Co-codamol
Encyclopedia
Compound analgesic
A compound analgesic is an analgesic with more than one active ingredient. This includes many of the stronger prescription analgesics.Common active ingredients used in compound analgesics include:* aspirin* paracetemol * codeine or oxycodone...
, a combination of codeine
Codeine
Codeine or 3-methylmorphine is an opiate used for its analgesic, antitussive, and antidiarrheal properties...
phosphate and paracetamol
Paracetamol
Paracetamol INN , or acetaminophen USAN , is a widely used over-the-counter analgesic and antipyretic . It is commonly used for the relief of headaches and other minor aches and pains and is a major ingredient in numerous cold and flu remedies...
(acetaminophen). Co-codamol (or Tylenol w/ Codeine as it's known in the U.S. and Canada) tablets are used for the relief of mild to moderate pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
when paracetamol (acetaminophen) or NSAIDS
Non-steroidal anti-inflammatory drug
Nonsteroidal anti-inflammatory drugs, usually abbreviated to NSAIDs or NAIDs, but also referred to as nonsteroidal anti-inflammatory agents/analgesics or nonsteroidal Anti-inflammatory medicines , are drugs with analgesic and antipyretic effects and which have, in higher doses, anti-inflammatory...
such as ibuprofen
Ibuprofen
Ibuprofen is a nonsteroidal anti-inflammatory drug used for relief of symptoms of arthritis, fever, as an analgesic , especially where there is an inflammatory component, and dysmenorrhea....
, aspirin
Aspirin
Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer...
or naproxen
Naproxen
Naproxen sodium is a nonsteroidal anti-inflammatory drug commonly used for the reduction of pain, fever, inflammation and stiffness caused by conditions such as:...
alone are not enough.
Formulations
Seven strengths are available:- 8 mg of codeine phosphate per tablet
- 10 mg of codeine phosphate per tablet
- 12.8 mg of codeine phosphate per tablet
- 15 mg of codeine phosphate per tablet (in Canada, United States, Norway, Australia (multiple brands), United Kingdom)
- 20 mg of codeine phosphate per tablet (Prontalgine in France, Empacod, South Africa and Zimbabwe)
- 30 mg of codeine phosphate per tablet (available in capsules as Tylex, available in tablets/caplets as Solpadol, Kapake and Zapain).
- 60 mg of codeine phosphate per tablet (Tylenol-4 and generic equivalents)
Formulations contain from 300 mg to 1000 mg (1 gram) of paracetamol per tablet. In the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
the 15/500 and 30/500 tablets are available only with a prescription, although the 8/500 and 12.8/500 strengths are available over-the-counter. In Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
the 30/500 tablets are available only with a prescription, and the 10/500 and 15/500 tablets are Schedule 3 (Pharmacist
Pharmacist
Pharmacists are allied health professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use...
Only Medicine). Manufacturer directions state not to exceed more than the recommended dosage of two tablets every four hours, and no more than eight in a 24 hour period, also it is recommended not to take more than 2 at any one time. Other drugs containing paracetamol should be avoided.
In the United States and Canada, Tylenol
Tylenol
Tylenol is a North American brand of drugs advertised for reducing pain, reducing fever, and relieving the symptoms of allergies, cold, cough, and flu. The active ingredient of its original, flagship product, paracetamol , is marketed as an analgesic and antipyretic...
produces tablets containing 8, 15, and 30 milligrams, named Tylenol No.1, 2, and 3, respectively. There is also a Tylenol 4 containing 60 mg of codeine. All tablets contain 300 mg of paracetamol. No Tylenol with codeine products in the U.S. contain caffeine
Caffeine
Caffeine is a bitter, white crystalline xanthine alkaloid that acts as a stimulant drug. Caffeine is found in varying quantities in the seeds, leaves, and fruit of some plants, where it acts as a natural pesticide that paralyzes and kills certain insects feeding on the plants...
. In Canada, preparations of Tylenol #1, #2 and #3 all contain 15 mg caffeine.
Co-codamol is marketed in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
and Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
also under the generic name "Atasol Codeine". In the UK it is marketed as "Solpadeine
Solpadeine
Solpadeine is the brand name of a range of pain-relief medication made by GlaxoSmithKline.In Australia it is marketed as PanadeineThere appear to be four different medicines using the Solpadeine name, with no common active ingredient between them....
Plus" and "Solpadeine Max", as well as "Solpadol". In Australia as "Panadeine", "Panadeine Extra" and "Panadeine Forte".
Co-codamol is sold as "Paralgin Minor" (15/200), "Paralgin Forte" (30/400), "Paralgin Major" (60/800), "Pinex Forte" (30/500) and Pinex Major" (60/1000) in Norway
Norway
Norway , officially the Kingdom of Norway, is a Nordic unitary constitutional monarchy whose territory comprises the western portion of the Scandinavian Peninsula, Jan Mayen, and the Arctic archipelago of Svalbard and Bouvet Island. Norway has a total area of and a population of about 4.9 million...
.
Side effects
Side effects can include constipationConstipation
Constipation refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation...
, skin rashes
Rash
A rash is a change of the skin which affects its color, appearance or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, cracked or blistered, swell and may be painful. The causes, and...
, dizziness
Dizziness
Dizziness refers to an impairment in spatial perception and stability. The term is somewhat imprecise. It can be used to mean vertigo, presyncope, disequilibrium, or a non-specific feeling such as giddiness or foolishness....
, sedation
Sedation
Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure...
, shortness of breath, hypersensitivity
Hypersensitivity
Hypersensitivity refers to undesirable reactions produced by the normal immune system, including allergies and autoimmunity. These reactions may be damaging, uncomfortable, or occasionally fatal. Hypersensitivity reactions require a pre-sensitized state of the host. The four-group classification...
reaction, fainting (syncope or near syncope), nausea
Nausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...
and/or vomiting
Vomiting
Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...
, confusion
ConFusion
ConFusion is an annual science fiction convention organized by the Stilyagi Air Corps and its parent organization, the Ann Arbor Science Fiction Association. Commonly, it is held the third weekend of January. It is the oldest science fiction convention in Michigan, a regional, general SF con...
, loss of short-term memory
Short-term memory
Short-term memory is the capacity for holding a small amount of information in mind in an active, readily available state for a short period of time. The duration of short-term memory is believed to be in the order of seconds. A commonly cited capacity is 7 ± 2 elements...
, drowsiness
Somnolence
Somnolence is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods . It has two distinct meanings, referring both to the usual state preceding falling asleep, and the chronic condition referring to being in that state independent of a circadian rhythm...
, changes in blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
, allergic reactions, euphoria
Euphoria (emotion)
Euphoria is medically recognized as a mental and emotional condition in which a person experiences intense feelings of well-being, elation, happiness, ecstasy, excitement and joy...
, dysphoria
Dysphoria
Dysphoria is medically recognized as a mental and emotional condition in which a person experiences intense feelings of depression, discontent and indifference to the world around them.Mood disorders can induce dysphoria, often with a heightened risk of suicide, especially in...
, abdominal pain, pruritus (itching), easy bruising
Bruise
A bruise, also called a contusion, is a type of relatively minor hematoma of tissue in which capillaries and sometimes venules are damaged by trauma, allowing blood to seep into the surrounding interstitial tissues. Bruises can involve capillaries at the level of skin, subcutaneous tissue, muscle,...
, bleeding gums
Gingiva
The gingiva , or gums, consists of the mucosal tissue that lies over the mandible and maxilla inside the mouth.-General description:...
, dry mouth and addiction.
Genetic differences between people give rise to differing rates of metabolism of codeine to morphine
Morphine
Morphine is a potent opiate analgesic medication and is considered to be the prototypical opioid. It was first isolated in 1804 by Friedrich Sertürner, first distributed by same in 1817, and first commercially sold by Merck in 1827, which at the time was a single small chemists' shop. It was more...
. 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.