Can you take Paracetamol with Codeine together?

Painkillers like codeine will often be prescribed to manage moderate to severe pain. Some people have used it alongside paracetamol or non-steroidal anti-inflammatory medicines like ibuprofen to manage their pain, however, is this safe? In this article we will explore whether or not you can use paracetamol and codeine at the same time, and moreover, whether you should use these medications together if you are struggling with pain management.

When you are experiencing pain, only having one kind of painkiller sometimes does not effectively manage your symptoms. In cases like these, you might need another painkiller to treat your condition. Different painkillers work in different ways, so taking them together can help to minimise pain whilst still keeping you safe from side effects.

Key Takeaways:

Combining Paracetamol and Codeine:

• Yes, it is safe to take paracetamol and codeine together. This combination is often used for effective pain relief, with products like co-codamol combining both. However, it's essential to follow recommended dosages and consult with a healthcare provider.

Effects of Codeine and Paracetamol:

• Codeine: Treats moderate to severe pain and can cause side effects like drowsiness, nausea, and constipation. Long-term use can lead to lethargy and confusion.

• Paracetamol: Commonly used for pain and fever relief with rare side effects. Some studies suggest it may affect empathy levels, but this is not a recognized side effect.

Prescription Requirements:

• Codeine: Requires a prescription due to its opioid nature and potential for addiction. It is used for pain that other painkillers cannot manage effectively.

• Paracetamol: Available over the counter and used for mild to moderate pain and fever. It should be used responsibly to avoid side effects.

Can you take Paracetamol with Codeine together?

Yes, according to guidance from the NHS, it's safe to take codeine alongside paracetamol, ibuprofen, or aspirin. Several painkillers that contain codeine are available including co-codamol and Solpadeine, both of which combine paracetamol and codeine. These combinations are formulated to provide effective pain relief by combining codeine and paracetamol. It's important to use these medications responsibly and as directed by a healthcare professional, as misuse or overuse can lead to an increased risk of side effects. You should always adhere to recommended dosages and consult with a healthcare provider if you have any concerns or questions about taking these medications together.

What does Codeine do?

Codeine is a painkiller that is used to treat mild to moderate pain and diarrhoea (NHS, 2022). This medication is available in tablet, syrup, and liquid form which is administered intravenously. The most commonly prescribed form for patients using codeine at home is orally through a tablet. Codeine is an opiate-based painkiller that is available via prescription only. This means that you cannot purchase it without a valid prescription. It is used to treat pain that may not be stopped by common painkiller medications. Small doses of codeine can be mixed with other medications, such as paracetamol, ibuprofen and aspirin. if it is not treating pain adequately alone. It is vital that you do not mix medications without first consulting with your healthcare provider.

What does Paracetamol do?

Paracetamol is a commonly used over-the-counter medication that is known for its effectiveness in alleviating pain and reducing fever. It is typically used as a first-line medication to address mild to moderate pain, such as headaches, toothaches, or sprains, as well as to lower body temperatures caused by illnesses like colds and flu, according to NHS Inform.

What does Codeine look like?

Codeine tablets are typically small and white, although some capsules are clear, according to Release. When the medication is in the form of syrup it closely resembles common cough syrups.

What does Paracetamol look like?

Paracetamol typically appears as white to off-white, capsule-shaped, uncoated tablets. These tablets often feature a break line on one side for ease of splitting and are plain on the other side, according to the emc.

How does Codeine make users feel?

Codeine is an opioid medication prescribed to reduce physical pain. As with all other medications, some side effects may occur when you use codeine. The medication, whilst easing pain, can also cause drowsiness, nausea, confusion, itchiness, relaxation, or constipation, according to the charity Talk to Frank. These sensations are more common when codeine is taken in higher doses.

How does Paracetamol make users feel?

Typically, paracetamol will simply treat and alleviate the symptoms of pain or fever. It will not usually make users feel much different to how they did before, aside from the easing of these symptoms. As with all other medications, some users may experience side effects when they use paracetamol. The NHS states that paracetamol side effects are rare, but can include rashes, allergic reactions, low blood pressure, and damage to the kidneys and liver.

According to findings put forward by the BBC, paracetamol has also been linked to a reduction in our capacity to experience empathy. This suggests that individuals may feel less able to connect emotionally with others in a positive manner after they have taken the medication. It should be noted that the study did not study negative empathy and that the full extent of this side effect is not yet known.

Can Codeine affect behaviour?

Yes, codeine can affect someone’s behaviour. Codeine may cause a ‘downer’ effect for some users. Most people who experience this may complain of feeling nauseous and drowsy when they use the medication. The medication can also cause some people to feel tired and sleepy. This is typically more common in people using a higher dosage. According to East Coast Recovery, long-term Codeine usage can also be linked to lethargy and confusion.

Can Paracetamol affect behaviour?

The NHS states that paracetamol will only very rarely cause side effects. However, as previously mentioned, some studies suggest that paracetamol may affect your behaviour when it comes to feeling empathy, although this is not listed as a recognised side effect.

Can Codeine affect physical health when mixed with other medications?

As with all other medications, Codeine can cause side effects that affect physical health. It should be noted that many people who use codeine do not experience any side effects, provided they take the right level or dosage as prescribed by their doctor. Using Codeine incorrectly or illegally can increase the risk of side effects. It should be noted that alcohol and codeine usage can significantly worsen side effects according to the Mayo Clinic.

Mixing medications can also increase the risk of side effects. When you mix medications such as co-codamol, diazepam and other opioid medications, you may experience the following physical side effects:

• Indigestion

• Bleeding in the stomach

• Liver failure

• Low blood pressure

• Abnormal breathing

Can Codeine affect mental health?

Yes, people who are using codeine may find that the medication affects their mental health if they become addicted to it. Extended and prolonged abuse of mood-altering substances such as codeine can contribute to symptoms such as depression and anxiety (Hari & Durrani, 2023). If you need to use codeine for a prolonged period then you should regularly consult with your doctor to ensure that you are not experiencing any side effects. 

Sources

Co-codamol for adults: painkiller containing paracetamol and codeine | NHS

Patient Information Controlling Your Pain After Surgery Paracetamol and Codeine | NHS East and North Hertfordshire  

Co-codamol | Drugs | BNF | NICE

Codeine-containing medicines | EMA

Co-codamol (Kapake, Solpadol, Tylex) | Cancer Research UK