Side Effects of Co-codamol

Co-codamol is a pain killer used to treat mild to moderate pain in adults and children over 12 years of age and it has side effects that affect several body systems. It is made up of a combination of codeine phosphate, an opioid, and paracetamol, or acetaminophen. It is not recommended for young children and pregnant women. The elderly are more sensitive and show more side effects. Before using this drug, you should consult a doctor and also read the manufacturer's leaflet.

Brain side effects

These include drowsiness, confusion, headache, sedation, loss of short-term memory, euphoria, abuse and dependence. The drug can also cause mood changes, such as depression. Rare side effects include convulsions, hallucinations, nightmares and uncontrolled muscle movements. The drug can also cause blurred or double vision. This is why patients are advised not to drive or use machinery, says the website

There is increased sedation if co-codamol is taken in combination with alcohol, antipsychotics, benzodiezepines, antihistamines, sleeping tablets or sedating antidepressants (See reference 1 and 3)

In 2009, a UK government watchdog suggested that people can become addicted to over the counter medication within three days (see Resource 4)

Stomach side effects.

Co-codamol's stomach side effects are fairly common and related to codeine. They include dry mouth, bleeding gums, constipation, nausea/vomiting, pancreatitis, abdominal pain and painful urination. It can also result in anorexia, according to the British National Formulary.

In acute alcoholism, it can slow bowel movements to dangerous levels, including paralytic ileus. Excessive consumption of co-codamol can cause liver damage ( see Reference 3)

Respiratory side effects

These include shortness of breath and in larger doses, respiratory depression. This is especially a risk in patients with chronic obstructive airways disease. Codeine should be avoided during an asthma attack. It should also be avoided in patients with head injuries.

Codeine crosses the placenta and is linked to respiratory and cardiac malformations in the baby. There are no studies to establish safety in pregnancy therefore use during pregnancy should be avoided. Physical dependence can occur in the baby. The drug also passes into breast milk. The amount of codeine is said to be too small to be harmful. Mothers may vary in their capacity to metabolize codeine resulting in a risk of morphine overdose in the baby, says the British National Formulary.

Cardiovascular side effects

Cardiovascular side effects of co-codamol include slow heart rate, fainting, low blood pressure and heart palpitations. There have been reports of blood disorders.

Generalized side effects

The speed that codeine breaks down varies considerably. This can lead to a reduced effect of the medication or increased side effects. Co-codamol should not be used in patients with moderate/severe renal and liver disease, obstructive airways disease. It should be used with caution in those with a enlarged prostate, myasthenia gravis, diseases of the biliary tract, thyroid diseases, convulsive disorders and by people with heart rhythm problems.

Other generalized side effects include allergic reactions, skin rashes, easy bruising, facial flushing and edema and itching.

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