Patient leaflet - Co-codamol 30 mg / 500 mg effervescent tablets
1. What Co-codamol is and what it is used for
The name of your medicine is Co-codamol 30mg/500mg Effervescent Tablets (called Co-codamol throughout this leaflet). This medicine has been prescribed for you for the relief of severe pain in adults. They can be used in children older than 12 years of age for the short-term relief of moderate pain that is not relieved by other painkillers such as paracetamol or ibuprofen alone. It contains codeine which belongs to a class of medicines called opioids, which are ‘pain relievers’ and paracetamol, another analgesic to relieve pain.
This medicine has been prescribed to you and should not be given to anyone else.
Opioids can cause addiction and you may get withdrawal symptoms if you stop taking it suddenly. Your prescriber should have explained how long you will be taking it for and when it is appropriate to stop, and how to do this safely.
2. What you need to know before you take Co-codamol
Tolerance, dependence, and addiction
This medicine contains codeine which is an opioid medicine. It can cause dependence and/or addiction. Repeated use of opioids can result in the drug being less effective (you become accustomed to it, known as tolerance). Repeated use of Co-codamol can also lead to dependence, abuse and addiction, which may result in life-threatening overdose. The risk of these side effects can increase with a higher dose and longer duration of use.
Dependence or addiction can make you feel that you are no longer in control of how much medicine you need to take or how often you need to take it.
The risk of becoming dependent or addicted varies from person to person. You may have a greater risk of becoming dependent on or addicted to Co-codamol if:
You or anyone in your family have ever abused or been dependent on alcohol, prescription medicines or illegal drugs (“addiction”). You are a smoker.
You have ever had problems with your mood (depression, anxiety, or a personality disorder) or have been treated by a psychiatrist for other mental illnesses.
If you notice any of the following signs whilst taking Co-codamol, it could be a sign that you have become dependent or addicted: You need to take the medicine for longer than advised by your doctor
You need to take more than the recommended dose
You might feel that you need to carry on taking your medicine, even when it doesn’t help to relieve your pain You are using the medicine for reasons other than prescribed, for instance, ‘to stay calm’ or ‘help you sleep’ You have made repeated, unsuccessful attempts to quit or control the use of the medicine
When you stop taking the medicine you feel unwell, and you feel better once taking the medicine again (‘withdrawal effects’) If you notice any of these signs, speak to your doctor to discuss the best treatment pathway for you, including when it is appropriate to stop and how to stop safely (See section 3, If you stop taking Co-codamol).
Do not take Co-codamol and tell your doctor if you:
are allergic (hypersensitive) to codeine, paracetamol or any of the other ingredients in your medicine (listed in section 6). Signs of an allergic reaction include a rash and breathing problems. There can also be swelling of the legs, arms, face, throat or tongue.
have severe asthma attacks or severe breathing problems.
have recently had a head injury
have been told by your doctor that you have increased pressure in your head. Signs of this include: headaches, being sick (vomiting) and blurred eyesight.
have recently had an operation on your liver, gallbladder or bile duct (biliary tract).
are taking medicine to treat depression called MAOIs (monoamine oxidase inhibitors) or have taken them in the last 2 weeks. MAOIs are medicines such as moclobemide, phenelzine or tranylcypromine (see ‘Other medicines and co-codamol’). are an alcoholic.
are under 12 years of age
are under 18 years of age and have had your tonsils or adenoids removed due to obstructive sleep apnoea syndrome. know that you metabolise very rapidly codeine into morphine.
are breastfeeding.
Do not take Co-codamol if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Co-codamol.
Warnings and precautions
Talk to your doctor before taking this medicine if you:
are or have ever been addicted to opioids, alcohol, prescription medicines, or illegal drugs.
have previously suffered from withdrawal symptoms such as agitation, anxiety, shaking or sweating, when you have stopped taking alcohol or drugs.
feel you need to take more of Co-codamol to get the same level of pain relief, this may mean you are becoming tolerant to the effects of this medicine or are becoming addicted to it. Speak to your prescriber who will discuss your treatment and may change your dose or switch you to an alternative pain reliever.
have severe kidney or liver problems.
have problems passing water or prostate problems.
have a bowel problem such as colitis or Crohn’s disease or a blockage of your bowel.
are elderly.
are sensitive to aspirin or other medicines used for the treatment of inflammation (Non Steroidal Anti-inflammatory Drugs) such as Ibuprofen.
have a condition called myasthenia gravis which weakens the muscles.
are taking a benzodiazepine.
know you are a slow or intermediate metaboliser of an enzyme called CYP2D6, because a different dose may be applicable to you. are taking a medicine that induces CYP3A4 enzyme activity such as rifampicin.
have severe illnesses, including severe renal impairment or sepsis (when bacteria and their toxins circulate in the blood leading to organ damage), or you suffer from malnutrition, chronic alcoholism or if you are also taking flucloxacillin (an antibiotic). A serious condition called metabolic acidosis (a blood and fluid abnormality) has been reported in patients in these situations when paracetamol is used at regular doses for a prolonged period or when paracetamol is taken together with flucloxacillin. Symptoms of metabolic acidosis may include: serious breathing difficulties with deep rapid breathing, drowsiness, feeling sick (nausea) and being sick (vomiting).
you experience pain or increased sensitivity to pain (hyperalgesia) which does not respond to a higher dosage of your medicine. Contact your doctor if you experience severe upper abdominal pain possibly radiating to the back, nausea, vomiting or fever as this could be symptoms associated with inflammation of the pancreas (pancreatitis) and the biliary tract system.
Codeine is transformed to morphine in the liver by an enzyme. Morphine is the substance that produces pain relief. Some people have a variation in this enzyme and this can affect people in different ways. In some people, morphine is not produced or is produced in very small quantities, and it will not provide enough pain relief. Other people are more likely to get serious side effects because a very high amount of morphine is produced. If you notice any of the following side effects, you must stop taking this medicine and seek immediate medical advice: slow or shallow breathing, confusion, sleepiness, small pupils, feeling or being sick, constipation, lack of appetite.
Sleep-related breathing disorders
Co-codamol can cause sleep-related breathing disorders such as sleep apnoea (breathing pauses during sleep) and sleep related hypoxemia (low oxygen level in the blood). The symptoms can include breathing pauses during sleep, night awakening due to shortness of breath, difficulties to maintain sleep or excessive drowsiness during the day. If you or another person observe these symptoms, contact your doctor. A dose reduction may be considered by your doctor. If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking this medicine. Other medicines and Co-codamol
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription, including herbal medicines. This is because Co-codamol can affect the way some other medicines work. Also, some other medicines can affect the way Co-codamol works.
Concomitant use with sedative medicines
Concomitant use of Co-codamol and sedative medicines such as benzodiazepines or related drugs increases the risk of drowsiness, difficulties in breathing (respiratory depression), coma and may be life- threatening. Because of this, concomitant use should only be considered when other treatment options are not possible. However if your doctor does prescribe Co-codamol together with sedative medicines the dose and duration of concomitant treatment should be limited by your doctor. Please tell your doctor about all sedative medicines you are taking, and follow your doctor’s dose recommendation closely. It could be helpful to inform friends or relatives to be aware of the signs and symptoms stated above. Contact your doctor when experiencing such symptoms. Co-codamol contains paracetamol. Do not take anything else containing paracetamol while taking this medicine. This includes some painkillers, cough and cold remedies. It also includes a wide range of other medicines available from your doctor and more widely in shops.
Do not take this medicine and tell your doctor if you are taking
Medicines to treat depression called MAOIs (monoamine oxidase inhibitors) or have taken them in the last 2 weeks. MAOIs are medicines such as moclobemide, phenelzine, tranylcypromine.
Tell your doctor or pharmacist if you are taking any of the following medicines, or have taken them in the past two weeks:
Medicines which make you drowsy or sleepy (CNS depressants or a benzodiazepine) such as sleeping tablets, sedatives, tranquilisers, hypnotics and medicines used to treat anxiety or anaesthetics
Anti-depressant medicines such as imipramine, amitriptyline, tranylcypromine, dosulepin, mirtazapine or chlorpromazine. Antihistamine medicines used to treat allergies.
Tell your doctor or pharmacist if you are taking any other medicines:
Medicines used to thin the blood such as warfarin.
Chloramphenicol - an antibiotic used for infections.
Metoclopramide or domperidone - used to stop you feeling sick (nausea) or being sick (vomiting). Colestyramine - for lowering blood cholesterol levels.
The oral contraceptive pill.
Medicines such as quinidine, fluoxetine, paroxetine, bupropion, cinacalcet, methadone or rifampicin, as these may alter the effect of Co-codamol.
Flucloxacillin (antibiotic), due to a serious risk of blood and fluid abnormality (called metabolic acidosis) that must have urgent treatment (see section 2).
Gabapentin or pregabalin to treat epilepsy or pain due to nerve problems (neuropathic pain)
If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Co-codamol. Taking Co-codamol with food and drink
You should not drink alcohol while you are taking these tablets. This is because Co-codamol can change the way alcohol affects you.
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As stated in design Package leaflet
TBA
TW275456 (MAT)
UK
All
NA
TBA
9 pts (Reg text)
NA 23/07/2026
Black C Pregnancy, breast feeding and fertility
Do not take Co-codamol if you are pregnant or think you might be pregnant unless you have discussed this with your prescriber and the benefits of treatment are considered to outweigh the potential harm to the baby.
If you use Co-codamol during pregnancy, your baby may become dependent and experience withdrawal symptoms after the birth which may need to be treated.
Do not take Co-codamol while you are breastfeeding as codeine passes into breast milk and will affect your baby. Children and adolescents
Use in children and adolescents after surgery
This medicine should not be used for pain relief in children and adolescents after removal of their tonsils or adenoids due to Obstructive Sleep Apnoea Syndrome.
Use in children with breathing problems
Codeine is not recommended in children with breathing problems, since the symptoms of morphine toxicity may be worse in these children.
Driving and using machines
The medicine can affect your ability to drive as it may make you sleepy or dizzy.
Do not drive while taking this medicine until you know how it affects you
It is an offence to drive if this medicine affects your ability to drive
However, you would not be committing an offence if:
The medicine has been prescribed to treat a medical or dental problem and
You have taken it according to the instructions given by the prescriber or in the information provided with the medicine and It was not affecting your ability to drive safely.
Talk to your doctor or pharrmacist if you are not sure whether it is safe for you to drive while taking this medicine. Co-codamol tablets contain sodium and sorbitol
This medicine contains 410mg sodium (main component of cooking/table salt) in each tablet. The maximum recommended daily dose of this medicinal product contains 3.28g sodium. This is equivalent to 164% of the recommended maximum daily dietary intake of sodium for an adult.
Talk to your doctor or pharmacist if you need 1 or more tablet daily for a prolonged period, especially if you have been advised to follow a low salt (sodium) diet.
Sorbitol is a source of fructose. If your doctor has told you that you (or your child) have an intolerance to some sugars or if you have been diagnosed with hereditary fructose intolerance (HFI), a rare genetic disorder in which a person cannot break down fructose, talk to your doctor before you (or your child) take or receive this medicine.
Changing or stopping treatment
Long term usage of Co-codamol may lead to tolerance and dependence. If you have taken regular daily doses of Co-codamol for a long time, do not increase the dose or suddenly stop treatment without discussing this with your doctor.
3. How to take Co-codamol
Always take Co-codamol exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. Before starting treatment and regularly during treatment, your doctor will discuss with you what you may expect from using Co-codamol, when and how long you need to take it, when to contact your doctor, and when you need to stop it (see also, If you stop taking Co-codamol).
Dissolve the effervescent tablets in at least half a tumbler-full of water before taking.
Adults
Two tablets every 4-6 hours when necessary, up to a maximum of 8 tablets in any 24 hour period. Use in children and adolescents
Children aged 16-18 years: one to two tablets every 6 hours when necessary, up to a maximum of 8 tablets in 24 hours. Children aged 12-15 years: one tablet every 6 hours when necessary, up to a maximum of 4 tablets in 24 hours. This medicine should not be taken for more than 3 days. If the pain does not improve after 3 days, talk to your doctor for advice. Co-codamol should be used for the shortest duration necessary to relieve symptoms. If no effective pain relief is achieved while taking the medicine, you should seek the advice of a physician.
Children under 12 years
Co-codamol should not be taken by children below the age of 12 years, due to the risk of severe breathing problems. If you take more Co-codamol than you should:
Tell your doctor or go to your nearest hospital casualty department straight away. This is because of the risk of delayed, serious liver damage.
Remember to take any remaining tablets and the pack with you. This is so the doctor knows what you have taken. If you forget to take Co-codamol
If you forget to take a dose at the right time, take it as soon as you remember. However if it is almost time for your next dose, skip the missed dose. Do not take two doses at or near the same time. Remember to leave at least 4 hours between doses. If you stop taking Co-codamol
Do not suddenly stop taking this medicine. If you want to stop taking this medicine, discuss this with your prescriber first. They will tell you how to do this, usually by reducing the dose gradually so that any unpleasant withdrawal effects are kept to a minimum. Withdrawal symptoms such as restlessness, difficulty sleeping, irritability, agitation, anxiety, feeling your heartbeat (palpitations), increased blood pressure, feeling or being sick, diarrhoea, shaking, shivering or sweating may occur if you suddenly stop taking this medicine.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Important side effects you should know about Co-codamol
Taking a painkiller for headaches too often or for too long can make them worse
Taking codeine regularly for a long time can lead to addiction which might cause you to feel restless and irritable when you stop the tablets.
Stop taking Co-codamol and see a doctor or go to a hospital straight away if:
you have difficulty in breathing or you feel dizzy
you get swelling of the hands, feet, ankles, face, lips or throat which may cause difficulty in swallowing or breathing. You could also notice an itchy, lumpy rash (hives) or nettle rash (urticaria). This may mean you are having an allergic reaction to Co-codamol (frequency of this effect cannot be estimated from the available data)
you get serious skin reactions (very rare: may affect up to 1 in 10,000 people)
you get severe stomach pain, which may reach through to your back. This could be a sign of inflammation of the pancreas (very rare: may affect up to 1 in 10,000 people).
Other side effects have been reported:
Not known (frequency cannot be estimated from the available data)
problem affecting a valve in the intestines (sphincter of Oddi dysfunction)
Codeine-related side effects:
Frequency and severity are determined by dosage, duration of treatment and individual sensitivity: Constipation.
Feeling sick (nausea), being sick (vomiting).
Dizziness, light-headedness, drowsiness, confusion.
Difficulty in passing water (urine).
Becoming dependent on codeine.
Paracetamol related side effects:
Very Rare (may affect up to 1 in 10,000 people):
You get infections or bruise more easily than usual. This could be because of a blood problem (such as neutropenia or thrombocytopenia).
Frequency not known (frequency cannot be estimated from the available data):
Difficulty breathing, wheezing, tightness in the chest (bronchospasm).
Low blood pressure (hypotension) with high doses.
You get infections more easily than usual. This could be because of a blood problem called agranulocytosis.) A serious condition that can make blood more acidic (called metabolic acidosis), in patients with severe illness using paracetamol (see section 2)
Drug Withdrawal
When you stop taking Co-codamol, you may experience drug withdrawal symptoms, which include restlessness, difficulty sleeping, irritability, agitation, anxiety, feeling your heartbeat (palpitations), increased blood pressure, feeling or being sick, diarrhoea, shaking, shivering or sweating.
How do I know if I am addicted?
If you notice any of the following signs whilst taking Co-codamol, it could be a sign that you have become addicted. You need to take the medicine for longer than advised by your prescriber
You feel you need to use more than the recommended dose
You are using the medicine for reasons other than prescribed
When you stop taking the medicine you feel unwell, and you feel better once taking the medicine again. If you notice any of these signs, it is important you talk to your prescriber.
Reporting of Side Effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
5. How to store Co-codamol
Keep this medicine out of the sight and reach of children.
Do not use after expiry date stated on the pack.
Store your medicine in the original package in order to protect from light and moisture. Do not store above 25°C. Store this medicine in a safe and secure storage space, where other people cannot access it. It can cause serious harm and be fatal to people when it has not been intended for them.
Ask your pharmacist how to dispose of medicines no longer required. Do not dispose of medicines by flushing down a toilet or sink or by throwing out with your normal household rubbish. This will help protect the environment.
6. Contents of the pack and other information
What Co-codamol 30mg/500mg Effervescent Tablets contain
Each tablet contains 30mg of the active ingredient Codeine phosphate hemihydrate and 500mg of the active ingredient Paracetamol. Other ingredients are included to aid the manufacture of the tablets and to make them soluble. These other ingredients are sodium hydrogen carbonate, anhydrous sodium carbonate, anhydrous citric acid, sodium docusate, sorbitol (E420), saccharin sodium, dimeticone, sodium benzoate and macrogol.
What Co-codamol 30mg/500mg Effervescent Tablets look like and contents of the pack
Co-codamol 30mg/500mg Effervescent Tablets are white, bevelled, flat, round tablets.
Co-codamol 30mg/500mg Effervescent Tablets are available in blister packs of 28, 30, 50, 56 and 100 or in tube packs of 10, 16, 32 and 96. Not all pack sizes or types may be marketed.
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Tillomed Laboratories Limited, 220 Butterfield, Great Marlings, Luton, LU2 8DL, United Kingdom Manufacturer
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This leaflet was last revised in July 2026
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