individual doses of each component than would be required if used separately.

The extent of codeine’s analgesic effect depends on individual genetic variation in the CYP2D6 enzyme. Poor metabolisers derive little benefit; ultra-rapid metabolisers may experience exaggerated opioid effects at standard doses.

Pro koho je určen/a Co-Codamol (Paracetamol/Codeine)?

Co-Codamol is indicated for adults and adolescents (12 years and over) experiencing moderate pain that is not adequately controlled by non-opioid analgesics alone. Typical indications include:

Musculoskeletal pain: Back pain, joint pain, and soft tissue injuries
Dental pain: Toothache, post-extraction discomfort
Headache and migraine: When standard analgesics have been insufficient
Post-operative pain: Short-term management following minor surgical procedures
Dysmenorrhoea: Moderate menstrual pain

Co-Codamol is not appropriate for children under 12 years, patients under 18 following certain surgical procedures (such as tonsillectomy), patients who are known ultra-rapid CYP2D6 metabolisers, or those with significant respiratory depression or severe hepatic impairment. It must not be used during breastfeeding. A full medical assessment is required before prescribing.

Dávkování

Co-Codamol is available in several strengths, the most common being 8/500 mg and 30/500 mg (codeine/paracetamol). Prescription-strength formulations (30/500 mg) are the subject of this page.

Patient Group	Dose	Maximum Daily Dose
Adults (18+)	30/500 mg, 1–2 tablets every 4–6 hours	8 tablets (240 mg codeine / 4,000 mg paracetamol) per 24 hours
Adolescents (12–17)	30/500 mg, 1 tablet every 6 hours	4 tablets (120 mg codeine / 2,000 mg paracetamol) per 24 hours

Important: Co-Codamol is intended for short-term use only (maximum 3 days). If pain persists beyond three days, patients should seek medical review rather than continuing treatment independently. The maximum paracetamol dose across all products must not exceed 4,000 mg per day; patients must not take Co-Codamol alongside other paracetamol-containing products.

Vedlejší účinky

As with all medicines, Co-Codamol may cause side effects. The codeine component in particular carries important risks that patients should be aware of.

Common side effects (may affect up to 1 in 10 people)

Constipation (the most common opioid side effect)
Nausea and vomiting
Dizziness and lightheadedness
Drowsiness
Headache
Dry mouth

Méně časté, ale závažné vedlejší účinky

Dependence and withdrawal: Codeine is an opioid and can cause physical and psychological dependence even at therapeutic doses with prolonged use. Abrupt discontinuation after extended use may cause withdrawal symptoms.
Respiratory depression: Codeine can suppress the respiratory drive, particularly at higher doses or in ultra-rapid metabolisers. This is a medical emergency.
Hepatotoxicity: Paracetamol overdose — even inadvertent overdose from taking multiple paracetamol-containing products simultaneously — is a leading cause of acute liver failure. Never exceed the maximum paracetamol daily dose.
Serotonin syndrome: Risk exists when codeine is used with other serotonergic drugs (SSRIs, MAOIs, triptans).
Allergic reactions: Rare hypersensitivity reactions including skin rashes and anaphylaxis have been reported.

This is not a complete list of side effects. Refer to the EMA-approved product information for full prescribing details.

Jak získat Co-Codamol (Paracetamol/Codeine) online v Evropě

Higher-strength Co-Codamol (30/500 mg) is a prescription-only medicine (POM) throughout the European Union. It cannot be legally dispensed without a valid prescription from a licensed medical professional.

Prescrivia operates as a technology intermediary platform: we do not prescribe medicines, employ doctors, or sell medicines. Our platform connects patients with independent EU-registered doctors who can conduct confidential online health assessments.

Postup je následující:

Vyplňte zdravotní dotazník: Answer a structured set of health questions covering your medical history, pain history, current medications, and any prior use of opioid-containing medicines.
Posouzení lékařem: An independent EU-registered doctor reviews your assessment. If Co-Codamol is clinically appropriate for your situation, they may issue a short-term prescription. If it is not appropriate, the doctor will advise on alternatives.
Předpis a vyřízení: If a prescription is issued, it is forwarded to a licensed EU pharmacy partner, which dispenses and ships the medicine directly to you.

Důležité: Prescrivia nezaručuje, že bude předpis vystaven. Veškerá rozhodnutí o předepisování provádějí nezávisle kvalifikovaní odborní lékaři na základě Vašich individuálních klinických okolností.

Důležité bezpečnostní informace

Nepoužívejte Co-Codamol (Paracetamol/Codeine) pokud:

Are under 12 years of age
Are under 18 and have had your tonsils or adenoids removed for sleep apnoea
Are breastfeeding (codeine passes into breast milk and can cause serious harm to the infant)
Are a known ultra-rapid CYP2D6 metaboliser
Have severe respiratory disease, severe asthma, or conditions causing respiratory depression
Are taking or have recently taken MAO inhibitors (within 14 days)

Informujte svého lékaře před zahájením užívání Co-Codamol (Paracetamol/Codeine) pokud máte:

Liver or kidney disease
A history of opioid dependence or substance misuse
Inflammatory bowel disease (Crohn’s disease, ulcerative colitis)
Hypothyroidism or Addison’s disease
A head injury or raised intracranial pressure
A history of asthma or breathing disorders

Lékové interakce: Co-Codamol interacts with alcohol (increased CNS depression), sedatives, benzodiazepines, antidepressants, antiepileptics, and other opioids. Alcohol must be avoided during treatment. Always disclose all current medications to your doctor during the assessment.

Co-Codamol is not appropriate for long-term pain management. Persistent or recurring pain should be assessed and managed with a comprehensive care plan by a qualified doctor.

Zdroje

Lékařské informace na této stránce vycházejí z následujících zdrojů:

European Medicines Agency (EMA). Assessment report for codeine-containing products — Paediatric use restrictions. EMA/PRAC/221275/2013.
World Health Organization (WHO). WHO Model List of Essential Medicines — Analgesics. who.int
Derry S, et al. Single dose oral codeine, as a single agent, for acute postoperative pain in adults. Cochrane Database Syst Rev. 2010.
European Medicines Agency (EMA). Questions and answers on the use of codeine for pain relief in children. Available at: ema.europa.eu

Tento obsah je pravidelně přezkoumáván s ohledem na aktualizované klinické pokyny. Je poskytován pouze pro informační účely a nepředstavuje lékařské poradenství. Vždy se poraďte s kvalifikovaným zdravotnickým pracovníkem o radě týkající se Vašich individuálních zdravotních okolností.

Co-Codamol (Paracetamol/Codeine)

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