Codeine/paracetamol

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.^[2][3]

Codeine/paracetamol

Combination of
Codeine	Opioid analgesic
paracetamol	Anilide analgesic
Clinical data
Trade names	Tylenol with codeine, others
MedlinePlus	a601005
License data	US DailyMed: Acetaminophen Codeine Phosphate
Routes of administration	By mouth
ATC code	N02BE51 (WHO)
Legal status
Legal status	AU: S4 (Prescription only) CA: Schedule I^[1] UK: POM (Prescription only) / P^[2]^[3] US: Schedule III / Schedule V^[4]^[5]
Identifiers
CAS Number	67889-72-9
PubChem CID	11949633
ChemSpider	10123946^Y
KEGG	D02146
^NY (what is this?)  (verify)

In 2020, it was the 187th most commonly prescribed medication in the United States, with more than 2 million prescriptions.^[6][7]

Side effects

The most common side effects include constipation, nausea, and drowsiness.^[8] 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.^[9]

Genetic differences between people cause differing rates of metabolism of codeine to morphine. In about 5% 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.^[10]

Society and culture

Availability

Of the European Union (EU) member states, 12 allow over-the-counter sale of solid dosage forms of codeine, including codeine/paracetamol; they are Bulgaria, Cyprus, Denmark, Estonia, France, Ireland, Latvia, Lithuania, Malta, Poland, Romania, and Slovenia.^[11]

References

1. "Acetaminophen with Codeine Product information". Health Canada. 25 April 2012. Retrieved 13 September 2022.
2. "Boots Paracetamol & Codeine 500mg/8mg Tablets - Patient Information Leaflet (PIL)". (emc). 30 November 2021. from the original on 18 July 2022. Retrieved 17 July 2022.
3. "Co-Codamol 15/500 Tablets - Summary of Product Characteristics (SmPC)". (emc). 25 March 2021. from the original on 5 August 2021. Retrieved 17 July 2022.
4. "Acetaminophen and Codeine Phosphate tablet". DailyMed. 31 July 2020. from the original on 18 March 2022. Retrieved 17 July 2022.
5. "Acetaminophen and Codeine Phosphate solution". DailyMed. 25 May 2022. from the original on 11 May 2021. Retrieved 17 July 2022.
6. "The Top 300 of 2020". ClinCalc. Retrieved 7 October 2022.
7. "Acetaminophen; Codeine - Drug Usage Statistics". ClinCalc. Retrieved 7 October 2022.
8. "Co-codamol for adults: painkiller containing paracetamol and codeine". National Health Service. 19 December 2018. from the original on 14 January 2022. Retrieved 16 April 2021.
9. Nielsen S, Van Hout MC (2017). "Over-the-Counter Codeine-from Therapeutic Use to Dependence, and the Grey Areas in Between". Current Topics in Behavioral Neurosciences. 34: 59–75. doi:10.1007/7854_2015_422. ISBN 978-3-319-60014-7. PMID 26768736.
10. "Codeine Use While Breastfeeding May Be Dangerous". CTV News. 20 August 2008. from the original on 1 September 2008. Retrieved 13 August 2020.
11. Foley M, Harris R, Rich E, Rapca A, Bergin M, Norman I, et al. (November 2015). "The availability of over-the-counter codeine medicines across the European Union". Public Health. 129 (11): 1465–1470. doi:10.1016/j.puhe.2015.06.014. PMID 26215740. from the original on 25 March 2022. Retrieved 8 July 2020.{{cite journal}}: CS1 maint: overridden setting (link)