1. About co-codamol for children
Co-codamol is a mixture of 2 different painkillers – paracetamol and codeine.
It's used to treat aches and pains including headaches, migraine, muscular pain and toothache.
Children aged 12 to 15 years can have co-codamol but only if everyday painkillers, such as ibuprofen or paracetamol on its own, have not worked.
Do not give co-codamol to children under 12 years old.
This medicine comes as tablets and capsules.
For adults and children aged 16 years and over, read our information on co-codamol for adults.
2. Key facts
- Do not give co-codamol to children less than 12 years old. It can cause severe breathing problems.
- Co-codamol tablets and capsules come in 3 strengths. You can buy the lowest strength co-codamol from pharmacies but higher strengths are only available on prescription.
- Giving your child too much co-codamol can be harmful. Do not increase the dose or give a double dose even if their pain is very bad.
- It's possible to become addicted to co-codamol, but your child's doctor will explain how to reduce the risks of becoming addicted.
- Always leave at least 6 hours between doses. The maximum dose for children is 4 co-codamol tablets in 24 hours.
- Co-codamol is also known by many different brand names. Talk to your pharmacist if you have any questions about different brands.
3. Who can and cannot take co-codamol
Co-codamol can be taken by children aged 12 to 15 years or older if other everyday painkillers have not worked.
Co-codamol is not suitable for some children. Tell your doctor before starting the medicine if your child has:
- lung problems or breathing difficulties
- a head injury
- adrenal gland problems
- a condition that causes fits or seizures
- liver problems
- had their tonsils or adenoids removed because of a sleep problem called obstructive sleep apnoea syndrome
4. How and when to give co-codamol
It's important to give co-codamol as your child's doctor has asked you to. This is particularly important because co-codamol can be addictive.
Co-codamol comes as tablets and capsules. They're swallowed whole with a drink of water, with or without food.
If your child finds it difficult to swallow tablets or capsules, co-codamol is also available as soluble tablets. These dissolve in water to make a drink.
Different co-codamol strengths
Co-codamol tablets and capsules come in 3 different strengths.
They contain 8mg, 15mg or 30mg of codeine.
All 3 strengths contain 500mg of paracetamol – the same as in a standard paracetamol tablet or capsule.
The strength of co-codamol appears as 2 numbers on the packet. For example, 8/500 means each tablet or capsule contains 8mg of codeine and 500mg of paracetamol.
You can buy the lowest strength of co-codamol (8/500) without a prescription but only from a pharmacy. The higher strengths (15/500 and 30/500) are only available on prescription from a doctor.
Dosage
The normal dose for children aged 12 to 15 years is 1 tablet of co-codamol (of any strength) up to 4 times in 24 hours.
Always leave at least 6 hours between doses.
The maximum dose is normally 4 co-codamol tablets (of any strength) in 24 hours.
It's important to leave a gap between doses of co-codamol. Giving your child too much co-codamol can be very dangerous. That's because the paracetamol in it can cause liver damage. Do not increase the dose of co-codamol or give a double dose even if their pain is very bad.
Do not give your child co-codamol that you have bought from a pharmacy for more than 3 days. If the pain does not improve after 3 days, talk to your child's doctor.
Important
The maximum dose of co-codamol for children aged 12 to 15 years is normally 4 tablets in 24 hours. Wait at least 6 hours between doses.
How long to give it for
If your child's doctor prescribes co-codamol, give it to your child it for as long as they recommended.
If you've bought co-codamol from a pharmacy, do not give it to a child for more than 3 days. If they still have pain, talk to a pharmacist or doctor.
Important
If your child has been taking co-codamol for more than a few weeks, it's important they do not stop taking it without speaking to a doctor first.
What if they take too much?
Taking more than the recommended dose can be dangerous.
Immediate action required: Call 999 or go to A&E if:
Your child has taken too much co-codamol and:
- they are seeing things that are not there
- they are finding it hard to breathe
Urgent advice: Contact 111 for advice now if:
- your child has taken too much co-codamol
Go to 111.nhs.uk or call 111.
If your child needs to go to hospital, take the co-codamol packet or leaflet inside it plus any remaining medicine with them.
5. Giving co-codamol with other painkillers
It's safe to give children co-codamol with ibuprofen.
Do not give children co-codamol with paracetamol or other medicines that contain paracetamol. Co-codamol already contains paracetamol so your child could get a paracetamol overdose.
Medicines that have paracetamol in them include painkillers (Tramacet and co-dydramol), migraine remedies and cough and cold remedies (Lemsip and Night Nurse).
Important
Before giving a child any other medicines together with co-codamol, check the label to see whether these contain paracetamol.
Never give aspirin to a child under the age of 16 (unless their doctor prescribes it). It can cause serious, even fatal, side effects.
6. Side effects
Like all medicines, co-codamol can cause side effects although not everyone gets them. Most children have no side effects or only minor ones.
Your child is more likely to have side effects if they take the higher strengths of co-codamol.
Common side effects
Common side effects happen in more than 1 in 100 children.
Tell your doctor if these side effects bother your child or do not go away:
- constipation
- feeling or being sick (nausea or vomiting)
- feeling sleepy
- headaches
Serious side effects
Serious side effects are rare and happen in less than 1 in 100 children.
Tell a doctor straight away if your child has:
- a skin rash
- difficulty peeing
- changes in their eyesight
- dizziness
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to co-codamol.
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of co-codamol. For a full list, see the leaflet inside the medicine packet.
You can report any suspected side effect to the UK safety scheme.
7. How to cope with side effects of co-codamol
What to do about:
- constipation – give your child plenty of high-fibre foods such as fresh fruit and vegetables and cereals. Get them to drink several glasses of water or other liquids each day.
- feeling or being sick (nausea or vomiting) – give co-codamol with or just after a meal or snack. Feelings of sickness should normally wear off after a few days. Talk to your doctor about giving your child an anti-sickness medicine if it carries on for longer.
- feeling sleepy – these side effects should wear off as your child gets used to co-codamol. Talk to your doctor if they carry on.
- headaches – make sure your child rests and drinks plenty of fluids. Talk to your doctor if the headaches last longer than a week or are severe.
8. Cautions with other medicines
Some medicines affect the way co-codamol works. Equally co-codamol can stop some medicines working as well as they should.
Tell your doctor if your child is taking:
- epilepsy medicines
- medicines for anxiety or sleep problems
- medicines to stop them feeling or being sick such as domperidone or metoclopramide
- medicines to treat infection, particularly rifampicin or ciprofloxacin
- antidepressants – some types do not mix with co-codamol
Mixing co-codamol with herbal remedies and supplements
It's not possible to say whether complementary medicines and herbal remedies are safe to take with co-codamol. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.
Important
Tell your pharmacist or doctor if your child is taking any other medicines, including herbal remedies, vitamins or supplements.
9. Common questions about co-codamol for children
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 opiates. 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 are other unwanted effects – for example slow and shallow breathing. It can also slow down digestion, which is why codeine can cause constipation.
When will my child feel better?
Co-codamol takes up to 1 hour to work. It keeps on working for about 5 hours.
How long can I give it for?
If you've bought co-codamol from a pharmacy, do not give it to your child for more than 3 days. If their pain has not gone away after 3 days, talk to a pharmacist or doctor.
If your doctor has prescribed co-codamol for your child, give it for as long as recommended.
Is co-codamol addictive in children?
Yes, taking co-codamol regularly for long periods of time could make your child addicted to the codeine in it. However, if they're taking it as a painkiller under medical supervision, it's very unlikely they will get addicted to it.
Your child's dose will be reviewed to make sure they are only taking the amount they need to control their pain.
Their treatment plan may include details of how and when they will stop taking co-codamol.
How will I know if my child is addicted?
If your child is addicted to co-codamol, they may find it difficult to stop taking it or feel they need to take it more often than necessary.
And if they stop taking co-codamol suddenly they may suffer from withdrawal symptoms.
These include:
- feeling restless, agitated, anxious or nervous
- panic attacks
- difficulty sleeping
- shaking
- pins and needles
- ringing in their ears
Talk to their doctor if you're worried about addiction. They can also help your child stop taking it safely and reduce withdrawal symptoms.
Is it safe for children to take co-codamol for a long time?
It's not usually recommended for children to take co-codamol that's been bought from a pharmacy for longer than 3 days.
If your child needs to take co-codamol for a long time their body can become tolerant to it. That means they may need higher doses to control their pain.
If your child has been taking co-codamol for a long time, you can prevent withdrawal symptoms by reducing their co-codamol gradually. Your doctor can help you do this.
Are there other painkillers that children can try?
Yes, there are other painkillers they can try.
Some painkillers work better than others for certain pains. For example, the best painkiller to ease a headache may not be the best one for backache.
Before giving your child co-codamol, try paracetamol to see if that helps the pain. Paracetamol can relieve most types of pain.
Painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can reduce inflammation as well as pain. These are good for cold symptoms and aches and pains after an injury like a sprain. However, NSAIDs are not suitable for some children. This includes children with stomach ulcers or severe heart, kidney or liver problems. If you would like them to try NSAIDs speak to your pharmacist or doctor.
Never give aspirin to a child younger than 16 years unless it is prescribed by their doctor. There's a possible link between aspirin and Reye's syndrome in children. Reye's syndrome is a very rare illness that can cause serious liver and brain damage.
Can my child ride a bike with co-codamol?
Co-codamol can make children feel sleepy or dizzy. If this happens, do not let them ride a bike until they feel better.
Is there any food or drink children need to avoid?
They can eat and drink normally while taking co-codamol.