Co-codamol is a mixture of 2 different painkillers – paracetamol and codeine. It's used to treat aches and pains including headaches, muscular pain, migraines and toothache.

It may help to take co-codamol if everyday painkillers, such as aspirin, ibuprofen or paracetamol on their own, have not worked.

This medicine comes as tablets and capsules.

For children under 16 years of age, read our information on co-codamol for children.

• Co-codamol tablets and capsules come in 3 strengths. You can buy the lowest strength co-codamol from pharmacies but the higher strengths are only available on prescription.
• The most common side effects of co-codamol are constipation and feeling sick (nausea) or sleepy.
• Taking too much co-codamol can be harmful. Do not be tempted to increase the dose or take a double dose if your pain is very bad.
• It's possible to become addicted to the codeine in co-codamol, but your doctor will explain how to reduce the risks of becoming addicted.
• If you need to take co-codamol for more than a few weeks, your treatment plan may include details of how and when to stop taking this medicine.

Adults and children aged 12 years or over can take co-codamol. However, it is only recommended for under-18s if other painkillers have not worked.

Co-codamol is not suitable for some people. Tell your doctor before starting the medicine if you:

• have lung problems or breathing difficulties
• have a head injury
• have adrenal gland problems
• have a condition that causes fits or seizures
• regularly drink more than the maximum recommended amount of alcohol (14 units a week)
• are trying to get pregnant, are already pregnant or are breastfeeding
• have liver problems – you may need to take a lower dose
• are under 18 years old and have had your tonsils or adenoids removed because of a sleep problem called obstructive sleep apnoea

It's important to take co-codamol as your doctor has asked you to. This is particularly important because co-codamol can be addictive.

Co-codamol comes as tablets and capsules. Swallow them whole with a drink of water.

Co-codamol also comes as soluble tablets that dissolve in water to make a drink.

You can take co-codamol with or without food.

Different co-codamol strengths

Co-codamol tablets and capsules come in 3 different strengths.

They contain 8mg, 15mg or 30mg of codeine.

All 3 strengths contain 500mg of paracetamol – the same as in a standard paracetamol tablet or capsule.

The strength of co-codamol appears as 2 numbers on the packet. For example, 8/500 means each tablet or capsule contains 8mg of codeine and 500mg of paracetamol.

You can buy the lowest strength of co-codamol (8/500) without a prescription but only from a pharmacy. The higher strengths (15/500 and 30/500) are only available on prescription from a doctor.

Dosage

Adults and young people aged 16 years and older can take 1 or 2 tablets (of any strength) up to 4 times in 24 hours. Always leave at least 4 to 6 hours between doses. The maximum dose is 8 co-codamol tablets in 24 hours.

It's important to leave a gap between doses of co-codamol. Taking too much co-codamol can be very dangerous. That's because the paracetamol in it can cause liver damage.

Do not increase the dose of co-codamol or take a double dose even if your pain is very bad.

It's safe to take co-codamol with ibuprofen and aspirin.

Do not take co-codamol with paracetamol, or other medicines that contain paracetamol. Co-codamol already contains paracetamol so you could be at risk of paracetamol overdose.

Medicines that have paracetamol in them include painkillers like Tramacet and co-dydramol, migraine remedies, and some cough and cold remedies (Lemsip and Night Nurse).

Like all medicines, co-codamol can cause side effects although not everyone gets them. Many people have no side effects or only minor ones.

You're more likely to have side effects if you take the higher strengths of co-codamol.

Common side effects

These common side effects happen in more than 1 in 100 people.

Tell your doctor if the side effects bother you or do not go away:

• constipation
• feeling or being sick (nausea or vomiting)
• feeling sleepy
• headaches

Serious side effects

Serious side effects are rare and happen in less than 1 in 100 people.

Tell a doctor straight away if you have:

• a skin rash
• difficulty peeing
• changes in your eyesight
• dizziness

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to co-codamol.

You can report any suspected side effect to the UK safety scheme.

What to do about:

• constipation – eat more high-fibre foods such as fresh fruit and vegetables and cereals. Try to drink several glasses of water or another non-alcoholic liquid each day. If you can, it may also help to do some gentle exercise.
• feeling or being sick (nausea or vomiting) – take co-codamol with or just after a meal or snack. Have small, frequent sips of water if you're being sick. Feelings of sickness should normally wear off after a few days. Talk to your doctor about taking an anti-sickness medicine if it carries on for longer.
• feeling sleepy or tired – do not drive, cycle or use tools or machinery if you're feeling this way. Do not drink any alcohol as this will make you feel more tired.
• headaches – make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Talk to your doctor if the headaches last longer than a week or are severe.

While co-codamol can be taken in pregnancy, other painkillers may be more suitable.

Co-codamol contains paracetamol and codeine. Paracetamol is safe to take in pregnancy, however codeine can affect your baby, particularly towards the end of pregnancy.

Your baby may get used to having codeine and may have withdrawal symptoms when they're born. There is a slightly higher risk of your baby having breathing problems. These are usually temporary, but your baby may need extra monitoring.

For these reasons, co-codamol is not generally recommended. However, if you have pain that requires stronger pain relief than paracetamol, talk to your doctor. They might prescribe co-codamol if they think this is the best option for you.

Co-codamol and breastfeeding

It's not recommended to take co-codamol while breastfeeding.

Small amounts of the codeine in co-codamol get into breast milk and can cause breathing problems in your baby.

However, paracetamol alone is safe to take while breastfeeding.

If you are taking co-codamol and want to breastfeed, discuss this with your doctor first. They can advise you on other pain relief options.

For more information about how codeine can affect you and your baby during pregnancy see the Best Use of Medicines in Pregnancy (BUMPS) website.

Some medicines affect the way co-codamol works. Equally co-codamol can stop some medicines working as well as they should.

Tell your doctor if you're taking:

• sleeping pills or tranquillisers – particularly benzodiazepines such as diazepam, temazepam or lorazepam
• antidepressants – some types do not mix with co-codamol
• medicines to stop you feeling or being sick such as domperidone or metoclopramide
• blood-thinning medicines (anticoagulants) such as warfarin
• medicines to treat infection, particularly rifampicin or ciprofloxacin
• epilepsy medicines

Mixing co-codamol with herbal remedies and supplements

It's not possible to say whether complementary medicines and herbal remedies are safe to take with co-codamol.

They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.