Skip to main content

Common questions about co-codamol for adults

How does co-codamol work?

Co-codamol contains paracetamol and codeine. These 2 painkillers work in different ways to relieve pain.

Paracetamol seems to work by blocking "chemical messengers" in the brain that tell us we have pain. It also reduces a high temperature by affecting the chemical messengers in an area of your brain that controls body temperature.

Codeine belongs to a group of medicines called opioids. It affects pain receptors in the central nervous system and the brain to block pain signals to the rest of the body.

When codeine blocks the pain receptors, there can be other unwanted effects, for example slow and shallow breathing. It can also slow down digestion, which is why codeine can cause constipation.

When will I feel better?

Co-codamol takes up to 1 hour to work. It keeps on working for about 5 hours.

Are there any long-term side effects?

If you've bought co-codamol from a pharmacy, do not use it for more than 3 days. If your pain has not gone away, talk to a pharmacist or doctor.

If you need to take co-codamol for a long time, your body can become tolerant to the codeine in it. That means you need higher doses to control your pain over time.

Some people can become more sensitive to pain (hyperalgesia). If this happens, your doctor will reduce your dose gradually to help these symptoms.

It's possible to become addicted to the codeine in co-codamol. For this reason, your dose will be reviewed to make sure you're only taking the amount you need to control your pain.

Your treatment plan may include details of how and when you'll stop taking co-codamol.

If you're having treatment for cancer pain or other severe pain, your pain control will be carefully monitored. Speak to your doctor if you're worried about tolerance, hyperalgesia or becoming addicted.

Can I become addicted to co-codamol?

If you take co-codamol regularly for a long time, you can become addicted to the codeine in it.

You're unlikely to become addicted if you follow your doctor's advice carefully about how long to take it for.

If you have bought co-codamol at a pharmacy, follow the instructions that come with the medicine and only take it for up to 3 days at a time. If your pain is not better after 3 days, it's important to ask your doctor for advice about further pain relief.

How will I know if I'm addicted?

If you're addicted to the codeine in co-codamol, you may find it difficult to stop taking it or feel you need to take it more often than necessary.

If you stop taking codeine suddenly you may get withdrawal symptoms.

These can include:

  • feeling agitated or anxious
  • panic attacks
  • feeling your heartbeat (palpitations)
  • difficulty sleeping
  • shaking
  • sweating
  • body aches
  • feeling restless

Talk to your doctor if you:

  • are worried about addiction
  • need help with addiction
  • want to stop taking codeine
Are there other painkillers I can try?

Yes, there are other painkillers you can try. Some painkillers work better than others for certain types of pain. For example, the best painkiller to ease your headache may not be the best one for your backache.

Before taking co-codamol, try taking paracetamol to see if that helps your pain. Paracetamol can relieve most types of pain.

Painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can reduce swelling (inflammation) as well as pain. These are good for joint, back and muscle pain.

However, NSAIDs are not suitable for some people. This includes people with stomach ulcers or severe heart, kidney or liver problems. If you want to try NSAIDs, speak to your pharmacist or doctor.

Will co-codamol affect my contraception?

Co-codamol does not affect any type of contraception, including the combined pill or emergency contraception.

However, if co-codamol makes you sick (vomit), your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Find out more:

Can I drive or ride a bike?

Do not drive a car, ride a bike or use tools or machinery if co-codamol makes you sleepy, gives you blurred vision or makes you feel dizzy, clumsy or unable to concentrate or make decisions. This may be more likely when you first start taking co-codamol but could happen at any time, for example when starting another medicine.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Even if your ability to drive is not affected, the police have the right to request a saliva sample to check how much co-codamol is in your body.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking co-codamol. GOV.UK has more information on the law on drugs and driving.

Can I drink alcohol while taking co-codamol?

It's best to stop drinking alcohol during the first few days of treatment until you see how co-codamol affects you.

Drinking alcohol while you're taking co-codamol can make you feel more sleepy. It can also increase the risk of serious side effects.

If you feel sleepy with co-codamol, stop drinking alcohol while you're taking it.

Is there any food or drink I need to avoid?

Apart from avoiding alcohol, you can eat and drink normally while taking co-codamol.

Will recreational drugs affect it?

If you take recreational drugs, such as cannabis, cocaine or heroin, while you're taking co-codamol, you're more likely to get the serious side effects of the codeine in co-codamol. These include breathing difficulties, heart problems, seizures or fits and even going into a coma.

Some recreational drugs, such as cannabis, also increase common codeine side effects such as feeling sleepy and feeling dizzy.

Taking heroin while you're on prescribed co-codamol is particularly dangerous. You're more likely to get all the side effects of the codeine in co-codamol, including addiction.

You can find out more about the side effects of recreational drugs on the Frank website.

Page last reviewed: 30 October 2023
Next review due: 30 October 2026