Codeine/paracetamol

Codeine/paracetamol, also known as codeine/acetaminophen and co-codamol, is a compound analgesic consisting of a combination of codeine phosphate and paracetamol (acetaminophen). Codeine/paracetamol is used for the relief of mild to moderate pain when paracetamol or non-steroidal anti-inflammatory drug (NSAIDs) such as ibuprofen, aspirin or naproxen alone do not sufficiently relieve symptoms.[2][3]

Codeine/paracetamol
Combination of
CodeineOpioid analgesic
paracetamolAnilide analgesic
Clinical data
Trade namesTylenol with codeine, others
MedlinePlusa601005
License data
Routes of
administration		By mouth
ATC code
Legal status
Legal status
Identifiers
CAS Number
PubChem CID
ChemSpider
KEGG
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In 2020, it was the 187th most commonly prescribed medication in the United States, with more than 2 million prescriptions.[6][7]

Side effects

The most common side effects of co-codamol are constipation and feeling sick (nausea) or sleepy.[8] Other side effects may include blood from mouth, skin rashes, dizziness, sedation, shortness of breath, hypersensitivity reaction, fainting (syncope or near syncope), confusion, loss of short-term memory, changes in blood, allergic reactions, euphoria, dysphoria, abdominal pain, itchiness, easy bruising, bleeding gums, vivid dreams, dry mouth and addiction.[9]

Genetic differences between people give rise to differing rates of metabolism of codeine to morphine. In about 5% of people this may happen particularly fast, leading to higher levels of morphine being passed through breast milk in amounts potentially able to cause fatal respiratory depression of a breastfed baby.[10]

Society and culture

Availability

Of the European Union (EU) member states, 12 countries (Bulgaria, Cyprus, Denmark, Estonia, France, Ireland, Latvia, Lithuania, Malta, Poland, Romania, Slovenia) allow over-the-counter sale of OTC codeine solid dosage forms.[11]

References
  1. "Acetaminophen with Codeine Product information". Health Canada. 25 April 2012. Retrieved 13 September 2022.
  2. "Boots Paracetamol & Codeine 500mg/8mg Tablets - Patient Information Leaflet (PIL)". (emc). 30 November 2021. Archived from the original on 18 July 2022. Retrieved 17 July 2022.
  3. "Co-Codamol 15/500 Tablets - Summary of Product Characteristics (SmPC)". (emc). 25 March 2021. Archived from the original on 5 August 2021. Retrieved 17 July 2022.
  4. "Acetaminophen and Codeine Phosphate tablet". DailyMed. 31 July 2020. Archived from the original on 18 March 2022. Retrieved 17 July 2022.
  5. "Acetaminophen and Codeine Phosphate solution". DailyMed. 25 May 2022. Archived from the original on 11 May 2021. Retrieved 17 July 2022.
  6. "The Top 300 of 2020". ClinCalc. Retrieved 7 October 2022.
  7. "Acetaminophen; Codeine - Drug Usage Statistics". ClinCalc. Retrieved 7 October 2022.
  8. "Co-codamol for adults: painkiller containing paracetamol and codeine". National Health Service. 19 December 2018. Archived from the original on 14 January 2022. Retrieved 16 April 2021.
  9. Nielsen S, Van Hout MC (2017). "Over-the-Counter Codeine-from Therapeutic Use to Dependence, and the Grey Areas in Between". Current Topics in Behavioral Neurosciences. 34: 59–75. doi:10.1007/7854_2015_422. ISBN 978-3-319-60014-7. PMID 26768736.
  10. "Codeine Use While Breastfeeding May Be Dangerous". CTV News. 20 August 2008. Archived from the original on 1 September 2008. Retrieved 13 August 2020.
  11. Foley M, Harris R, Rich E, Rapca A, Bergin M, Norman I, et al. (November 2015). "The availability of over-the-counter codeine medicines across the European Union". Public Health. 129 (11): 1465–1470. doi:10.1016/j.puhe.2015.06.014. PMID 26215740. Archived from the original on 25 March 2022. Retrieved 8 July 2020.
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