Codeine is a relatively mild prescription opioid given to patients to help treat moderate pain and cough. It’s sometimes also used to treat diarrhea. Codeine may be mild when compared to other opioids, but there are still risks that come with the use of this medication including physical dependence and addiction.

When someone takes codeine, it converts back to morphine when it reaches their brain, and then binds to opioid receptors. When this happens, it suppresses their cough reflex and sensations of pain, and it also depresses the central nervous system.

Codeine, as with other opioids, can also trigger a flood of certain neurotransmitters in the brain, and this can cause a euphoric high in some people, particularly when larger doses are taken. This is one of the reasons codeine can be addictive, although the risk of addiction is lower when you take it for a short period and as prescribed by your physician.

Codeine is also often combined with other drugs to increase its effectiveness, and one of those is paracetamol, also known as acetaminophen.

Below is more information about the combination of paracetamol and codeine, and an overview of codeine and paracetamol tablets and side effects.

Paracetamol and Codeine

Before looking at drugs that combine paracetamol and codeine, what is paracetamol?

Paracetamol, which is also called acetaminophen, is an over-the-counter drug that can be used to treat pain and fever. Along with the paracetamol and codeine combination, it’s often used in other combination medicines as well, such as cold and flu medicines. It’s one of the most commonly used pain medicines in the U.S. and the world, and it’s available in brand name versions like Tylenol.

At recommended doses, paracetamol is considered safe, but if someone takes too much, it can be dangerous or deadly. Paracetamol can cause liver damage at high doses, or when it’s combined with other substances that affect the liver, like alcohol. Along with liver damage, acute liver failure or death can occur if too much paracetamol is taken. Toxicity from paracetamol is one of the top causes of acute liver failure in the world.

While the risk of liver damage is possible with paracetamol, it’s not an addictive or habit-forming substance, but codeine is. While codeine is classified as an opioid, paracetamol is classified as an analgesic, which means a pain reliever and an antipyretic, which is a fever reducer.

Paracetamol and codeine combinations are found in brand-name drugs like Tylenol 3 and Tylenol 4.

Codeine and Paracetamol Tablets

Codeine and paracetamol tablets are available as drugs like Tylenol 3 and Tylenol 4. Some codeine and paracetamol tablets also contain caffeine, which is a stimulant.

Codeine and paracetamol tablets can be prescribed for a variety of reasons including headaches and migraines, for dental pain, and for pain following an accident or surgery.

Codeine and paracetamol tablets are usually only recommended for people who are at least 12 years old, and since they contain paracetamol, it’s important to following dosing instructions very carefully to avoid liver damage.

Codeine and paracetamol tablets shouldn’t be used for more than five days in a row unless directed by a doctor.

Paracetamol and Codeine Phosphate

In some countries like the UK, there is a paracetamol and codeine phosphate product available.

The dosing and information for paracetamol and codeine phosphate are similar to other versions of the drug, which are detailed below.

Paracetamol and Codeine Side Effects

So, what are the paracetamol and codeine side effects? Most of the potential paracetamol and codeine side effects are more related to the codeine in these medications than the acetaminophen.

Some of the common side effects can include nausea, drowsiness, constipation, lightheadedness, and dizziness. Most people don’t have serious paracetamol and codeine side effects, however, as long as they use the drug as directed by their doctor.

It is possible to abuse or become addicted to this drug because of the codeine, but the risk is lower when you follow dosing instructions.

Severe but uncommon paracetamol and codeine side effects can include mood or mental changes, severe abdominal pain, vision changes, problems urinating, or fainting. Also possible is liver damage or acute liver failure.

People who take paracetamol and codeine may also feel high, and this is because of how the codeine impacts the brain. If you take too much, it can slow respiration to a dangerous level or cause an overdose or death.

Paracetamol Codeine Dosage

When a physician is prescribing a paracetamol codeine dosage, they’re going to look at individual factors such as liver functionality, age, and weight, but some general dosage guidelines can be used.

  • Dosage Guidelines:

    • The paracetamol codeine dosage for the oral liquid form of the drug is 15 mL every four hours as needed for adults
    • For children ages 7 to 12 taking the liquid, it’s 10 mL 3 or 4 times a day, and for children ages 3 to 6 it’s 5 mL 3 or 4 times a day
    • For tablet paracetamol codeine dosages, it’s 1 to 2 tablets every four hours as needed for pain in adults, and child dosages have to be determined by a doctor.

These are just rough guidelines and should never be used instead of your doctor’s advice.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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