About Co-codamol

About Co-codamol

Co-codamol is a combination drug used to treat pain. These pills contain a regular dose of paracetamol and a relatively smaller dose of codeine. This combination is known to synergistically work to relieve pain more effectively than either paracetamol or codeine alone. Since it contains codeine, it is considered an opioid. While generally safe, opioids do carry more risks than other painkillers. 

Co-codamol is something you should only take after you’ve already tried all of the regular painkillers (paracetamol, ibuprofen, aspirin, and naproxen). For most people, this medication is best used short-term. If it is taken long-term, a tolerance can develop. It is also quite hard on the liver to consume paracetamol every day, especially if you are predisposed to liver problems. (1)

Chronic Pain

It’s important to meet with a doctor when you are experiencing pain, especially if it is interfering with your quality of life. Pain can be a sign of something harmless or something serious, and doctors are trained to tell the difference. They are far from perfect, but their expertise could lead to your pain being cured. At the very least, a doctor can tell you what pain management approach would be best suited for your situation, and whether or not there are non-medication options to explore. Because co-codamol is an opioid, it is typically only prescribed short-term, such as after surgery. The exception to this is chronic pain; there are doctors who specialize in chronic pain. They can decide to prescribe someone co-codamol long-term if the benefits outweigh the risks. (5)

How It Works

This medication takes effect in about an hour. How long it lasts depends on your specific case, but on average, it works for five hours. Paracetamol and codeine both reduce the amount of pain you’re feeling, but they do so in different ways. Paracetamol’s mechanism of action isn’t totally clear, but we do know that it helps block pain signals from traveling to the brain. Codeine works with what we already have in our bodies: opioid receptors. 

When we get injured, our bodies have a natural pain-relief system in place that uses opioids and chemical receptors. Taking codeine increases the effect of opioids on our receptors, leading to decreased pain. Co-codamol comes in capsules and tablets; it can be dissolved in water and drunk, if desired. (2)

What Are The Risks?

The most well-known risk is addiction/dependence. This is not a concern for non-opioid painkillers (paracetamol, ibuprofen, aspirin, and naproxen). It’s impossible to determine whether someone is going to become addicted, but it is always a risk. This is part of why opioid pain medications are typically only prescribed short-term. The other main risk is liver toxicity; this is because there is a full dose of paracetamol in each capsule/tablet of co-codamol. 

Pain patients are allowed to take several doses per day, so you have to be careful. Always check the time when you are taking a dose, and keep your doses far enough apart (usually at least 6 hours). The daily maximum intake for paracetamol is 4,000mg. If you manage to take more than this, or if you exceed your daily allotment of co-codamol, go to A&E right away. Otherwise, it’s possible for acute liver toxicity to occur.

Things To Keep In Mind

Patients may develop a tolerance if the medication is taken for too long. Codeine is especially likely to cause a tolerance, so make sure that you communicate with your doctor about how the medication is working for you. There are three dosages available, so they can alter your dose as needed. Co-codamol only treats the symptom of pain, not the cause of the pain. Just be open with your doctor about what you’re experiencing and what your needs are. 

The main side effects of co-codamol include: constipation, nausea, fatigue, rash, difficulty breathing, dizziness, dry mouth, and light-headedness. Withdrawal symptoms can occur if you stop taking co-codamol suddenly. If you plan to stop taking the medication, it should be tapered off to minimize withdrawal symptoms. (3)

Should You Take Co-codamol?

This medication is for patients with severe pain. Due to the risks outlined above, co-codamol should only be used in certain cases. If the pain can be treated with other medications (paracetamol, ibuprofen, aspirin, or naproxen) then those should be used instead. If the pain can be reduced via physical therapy, chiropractic, or massage, it may be advised that you try that as soon as possible. A doctor can prescribe pain management in the short-term while you gain more strength and/or recover from an injury. 

It is also helpful to pair paracetamol with an NSAID; the three main NSAIDs are ibuprofen, aspirin, and naproxen. The paracetamol and the NSAID work synergistically, and it often provides relief that either medication couldn’t achieve alone. For example, you would take a dose of paracetamol and a dose of ibuprofen at the same time. It is best to take NSAIDs with food, especially if you take them regularly. Make sure to space apart your doses far enough – read the instructions label on your medication of choice to find out how often you can take it. 

Take-Home Message

Co-codamol contains two painkillers: paracetamol and codeine. This medication is not suitable for everyone, so do your research and/or consult with a doctor before taking it. Co-codamol is used to treat both acute pain and chronic pain, depending on the individual. If your doctor puts you on co-codamol, it means that they have weighed the risks and benefits and determined that, in your case, the benefits outweigh the risks. When taking opioids, there is always the risk of becoming addicted/dependent. Most people do well on this medication, especially when it is used short-term. If you have any concerns about what medication is best for you, ask your doctor. (4)