Codeine and Paracetamol

Narcotic Analgesic · Opioid analgesic/Para-aminophenol derivative

Indications

Moderate to severe pain.

Dosage

Adults: 2 tab every 4 hr; max 8 in 24 hr. Children: Not recommended.

Adverse Effects

Tolerance, dependence, constipation, nausea, dry mouth, dizziness, sedation, blurred vision, confusion, urinary retention, dyspnoea.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Respiratory depression, obstructed airways, acute alcoholism, head injury, raised intra cranial pressure, biliary tract surgery, acute asthma, CYP2D6 ultra-rapid metabolisers. Children <18 years: respiratory impairment; tonsillectomy or adenoidectomy for sleep apnoea. Precautions: Hypothyroidism, renal or hepatic impairment, BPH, inflammatory or obstructive bowel disease. Elderly. Labour. Sodium restricted diets. Acute abdominal conditions, urethral stricture, Addison disease. Risk of tolerance and dependence.

Interactions

MAOIs or CNS depressants, TCADs, alcohol, anticholinergics, metoclopramide, domperidone, colestyramine, oral anticoagulants, antihypertensives, quinine, cimetidine.

Advice to Patient

Take with or without meals. Do not take medication for more than 3 days without consulting prescriber. Contact prescriber if you experience changes in mood, depression, agitation, hallucinations, severe stomach pain, irregular heartbeat, difficulty in urination, changes in vision, slow or shallow breathing, confusion. Change position slowly from sitting or lying to standing. Avoid alcohol during therapy. Avoid excessive amount of drinks that contain caffeine.

Pharmacokinetics

CODEINE: Onset of action: Oral: Immediate release: 0.5-1 hr. Peak effect: Oral: Immediate release: 1-1.5 hrs. Duration: Immediate release: 4-6 hrs. Absorption: Oral: Adequate. Metabolism: Hepatic. Bioavailability: 53%. Half-life elimination: Approx. 3 hrs. Time to peak, plasma: Immediate release: 1 hr; Controlled release: 3.3 hrs. Excretion: Urine (approx. 90%). Faeces. PARACETAMOL: Onset of action: Oral: <1 hr. IV: Analgesia: 5-10 min. Antipyretic: Within 30 min. Peak effect: IV: Analgesic: 1 hr. Duration: IV, Oral: Analgesia: 4-6 hrs. IV: Antipyretic: =6 hrs. Absorption: Primarily absorbed in small intestine, minimal absorption from stomach (varies by dosage form). Metabolism: Hepatic. Half-life elimination: Neonates: 7 hrs. Infants: Approx. 4 hrs. Children: 3 hrs. Adolescents: Approx. 3 hrs. Adults: Approx. 2 hrs. CrCl<30 mL/min: 2-5.3 hrs. Time to peak, serum: Oral: Immediate…

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.