Codeine/paracetamol

{{Short description|Compound medication}} {{More citations needed|date=July 2012}} {{Use dmy dates|date=May 2026}} {{cs1 config |name-list-style=vanc |display-authors=6}} {{Infobox drug | Verifiedfields = changed | Watchedfields = changed | verifiedrevid = 455046896 | type = combo | image = Codeine and paracetamol.svg | image_class = skin-invert-image | width = 165 | alt =  | component1 = Codeine | class1 = Opioid analgesic | component2 = Paracetamol | class2 = Anilide analgesic

| tradename = Tylenol with codeine<br>Zapain<br>Panadeine Forte | Drugs.com = | MedlinePlus = a601005 | DailyMedID = Acetaminophen codeine | pregnancy_AU =  | pregnancy_AU_comment = | pregnancy_category = | dependency_liability = | addiction_liability = | routes_of_administration = By mouth | ATC_prefix = N02 | ATC_suffix = BE51 | ATC_supplemental =  | legal_AU = S4 | legal_AU_comment = | legal_BR =  | legal_BR_comment = | legal_CA = Schedule I | legal_CA_comment = <ref>{{cite web | title=Acetaminophen with Codeine Product information | website=Health Canada | date=25 April 2012 | url=https://health-products.canada.ca/dpd-bdpp/info.do?lang=en&code=31568 | access-date=13 September 2022 | archive-date=13 September 2022 | archive-url=https://web.archive.org/web/20220913075059/https://health-products.canada.ca/dpd-bdpp/info.do?lang=en&code=31568 | url-status=live }}</ref> | legal_DE =  | legal_DE_comment = | legal_NZ =  | legal_NZ_comment = | legal_UK = POM | legal_UK_comment = / P<ref name="Boots PIL">{{cite web | title=Boots Paracetamol & Codeine 500mg/8mg Tablets - Patient Information Leaflet (PIL) | website=(emc) | date=30 November 2021 | url=https://www.medicines.org.uk/emc/product/13090/pil | access-date=17 July 2022 | archive-date=18 July 2022 | archive-url=https://web.archive.org/web/20220718044159/https://www.medicines.org.uk/emc/product/13090/pil | url-status=live }}</ref><ref name="Co-Codamol SmPC">{{cite web | title=Co-Codamol 15/500 Tablets - Summary of Product Characteristics (SmPC) | website=(emc) | date=25 March 2021 | url=https://www.medicines.org.uk/emc/product/4051/smpc | access-date=17 July 2022 | archive-date=5 August 2021 | archive-url=https://web.archive.org/web/20210805074246/https://www.medicines.org.uk/emc/product/4051/smpc | url-status=live }}</ref> | legal_US = Schedule III | legal_US_comment = / Schedule V<ref>{{Cite web |url=https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf |title=Controlled Substances - Alphabetical Order |access-date=29 June 2024 |archive-date=21 April 2021 |archive-url=https://web.archive.org/web/20210421180644/https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf |url-status=live }}</ref><ref>{{cite web | title=Acetaminophen and Codeine Phosphate tablet | website=DailyMed | date=31 July 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a9b11cbf-7585-4532-868f-5686f028679f | access-date=17 July 2022 | archive-date=18 March 2022 | archive-url=https://web.archive.org/web/20220318083011/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a9b11cbf-7585-4532-868f-5686f028679f | url-status=live }}</ref><ref>{{cite web | title=Acetaminophen and Codeine Phosphate solution | website=DailyMed | date=25 May 2022 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=83a536d8-385d-46ed-9cd2-47b7efe96ccf | access-date=17 July 2022 | archive-date=11 May 2021 | archive-url=https://web.archive.org/web/20210511045036/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=83a536d8-385d-46ed-9cd2-47b7efe96ccf | url-status=live }}</ref> | legal_EU = | legal_EU_comment = | legal_UN =  | legal_UN_comment = | legal_status =

| CAS_number = 67889-72-9 | PubChem = 11949633 | IUPHAR_ligand = | DrugBank = | ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}} | ChemSpiderID = 10123946 | UNII = | KEGG = D02146 | ChEBI = | ChEMBL = | synonyms =  }}

'''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.<ref name="Boots PIL" /><ref name="Co-Codamol SmPC" />

In 2023, it was the 210th most commonly prescribed medication in the United States, with more than 2{{nbsp}}million prescriptions.<ref>{{cite web | title=The Top 300 of 2023 | url=https://clincalc.com/DrugStats/Top300Drugs.aspx | website=ClinCalc | access-date=12 August 2025 | archive-date=12 August 2025 | archive-url=https://web.archive.org/web/20250812130026/https://clincalc.com/DrugStats/Top300Drugs.aspx | url-status=live }}</ref><ref>{{cite web | title = Acetaminophen; Codeine Drug Usage Statistics, United States, 2014 - 2023 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/AcetaminophenCodeine | access-date = 20 August 2025 }}</ref>

==Side effects== The most common side effects include constipation, nausea and drowsiness.<ref name="NHS">{{cite web |url=https://www.nhs.uk/medicines/co-codamol-adults/ |title=Co-codamol for adults: painkiller containing paracetamol and codeine |newspaper=National Health Service |date=19 December 2018 |access-date=16 April 2021 |archive-date=14 January 2022 |archive-url=https://web.archive.org/web/20220114124849/https://www.nhs.uk/medicines/co-codamol-adults/ |url-status=live }}</ref> 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.<ref>{{cite book | vauthors = Nielsen S, Van Hout MC | title = Over-the-Counter Codeine-from Therapeutic Use to Dependence, and the Grey Areas in Between | series = Current Topics in Behavioral Neurosciences| volume = 34 | pages = 59–75 | date = 2017 | pmid = 26768736 | doi = 10.1007/7854_2015_422 | isbn = 978-3-319-60014-7 | hdl = 1959.4/unsworks_62273 | hdl-access = free }}</ref>

Genetic differences between people cause differing rates of metabolism of codeine to morphine. In about 5 percent 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.<ref>{{cite news|title=Codeine Use While Breastfeeding May Be Dangerous|url=https://www.ctvnews.ca/codeine-use-while-breastfeeding-may-be-dangerous-1.317673|work=CTV News|date=20 August 2008|access-date=13 August 2020|archive-date=1 September 2008|archive-url=https://web.archive.org/web/20080901210431/https://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080820/tylenol_3_breastfeeding_080820/20080820|url-status=dead}}</ref>

== Society and culture == === Availability === Of the European Union member states, eleven allow over-the-counter sale of solid dosage forms of codeine, including codeine/paracetamol: Bulgaria, Cyprus, Denmark, Ireland, Latvia, Lithuania, Malta, Poland, Romania, and Slovenia.<ref>{{Cite journal|vauthors = Foley M, Harris R, Rich E, Rapca A, Bergin M, Norman I, Van Hout MC |title=The availability of over-the-counter codeine medicines across the European Union|url=https://www.academia.edu/19659390|journal=Public Health|date = November 2015|volume=129|issue=11|pages=1465–1470|doi=10.1016/j.puhe.2015.06.014|pmid=26215740|access-date=8 July 2020|archive-date=25 March 2022|archive-url=https://web.archive.org/web/20220325081404/https://www.academia.edu/19659390|url-status=live }}</ref> It is a controlled drug in the UK.

==References== {{Reflist}}

Category:Combination analgesics Category:Hepatotoxins Category:Opiates