Co-codamol

Co-codamol (BAN) is a non-proprietary name used to denote a compound analgesic, a combination of codeine phosphate and paracetamol (acetaminophen). Co-codamol tablets are used for the relief of mild/moderate (or in the case of 30/500mg - severe) pain.

Formulations

Four strengths are available:

8mg of codeine phosphate per tablet
12.8mg of codeine phosphate per tablet
15mg of codeine phosphate per tablet*
30mg of codeine phosphate per tablet (available in capsules as Tylex, available in tablets/caplets as Solpadol, Kapake and Zapain).

Formulations contain from 300 mg to 1000 mg of paracetamol per tablet. In the United Kingdom the 15/500 and 30/500 tablets are available only with a prescription, and the 8/500 12.8/500 strength is available over the counter. This is also the case in Australia, however 15/500 tablets in packs of 12 or less are Schedule 3 (Pharmacist 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. Do not take more than 2 at any one time. Other drugs containing paracetamol should be avoided.

In the United States, Tylenol produces tablets containing 8, 15, and 30 milligrams, named Tylenol No.1, 2, and 3, respectively. There is also a Tylenol 4 containing 60mg of codeine. All tablets contain 300mg of paracetamol. No Tylenol with codeine products in the U.S. contain caffeine. In Canadian preparations Tylenol #2 & #3 contain 15mg caffeine.

Co-codamol is marketed in the United States and Canada as Tylenol 3 with Codeine, in the UK as both Solpadeine and Solpadol and in Australia as Panadeine, Panadeine 15 and Panadeine Forte.

Side effects

Side effects can include: constipation, skin rashes, dizziness, sedation, shortness of breath, hypersensitivity reaction, fainting (syncope or near syncope), nausea and/or vomiting, confusion, loss of short-term memory, drowsiness, changes in blood, allergic reactions, euphoria, dysphoria, abdominal pain, pruritus (itching), easy bruising and bleeding gums.

Genetic differences between people gives 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.