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
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][6]
Identifiers
CAS Number	67889-72-9
PubChem CID	11949633
ChemSpider	10123946 Y
KEGG	D02146
NY (what is this?)  (verify)

In 2022, it was the 166th most commonly prescribed medication in the United States, with more than 3 million prescriptions.^[7][8]

Side effects

The most common side effects include constipation, nausea and drowsiness.^[9] 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.^[10]

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.^[11]

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, France, Ireland, Latvia, Lithuania, Malta, Poland, Romania, and Slovenia.^[12]