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Compound analgesic (weak opioid + paracetamol)

Co-codamol (codeine + paracetamol)

Brand names: Solpadol (30/500), Tylex (30/500), Kapake (30/500), Codipar, Solpadeine Max

Used in: Burns

Co-codamol is a compound analgesic combining codeine with paracetamol, used for mild-to-moderate pain not adequately controlled by paracetamol alone.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Paracetamol provides analgesic and antipyretic effects through central mechanisms, while codeine is an opioid that is metabolised to morphine and acts at opioid receptors to relieve pain.

Prescribing in practice

  • Codeine is metabolised to morphine by CYP2D6 and is contraindicated in known ultra-rapid metabolisers, in children under twelve years, and in breastfeeding, because of the risk of life-threatening opioid toxicity; it is also not recommended after tonsillectomy or adenoidectomy in children.
  • As it contains paracetamol, beware additive overdose from other paracetamol-containing products, and as it contains an opioid it carries risks of dependence, constipation and respiratory depression.
  • Doses are expressed by the strengths of the two components, so prescribe and dispense the specific strength clearly to avoid confusion.

Monitoring

Monitor for adequacy of analgesia, opioid adverse effects such as sedation, constipation and respiratory depression, and ensure total paracetamol intake from all sources is not exceeded.

Counselling the patient

  • Do not take other paracetamol-containing medicines at the same time.
  • It may cause drowsiness and constipation; do not drive if affected.
  • Seek urgent advice if too much is taken, even if you feel well, because of the risk of paracetamol toxicity.

Evidence & guidelines

The combination is supported by long-standing analgesic use and by established safety guidance on codeine metabolism from the MHRA.

Reference: MHRA Drug Safety Update Apr 2013 (codeine in children); NICE NG193 (chronic primary pain 2021); FDA Codeine Black Box Warning; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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