Codeine + Paracetamol/acetaminophen

Dosage Forms Available

• Codeine + Paracetamol/Acetaminophen is available in several oral dosage forms, like tablets, capsules, liquids/solutions, or effervescent tablets.

Age and Dose Restrictions

• This combination can be used by adults and children, but specific age restrictions may apply, particularly for younger children. It is generally used in children over a certain age, as determined by a doctor based on individual health needs and risks.

Contraindications

• This combination is contraindicated in patients with hypersensitivity to codeine or paracetamol.

• It is also contraindicated in those suffering from respiratory depression, acute asthma or hypercarbia, paralytic ileus, or diarrhoea caused by poisoning or antibiotic use.

Other Medications to Avoid

• This combination may interact with central nervous system depressants (such as opioids, sedatives, tranquillisers, hypnotics, and general anaesthetics), anticholinergics (including medications like atropine and scopolamine), anticoagulants (such as warfarin), certain antibiotics (like chloramphenicol), antiretrovirals (such as zidovudine), enzyme inducers (like barbiturates, carbamazepine, rifampin), and antiarrhythmics (such as quinidine).

Overdose and Missed Dose

• Overdose symptoms include respiratory depression, stupor, coma, extreme drowsiness, nausea, vomiting, sweating, hypotension, and potential liver damage. Immediate medical attention is necessary.

• If a dose is missed, it should be taken as soon as you remember. However, if it is nearly time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.

Management of Side Effects

Most side effects are temporary and generally harmless and resolve when discontinuing this combination. However, if you experience any severe side effects or worsening of any of the symptoms, please consult your doctor.

• To manage dizziness or drowsiness, it may help to adjust the timing of taking the medication to when you do not need to be most alert. Discuss it with your doctor before doing so.

• For constipation, increasing water intake might be beneficial.

Use in Driving and Operating Machinery

• This combination may impair your ability to drive or operate machinery safely. If experiencing drowsiness or dizziness after taking this medicine, avoid engaging in these activities.

Use in Pregnancy and Lactation

• Codeine + Paracetamol/Acetaminophen should be used during pregnancy and lactation only if prescribed by a doctor. The potential risks to the foetus or neonate should be weighed against the benefits to the mother.

Caution in Other Conditions

• Caution is advised when using this combination in patients with hepatic impairment as paracetamol can aggravate liver dysfunction.

• Those with renal impairment should also use this combination cautiously as codeine and its metabolites may accumulate in such conditions.

Special Dietary and Lifestyle Recommendations

• Ensure adequate hydration to help reduce the risk of constipation associated with opioid use.

• Consider increasing dietary fibre intake to manage gastrointestinal side effects effectively.