What is Co-Codamol?
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.
How does Co-Codamol work?
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.
Who is Co-Codamol for?
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. Se requiere una evaluación médica completa antes de la prescripción.
Posología
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.
| Grupo de pacientes | Dosis | Dosis diaria máxima |
|---|---|---|
| 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 |
Importante: 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.
Efectos secundarios
Como todos los medicamentos, Co-Codamol puede causar efectos secundarios. The codeine component in particular carries important risks that patients should be aware of.
Efectos secundarios frecuentes (pueden afectar hasta a 1 de cada 10 personas)
- Constipation (the most common opioid side effect)
- Nausea and vomiting
- Dizziness and lightheadedness
- Drowsiness
- Headache
- Dry mouth
Efectos secundarios poco frecuentes pero graves
- 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.
Esta no es una lista completa de efectos secundarios. Consulte la información del producto aprobada por la EMA para obtener los detalles completos de prescripción.
How to get Co-Codamol online in Europe
Higher-strength Co-Codamol (30/500 mg) is a prescription-only medicine (POM) throughout the European Union. No puede dispensarse legalmente sin una receta válida de un profesional médico autorizado.
Prescrivia opera como plataforma intermediaria tecnológica: no prescribimos medicamentos, no empleamos médicos ni vendemos medicamentos. Nuestra plataforma conecta a los pacientes con médicos independientes registrados en la UE que pueden realizar evaluaciones de salud en línea confidenciales.
El proceso funciona de la siguiente manera:
- Complete una evaluación de salud: Responda a un conjunto estructurado de preguntas de salud covering your medical history, pain history, current medications, and any prior use of opioid-containing medicines.
- Revisión médica: Un médico independiente registrado en la UE revisa su evaluación. 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.
- Prescripción y dispensación: Si se emite una receta, se remite a una farmacia asociada autorizada de la UE, que dispensa y envía el medicamento directamente a usted.
Importante: Prescrivia no garantiza que se emita una receta. Todas las decisiones de prescripción son tomadas de forma independiente por profesionales médicos cualificados en función de sus circunstancias clínicas individuales.
Información importante de seguridad
No utilice Co-Codamol si usted:
- 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)
Informe a su médico antes de starting Co-Codamol if you have:
- 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
Interacciones medicamentosas: Co-Codamol interacts with alcohol (increased CNS depression), sedatives, benzodiazepines, antidepressants, antiepileptics, and other opioids. Alcohol must be avoided during treatment. Informe siempre a su médico de todos los medicamentos que toma actualmente durante la evaluación.
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.
Fuentes
La información médica de esta página se basa en las siguientes fuentes:
- 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. Disponible en: ema.europa.eu
Este contenido se revisa periódicamente para reflejar las directrices clínicas actualizadas. Se proporciona únicamente con fines informativos y no constituye asesoramiento médico. Consulte siempre a un profesional sanitario cualificado para obtener asesoramiento relevante para sus circunstancias de salud individuales.
Frequently asked questions
- What is Co-Codamol used for?
- 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.
- Can I get Co-Codamol online in Europe?
- Higher-strength Co-Codamol formulations (containing codeine 30 mg) are prescription-only medicines in the EU. Prescrivia is an intermediary platform connecting patients with independent EU-registered doctors who can assess whether Co-Codamol es clínicamente apropiado para su situación.
- What are the most common side effects of Co-Codamol?
- 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.
Tratamientos
Prescrivia es únicamente una plataforma intermediaria. No prestamos servicios médicos, no prescribimos tratamientos ni dispensamos medicamentos. Todas las decisiones médicas son tomadas por médicos independientes registrados en la UE. Todos los medicamentos son dispensados por farmacias autorizadas de la UE. Esta plataforma facilita la conexión entre pacientes y profesionales sanitarios.