Co-Codamol 32 Tablets are a pain relief medicine for the relief of mild to moderate pain including headache & migraine , toothache, period pains , muscle pains and backache .  It can also relieve symptoms of rheumatic pains , influenza and colds .

Directions for using Co-Codamol 8mg/500mg Tablets

Dose: unless otherwise directed by a doctor:

Adults and children over 12 years:  One to two tablets to be swallowed with water. The dose should not be taken more frequenly than every 4 hours and not more than 4 times in any 24 hour period.

• Maximum daily dose: 8 tablets (4.0g of paracetamol and 64mg of codeine) in any 24 hours period in divided doses. The dose should be reduced in elderly patients.
• You may need a reduced dose if your kidney or liver is not working as well as it should be.
• Do not give to childen under 12 years of age, except on the advice of a doctor.
• If symptoms persist, consult your doctor.  If you need to use this medicine for more thana 3 days at a time, see your doctor or pharmacist.
• Do not exceed the stated dose.
• You should avoid alcohol or anything containing alcohol whilst taking this medicine.

If you miss a single dose of Co-Codamol 8mg/500mg Tablets do not worry and take the next one at the normal time.  Do not double up on dose to make up for the missing one.

Immediate medical advice should be sought in the event of an overdose, even if you feel well becaused of the risk of delayed, serious liver damage.  Contact the nearest casualty department or your doctor at once, or if you think a child has taken any tablets.  Make sure the hospital/doctor knows what tablets have been taken.

Dependence: These tablets are not recommended for long term use because your body may become dependent on them, leading to withdrawal symptoms when use is stopped.

Each Co-Codamol 8mg/500mg Tablet contains active ingredients:

• Paracetamol 500mg
• Codeine Phosphate 8.0mg

Before Taking Co-Codamol 8mg/500mg Tablets

• If you need to use this medicine for more than three days at a time, see your doctor, pharmacist, or health care professional
• Taking codeine regularly for a long time can lead to addiction,which might cause you to feelrestless and irritable when you stop the tablets
• Taking a painkiller for headaches too often or for too long can make them worse
• Do not take with any other paracetamol containing products

• You have severe problems with breathing
• You are or you have been allergic to paracetamol, codeine (or other opoid pain killers) and/or any of the ingredients
• You have been told you have liver disease
• You have recently suffered from a head injury or you have been told you have raised pressure on the brain
• You are suffering from acute alcohol poisoning
• You are at risk from intestinal paralysis or have a swollen abdomen
• You are suffering from severe diarrhoea
• You are taking any other paracetamol or paracetamol-containing products
• You are 12 years of age or under

Please tell your doctor or pharmacist before you take your tablets if any of the following apply to you:

• You are pregnant or breastfeeding, or wish to become pregnant or start breastfeeding
• Your alcohol consumption is excessive
• Your kidney or liver is not working as well as it should be
• You suffer from enlargement of the prostrate (in men) or have difficulty passing water
• You suffer from low blood pressure, are in a state of severe shock or very run down
• You have an under-active thyroid (hypothyroidism) or adrenal glands
• You suffer from convulsions or have a seizure disorder (fits)
• You have had a drug addiction
• You suffer from asthma, bronchitis or emphusema (if your asthma is controlled you can take Co-Codamol 8mg/500mg Tablets but use with care, especially if your asthma is known to be made worse by asprin or other painkillers - you should not take codeine if you are having an acute asthma attack)
• You are taking any other medicines particularly: paracetamol or paracetamol-containing products, quindine, mexiletine (used to regularise heart rhythm), anticoagulants such as warfarin (drugs to thin the blood),  anticonvulsants such as carbamazepine, phenobarbital, phenytoin, primidone (drugs used to treat epilepsy),  cimetidine (used to treat ulcers),  colestyramine (a cholesterol lowering drug),  isonaizid (used to treat tuberculosis),  diflunisal (a pain killer),  oral contraceptives,  probenecid (used to treat gout),  medicines used to treat depression, including tricyclic antidepressants and MAOIs or within 2 weeks of stopping treatment, sedatives, antidiarroeals such as loperamide or kaolin, metoclopramide or domperidone (drugs used in the treatment of nausea/vomiting), medicines used to treat anxiety and insomnia, e.g. diazepam and nitrazepam, antipsychotics such as chlopromazine and haloperidol (used to treat mental illnesses including schizoprenia).

If you go into hospital for surgery or tests, tell your doctor you are taking co-codamol 8mg/500mg tablets, as they may interact with some anaesthetics ad influence the results of certain tests and diagnostic procedures.

Co-codamol 8mg/500mg tablets contain parahydroxybenzoates (E218, E214 and E216), which may cause allergic reactions (possibly delayed).

Side Effects: The most common are feeling sick, being sick, constipation or drowsiness. Other less frequent and rare side-effects include the following:

• Problems with vision
• Mood changes (including depression and more rarely euphoria)
• Confusion
• Dizziness
• Dry mouth
• Vertigo
• Tiredness
• A general feeling of discomfort
• Headache (which can be made worse by taking Co-Codamol 8mg/500mg Tablets for too long)
• Respiratory depression
• Sweating
• Flushing
• Facial oedema (swelling caused by fluids)
• Anorexia
• Wheals or itching
• Slower or faster heart beat
• Palpitations (irregular heartbeat)
• Low blood pressure (which may cause fainting)
• Skin rashes and blood problems (which may cause sore throat, mouth ulcers and fever or a tendency to bleed or buise easily)
• Abdominal pain (caused by spasm in the tubes that carry urine to the bladder or bile to the intestines)
• Dyspnoea (breathing difficulties)
• Convulsions
• Hallucinations
• Nightmares
• Uncontrolled muscle movements
• Muscle rigidity
• Pain or difficulties when passing urine, an increased or decreased frequency of passing urine
• Weak erection in men

Patients with asthma that is made worse by asprin or other painkillers may find that that Co-Codamol 8mg/500mg Tablets also cause wheezing. Taking high doses of paracetamol for a long time can cause kidney problems.

If you experience these or any other unusual or unexpected symptoms which persist or are troublesome, consult your doctor or pharmacist.

Driving/Operating machinery: This medicine may cause drowsiness and/or blurred or double vision.  If affected do not drive or operate machinery whilst taking the medicine.