# Codeine/paracetamol

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> Markdown URL: https://mediated.wiki/source/Codeine%2Fparacetamol.md
> Source: https://en.wikipedia.org/wiki/Codeine%2Fparacetamol
> Source revision: 1356471920
> License: Creative Commons Attribution-ShareAlike 4.0 International (https://creativecommons.org/licenses/by-sa/4.0/)

{{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 = <!-- Combo data -->
| component1 = Codeine
| class1 = [Opioid](/source/Opioid) [analgesic](/source/analgesic)
| component2 = Paracetamol
| class2 = [Anilide](/source/Anilide) analgesic

<!-- Clinical data -->| tradename = Tylenol with codeine<br>Zapain<br>Panadeine Forte
| Drugs.com = 
| MedlinePlus = a601005
| DailyMedID = Acetaminophen codeine
| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
| pregnancy_AU_comment = 
| pregnancy_category = 
| dependency_liability = 
| addiction_liability = 
| routes_of_administration = [By mouth](/source/Oral_administration)
| ATC_prefix = N02
| ATC_suffix = BE51
| ATC_supplemental = <!-- Legal status -->
| legal_AU = S4
| legal_AU_comment = 
| legal_BR = <!-- OTC, A1, A2, A3, B1, B2, C1, C2, C3, C4, C5, D1, D2, E, F -->
| 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 = <!-- Anlage I, II, III or Unscheduled -->
| legal_DE_comment = 
| legal_NZ = <!-- Class A, B, C -->
| legal_NZ_comment = 
| legal_UK = POM
| legal_UK_comment = /&nbsp;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 = /&nbsp;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 = <!-- N I, II, III, IV / P I, II, III, IV -->
| legal_UN_comment = 
| legal_status = <!-- For countries not listed above -->

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

'''Codeine/paracetamol''', also called '''codeine/acetaminophen''' and '''co-codamol''', is a [compound analgesic](/source/compound_analgesic), comprising [codeine phosphate](/source/codeine_phosphate) and [paracetamol](/source/paracetamol) (acetaminophen). Codeine/paracetamol is used for the relief of mild to moderate [pain](/source/pain) when paracetamol or [non-steroidal anti-inflammatory drug](/source/non-steroidal_anti-inflammatory_drug)s (NSAIDs; such as [ibuprofen](/source/ibuprofen), [aspirin](/source/aspirin), and [naproxen](/source/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](/source/hemoptysis), [skin rashes](/source/Rash), [dizziness](/source/dizziness), [sedation](/source/sedation), shortness of breath, [hypersensitivity](/source/hypersensitivity) reaction, [fainting](/source/fainting) (syncope or near syncope), [confusion](/source/confusion), loss of [short-term memory](/source/short-term_memory), changes in [blood](/source/blood), allergic reactions, [euphoria](/source/euphoria), [dysphoria](/source/dysphoria), abdominal pain, itchiness, easy [bruising](/source/bruise), bleeding [gums](/source/Gingiva), [vivid dream](/source/vivid_dream)s, 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](/source/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](/source/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](/source/Over-the-counter_drug) 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}}

{{Analgesics}}
{{Anti-inflammatory products}}
{{Opioidergics}}
{{Portal bar | Medicine}}
{{Authority control}}

Category:Combination analgesics
Category:Hepatotoxins
Category:Opiates

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Adapted from the Wikipedia article [Codeine/paracetamol](https://en.wikipedia.org/wiki/Codeine%2Fparacetamol) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Codeine%2Fparacetamol?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.