Co-codamol contains two painkilling ingredients: paracetamol and codeine. It is given to relieve short-lasting painful conditions where paracetamol alone is not sufficient. There are three different strengths of co-codamol available, one of which can be bought without a prescription at a pharmacy. The amount of paracetamol in the three different strengths is the same (500 mg), but the amount of codeine differs and this determines the strength of the preparation. The three main tablet strengths are: 8 mg/500 mg, 15 mg/500 mg, and 30 mg/500 mg, where the first number relates to how much codeine is in the tablet, and the second is the amount of paracetamol present.

Combination painkillers like co-codamol can be useful to reduce the total number of tablets that need to be taken in a day, but they may not always offer the best pain control. This is because it is difficult to adjust the dose to suit the level of your pain without increasing the risk of side-effects. Consequently, many doctors prefer not to prescribe combination painkillers.

Before taking co-codamol

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking co-codamol, it is important that your doctor or pharmacist knows:

• If you are pregnant or breastfeeding.
• If you have a problem with the way your liver works, or a problem with the way your kidneys work.
• If you have prostate problems or any difficulties passing urine.
• If you have any breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD).
• If you have been told you have low blood pressure or an abnormal heart rhythm.
• If you have any problems with your thyroid or adrenal glands.
• If you have epilepsy.
• If you have gallstones or a problem with your gallbladder or bile duct.
• If you have been constipated for more than a week or have an inflammatory bowel problem.
• If you have a condition causing muscle weakness, called myasthenia gravis.
• If you have recently had a severe head injury.
• If you have ever been dependent on drugs or alcohol.
• If you have ever had an allergic reaction to a medicine.
• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

How to take co-codamol

• Before you start the treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about co-codamol and will provide you with a full list of the side-effects which you may experience from taking it.
• Take co-codamol exactly as your doctor or pharmacist tells you to. The usual dose for adults is one or two tablets/capsules every 4-6 hours if needed. Remember to leave at least four hours between doses and do not take more than two tablets or capsules at any one time or more than eight tablets or capsules in any 24-hour period. This maximum recommended dose for all strengths of co-codamol is due to the paracetamol content of the tablets/capsules.
• Swallow the tablets/capsules with a drink of water. If you have been supplied with effervescent tablets, mix the tablet into a small glassful of water and allow it to dissolve first.
• You can take co-codamol either before or after food, but taking your doses after food can help prevent feelings of sickness which can occur with the first few doses.
• If you forget to take a dose, take it when you next need pain relief and then continue as before, taking your doses every four to six hours if needed. Do not take two doses together to make up for a forgotten dose.

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