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. È necessaria una valutazione medica completa prima della prescrizione.
Posologia
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.
| Gruppo di pazienti | Dose | Dose giornaliera massima |
|---|---|---|
| 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.
Effetti collaterali
Come tutti i farmaci, Co-Codamol può causare effetti collaterali. The codeine component in particular carries important risks that patients should be aware of.
Effetti collaterali comuni (possono interessare fino a 1 persona su 10)
- Constipation (the most common opioid side effect)
- Nausea and vomiting
- Dizziness and lightheadedness
- Drowsiness
- Headache
- Dry mouth
Effetti collaterali non comuni ma gravi
- 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.
Questa non è una lista completa degli effetti collaterali. Consulti le informazioni sul prodotto approvate dall’EMA per i dettagli completi sulla prescrizione.
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. Non può essere legalmente dispensato senza una prescrizione valida da parte di un professionista medico autorizzato.
Prescrivia opera come piattaforma intermediaria tecnologica: non prescriviamo farmaci, non impieghiamo medici né vendiamo medicinali. La nostra piattaforma mette in contatto i pazienti con medici indipendenti registrati nell’UE che possono condurre valutazioni sanitarie online riservate.
Il processo funziona come segue:
- Completi una valutazione della salute: Risponda a un insieme strutturato di domande sulla salute covering your medical history, pain history, current medications, and any prior use of opioid-containing medicines.
- Revisione medica: Un medico indipendente registrato nell’UE esamina la Sua valutazione. 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.
- Prescrizione e dispensazione: Se viene emessa una prescrizione, viene inoltrata a una farmacia partner autorizzata dell’UE, che dispensa e spedisce il farmaco direttamente a Lei.
Importante: Prescrivia non garantisce che venga emessa una prescrizione. Tutte le decisioni prescrittive vengono prese in modo indipendente da professionisti medici qualificati in base alle Sue circostanze cliniche individuali.
Informazioni importanti sulla sicurezza
Non utilizzi Co-Codamol se Lei:
- 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)
Informi il Suo medico prima di 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
Interazioni farmacologiche: Co-Codamol interacts with alcohol (increased CNS depression), sedatives, benzodiazepines, antidepressants, antiepileptics, and other opioids. Alcohol must be avoided during treatment. Informi sempre il Suo medico di tutti i farmaci attualmente assunti durante la valutazione.
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.
Fonti
Le informazioni mediche presenti in questa pagina si basano sulle seguenti fonti:
- 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. Disponibile su: ema.europa.eu
Questo contenuto viene rivisto periodicamente per riflettere le linee guida cliniche aggiornate. Viene fornito esclusivamente a scopo informativo e non costituisce consulenza medica. Consulti sempre un professionista sanitario qualificato per consigli pertinenti alle Sue circostanze di salute individuali.
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 è clinicamente appropriato per la Sua situazione.
- 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.
Trattamenti
Prescrivia è solo una piattaforma di intermediazione. Non forniamo servizi medici, non prescriviamo trattamenti e non dispensiamo farmaci. Tutte le decisioni mediche sono prese da medici indipendenti registrati nell'UE. Tutti i farmaci sono dispensati da farmacie autorizzate dell'UE. Questa piattaforma facilita i collegamenti tra pazienti e operatori sanitari.