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Codeine/paracetamol, also known as codeine/acetaminophen and co-codamol, is a compound analgesic consisting of a combination of codeine phosphate and paracetamol (acetaminophen). Co-codamol tablets are used for the relief of mild to moderate pain when paracetamol or NSAIDs such as ibuprofen, aspirin or naproxen alone do not sufficiently relieve a patient's symptoms, or where their use is ill-advised.

Codeine and paracetamol.svg
Combination of
CodeineOpioid analgesic
paracetamolAnilide analgesic
Clinical data
Trade namesTylenol with codeine, others
License data
Routes of
By mouth
ATC code
Legal status
Legal status
CAS Number
PubChem CID
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In 2019, it was the 173rd most commonly prescribed medication in the United States, with more than 3 million prescriptions.[5][6]

Side effectsEdit

The most common side effects of co-codamol are constipation and feeling sick (nausea) or sleepy.[7] 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.[citation needed]

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.[8]

Society and cultureEdit

Brand namesEdit

Combination products containing codeine are available over the counter in Barbados, Canada, United Kingdom, Israel and Costa Rica.[9]

Of the European Union (EU) member states, 12 countries (Bulgaria, Cyprus, Denmark, Estonia, France, Ireland, Latvia, Lithuania, Malta, Poland, Romania, Slovenia) allow the sale of OTC codeine solid dosage forms.[10]

Co-codamol is marketed in Canada and the United States also under the generic name "Atasol Codeine". In the United Kingdom, it is marketed as "Solpadeine Plus" and "Solpadeine Max", as well as "Solpadol". In Australia it is marketed as "Panadeine", "Panadeine Extra" and "Panadeine Forte". In Norway, Co-codamol is sold as "Paralgin Minor" (15/200) (not available as of 2015), "Paralgin Forte" (30/400), "Paralgin Major" (60/800), "Pinex Forte" (30/500) and "Pinex Major" (60/1000).


  1. ^ "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.
  2. ^ "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.
  3. ^ "Acetaminophen and Codeine Phosphate tablet". DailyMed. 31 July 2020. Archived from the original on 18 March 2022. Retrieved 17 July 2022.
  4. ^ "Acetaminophen and Codeine Phosphate solution". DailyMed. 25 May 2022. Archived from the original on 11 May 2021. Retrieved 17 July 2022.
  5. ^ "The Top 300 of 2019". ClinCalc. Archived from the original on 18 March 2020. Retrieved 16 October 2021.
  6. ^ "Acetaminophen; Codeine - Drug Usage Statistics". ClinCalc. Archived from the original on 24 October 2021. Retrieved 16 October 2021.
  7. ^ "Co-codamol for adults: painkiller containing paracetamol and codeine - NHS". Https. 19 December 2018. Archived from the original on 14 January 2022. Retrieved April 16, 2021.
  8. ^ "Codeine Use While Breastfeeding May Be Dangerous". CTV News. 2008-08-20. Archived from the original on 2008-09-01. Retrieved 2020-08-13.
  9. ^ Health risks from codeine based medicines - Whelehan's Pharmacy[permanent dead link]
  10. ^ Bergin M (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 2022-03-25. Retrieved 2020-07-08.

External linksEdit