Codeine, Paracetamol and Caffeine

Narcotic Analgesic · Opioid analgesic/Para-aminophenol derivative/Xanthine

Indications

Moderate to severe pain.

Dosage

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

Adverse Effects

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

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. Precautions: Hypothyroidism, renal or hepatic impairment, BPH, inflammatory or obstructive bowel disease. Elderly. Labour. Sodium restricted diets.

Interactions

MAOIs or CNS depressants.

Advice to Patient

Take with or without meals. Contact prescriber if there is decreased consciousness, sleepiness, slow/shallow breathing, 'pin-point' pupils, lack of appetite, itching, skin rash, difficulty in urination, constipation, or nausea and vomiting. Do not take OTC medications especially tranquilizers, sedatives, antihistamines, pain medications without consulting prescriber. Do not take for more than 3 days without consulting prescriber. Avoid alcohol during therapy. Do not take 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.