Codeine/paracetamol, also called codeine/acetaminophen and co-codamol, is a compound analgesic, comprising codeine phosphate and paracetamol (acetaminophen). Codeine/paracetamol is used for the relief of mild to moderate pain when paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs; such as ibuprofen, aspirin, and naproxen) alone do not sufficiently relieve symptoms.[2][3]
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Codeine | Opioid analgesic |
paracetamol | Anilide analgesic |
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Trade names | Tylenol with codeine, others |
MedlinePlus | a601005 |
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Routes of administration | By mouth |
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In 2021, it was the 176th most commonly prescribed medication in the United States, with more than 2 million prescriptions.[6][7]
The most common side effects include constipation, nausea, and drowsiness.[8] Others include coughing up blood from the lungs, 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 cause differing rates of metabolism of codeine to morphine. In about 5% of people this may happen particularly fast, causing morphine to be passed through breast milk in amounts that may cause fatal respiratory depression in a breastfed baby.[10]
Of the European Union (EU) member states, 11 allow over-the-counter sale of solid dosage forms of codeine, including codeine/paracetamol; they are Bulgaria, Cyprus, Denmark, France, Ireland, Latvia, Lithuania, Malta, Poland, Romania, and Slovenia.[11]