Codeine/paracetamol
{{Short description|Compound medication}}
{{More citations needed|date=July 2012}}
{{Use dmy dates|date=January 2023}}
{{cs1 config |name-list-style=vanc |display-authors=6}}
{{Infobox drug
| Verifiedfields = changed
| Watchedfields = changed
| verifiedrevid = 455046896
| type = combo
| image = Codeine and paracetamol.svg
| image_class = skin-invert-image
| width = 165
| alt =
| component1 = Codeine
| component2 = Paracetamol
| class2 = Anilide analgesic
| tradename = Tylenol with codeine, others
| Drugs.com =
| MedlinePlus = a601005
| DailyMedID = Acetaminophen codeine
| pregnancy_AU =
| pregnancy_AU_comment =
| pregnancy_category =
| dependency_liability =
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| routes_of_administration = By mouth
| ATC_prefix = N02
| ATC_suffix = BE51
| ATC_supplemental =
| legal_AU = S4
| legal_AU_comment =
| legal_BR =
| legal_BR_comment =
| legal_CA = Schedule I
| legal_DE =
| legal_DE_comment =
| legal_NZ =
| legal_NZ_comment =
| legal_UK = POM
| legal_UK_comment = / P{{cite web | title=Boots Paracetamol & Codeine 500mg/8mg Tablets - Patient Information Leaflet (PIL) | website=(emc) | date=30 November 2021 | url=https://www.medicines.org.uk/emc/product/13090/pil | access-date=17 July 2022 | archive-date=18 July 2022 | archive-url=https://web.archive.org/web/20220718044159/https://www.medicines.org.uk/emc/product/13090/pil | url-status=live }}{{cite web | title=Co-Codamol 15/500 Tablets - Summary of Product Characteristics (SmPC) | website=(emc) | date=25 March 2021 | url=https://www.medicines.org.uk/emc/product/4051/smpc | access-date=17 July 2022 | archive-date=5 August 2021 | archive-url=https://web.archive.org/web/20210805074246/https://www.medicines.org.uk/emc/product/4051/smpc | url-status=live }}
| legal_US = Schedule III
| legal_US_comment = / Schedule V{{Cite web |url=https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf |title=Controlled Substances - Alphabetical Order |access-date=29 June 2024 |archive-date=21 April 2021 |archive-url=https://web.archive.org/web/20210421180644/https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf |url-status=live }}{{cite web | title=Acetaminophen and Codeine Phosphate tablet | website=DailyMed | date=31 July 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a9b11cbf-7585-4532-868f-5686f028679f | access-date=17 July 2022 | archive-date=18 March 2022 | archive-url=https://web.archive.org/web/20220318083011/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a9b11cbf-7585-4532-868f-5686f028679f | url-status=live }}{{cite web | title=Acetaminophen and Codeine Phosphate solution | website=DailyMed | date=25 May 2022 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=83a536d8-385d-46ed-9cd2-47b7efe96ccf | access-date=17 July 2022 | archive-date=11 May 2021 | archive-url=https://web.archive.org/web/20210511045036/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=83a536d8-385d-46ed-9cd2-47b7efe96ccf | url-status=live }}
| legal_EU =
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| legal_UN =
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| legal_status =
| CAS_number = 67889-72-9
| PubChem = 11949633
| IUPHAR_ligand =
| DrugBank =
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = 10123946
| UNII =
| KEGG = D02146
| ChEBI =
| ChEMBL =
| synonyms =
}}
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.
In 2022, it was the 166th most commonly prescribed medication in the United States, with more than 3{{nbsp}}million prescriptions.{{cite web | title=The Top 300 of 2022 | url=https://clincalc.com/DrugStats/Top300Drugs.aspx | website=ClinCalc | access-date=30 August 2024 | archive-date=30 August 2024 | archive-url=https://web.archive.org/web/20240830202410/https://clincalc.com/DrugStats/Top300Drugs.aspx | url-status=live }}{{cite web | title = Acetaminophen; Codeine Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/AcetaminophenCodeine | access-date = 30 August 2024 }}
Side effects
The most common side effects include constipation, nausea and drowsiness.{{cite web |url=https://www.nhs.uk/medicines/co-codamol-adults/ |title=Co-codamol for adults: painkiller containing paracetamol and codeine |newspaper=National Health Service |date=19 December 2018 |access-date=16 April 2021 |archive-date=14 January 2022 |archive-url=https://web.archive.org/web/20220114124849/https://www.nhs.uk/medicines/co-codamol-adults/ |url-status=live }}
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.{{cite book | vauthors = Nielsen S, Van Hout MC | title = Over-the-Counter Codeine-from Therapeutic Use to Dependence, and the Grey Areas in Between | series = Current Topics in Behavioral Neurosciences| volume = 34 | pages = 59–75 | date = 2017 | pmid = 26768736 | doi = 10.1007/7854_2015_422 | isbn = 978-3-319-60014-7 | hdl = 1959.4/unsworks_62273 | hdl-access = free }}
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.{{cite news|title=Codeine Use While Breastfeeding May Be Dangerous|url=https://www.ctvnews.ca/codeine-use-while-breastfeeding-may-be-dangerous-1.317673|work=CTV News|date=20 August 2008|access-date=13 August 2020|archive-date=1 September 2008|archive-url=https://web.archive.org/web/20080901210431/https://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080820/tylenol_3_breastfeeding_080820/20080820|url-status=live}}
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.{{Cite journal|vauthors = Foley M, Harris R, Rich E, Rapca A, Bergin M, Norman I, Van Hout MC |title=The availability of over-the-counter codeine medicines across the European Union|url=https://www.academia.edu/19659390|journal=Public Health|date = November 2015|volume=129|issue=11|pages=1465–1470|doi=10.1016/j.puhe.2015.06.014|pmid=26215740|access-date=8 July 2020|archive-date=25 March 2022|archive-url=https://web.archive.org/web/20220325081404/https://www.academia.edu/19659390|url-status=live }}
References
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{{Analgesics}}
{{Anti-inflammatory products}}
{{Opioidergics}}
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