1. About co-codaprin
Co-codaprin is a mixture of 2 different painkillers: aspirin and codeine.
It's used to treat aches and pains, including headaches, muscular pain, migraine and toothache. It can also be used to treat the symptoms of colds and flu.
Aspirin belongs to a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs).
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.
It's usually taken when everyday painkillers, such as paracetamol, ibuprofen and aspirin alone, have not worked.
This medicine comes as tablets. It's available on prescription. Co-codaprin is available without a prescription, but only from a pharmacy.
2. Key facts
- Co-codaprin is another name for aspirin and codeine.
- If you buy co-codaprin from a pharmacy and your pain is not better after 3 days, it's important to ask your doctor for advice about ongoing pain relief.
- It's possible to become addicted to the codeine in this medicine if you take it for too long. Only take it when you need it for pain relief.
- It's best to take co-codaprin with or just after eating food. You'll be less likely to get mild indigestion or stomach pain. These are common side effects of co-codaprin.
- Never give co-codaprin to children under 16 years old, unless their doctor prescribes it. This is because it contains aspirin, which can cause serious side effects in children.
3. Who can and cannot take co-codaprin
Who can take co-codaprin
Most people aged 16 years old and over can safely take co-codaprin. But co-codaprin is not suitable for some people.
There's a possible link between the aspirin in co-codaprin and Reye's syndrome in children. Reye's syndrome is a very rare condition that can cause serious liver and brain damage.
Do not give co-codaprin to anyone aged 18 years or under who has had their tonsils or adenoids taken out to treat obstructive sleep apnoea.
Important: Children under 16 years
Never give co-codaprin to children younger than 16 years old, unless their doctor prescribes it.
Who may not be able to take co-codaprin
To make sure co-codaprin is safe for you, tell your doctor or pharmacist if you:
- have ever had an allergy to aspirin or codeine (or similar painkillers such as ibuprofen and morphine)
- have surgery planned – you'll need to stop taking aspirin several days before you have surgery (including dental surgery)
- have ever had a blood clotting problem
- have ever had a stomach ulcer
- have indigestion
- have recently had a stroke, although it depends on the kind of stroke you have had (your doctor may recommend that you take low-dose aspirin to prevent another one)
- have low blood pressure (hypotension) or high blood pressure (hypertension)
- have asthma or lung disease
- have liver or kidney problems
- have gout – it can get worse for some people who take aspirin
- get heavy periods – they can get heavier with aspirin
- have a head injury or a condition that causes seizures or fits
- have adrenal gland problems or an underactive thyroid gland
- have an addiction to alcohol or drugs
- have gallstones
- have an enlarged prostate
- have myasthenia gravis (a rare condition that causes muscle weakness)
- have symptoms of ulcerative colitis (a bowel condition)
- have glucose-6-phosphate dehydrogenase (G6PD) deficiency
- are pregnant, trying to get pregnant or want to breastfeed
4. How and when to take co-codaprin
Follow the instructions that come with your medicine. This is particularly important because the codeine in co-codaprin can be addictive.
Dosage and strength
The strength of co-codaprin appears as 2 numbers on the packet, for example, as 8/400. This means it contains 8mg of codeine and 400mg of aspirin.
The usual dose for adults (over the age of 18) is 1 or 2 co-codaprin tablets, up to 4 times in 24 hours.
Always leave at least 4 hours between doses.
The maximum dose is 8 tablets in 24 hours.
The usual dose for teenagers aged 16 to 18 years old is the same. They should not have co-codaprin, however, if they have had their tonsils or adenoids taken out to treat obstructive sleep apnoea.
Important
Do not take more than 8 co-codaprin tablets in 24 hours.
How to take it
Swallow co-codaprin tablets whole with a drink of water. It's best to take them with or just after food.
How long to take it for
If you have bought co-codaprin from a pharmacy, do not use it for more than 3 days. If you still have pain, talk to your pharmacist or doctor. It's important to ask them for advice about ongoing pain relief.
If your doctor has prescribed co-codaprin for you, follow their advice carefully.
If you take too much
If you take 1 or 2 extra tablets of co-codaprin on a single occasion, it's unlikely to be harmful.
If this happens, wait at least 24 hours before you take any more. Taking more than this can be dangerous.
If you have taken too much co-codaprin by mistake, you may feel very sleepy, sick or dizzy. You may also find it difficult to breathe.
In serious cases, you can become unconscious and may need emergency treatment in hospital.
Urgent advice: Contact 111 for advice now if:
- you take more than your usual dose of co-codaprin and feel sleepy, sick or dizzy
Go to 111.nhs.uk or call 111
Immediate action required: Call 999 or go to A&E now if:
- you take too much co-codaprin and have difficulty breathing
If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.
Bring the co-codaprin packet or leaflet inside it, any remaining medicine, and any other medicines you take.
5. Taking co-codaprin with other painkillers
It's safe to take co-codaprin with paracetamol.
Do not take co-codaprin with any other medicines that contain codeine.
Also do not take it with any other non-steroidal anti-inflammatory drugs (NSAIDs) including aspirin, ibuprofen or naproxen. If you take NSAIDs together, it may increase the chance of you getting side effects like stomach ache or bleeding.
These painkillers are often included in medicines you can buy from pharmacies. For example, Nurofen or Nurofen Plus, or cough and cold remedies such as Nurofen Cold & Flu or Beechams Powders.
Important
Before taking any other medicines, check the label to see if they contain codeine, aspirin, ibuprofen or other NSAIDs.
6. Side effects
Like all medicines, co-codaprin can cause side effects, although not everyone gets them. Many people have no side effects or only minor ones.
Common side effects
These side effects happen in more than 1 in 100 people. Tell your doctor if these side effects bother you or do not go away:
- mild indigestion
- feeling or being sick (nausea or vomiting)
- constipation
- feeling sleepy
- bleeding more easily than normal – because aspirin thins your blood, it can sometimes make you bleed more easily (for example, you may get nosebleeds, bruise more easily and, if you cut yourself, the bleeding may take longer than normal to stop)
- dizziness and vertigo (a sensation of spinning)
- headaches
Serious side effects
Serious side effects are rare and happen in less than 1 in 100 people.
Contact a doctor straight away if you have:
- a change in your normal heart rate (slower or faster) and you feel dizzy or very tired – these can be signs of a heart problem
- a fit or seizure
- difficulty breathing or short, shallow breathing
- stiffness in your muscles
- feeling faint when you stand up or sit quickly – this can be a sign of low blood pressure
- coughing up blood or blood in your pee, poo or vomit
- dark pee or the whites of your eyes turn yellow – this can be a sign of liver problems
- painful joints in your hands and feet – this can be a sign of high levels of uric acid in the blood
- swollen hands or feet – this can be a sign of a build-up of fluid in your body
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to co-codaprin.
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.
Do not drive yourself to A&E.
The person you speak to at 999 will give you advice about what to do.
Long-term side effects
If you've bought co-codaprin from a pharmacy, do not use it for more than 3 days. If your pain has not gone away, talk to a pharmacist or doctor.
If you need to take co-codaprin for a long time, your body can become tolerant to the codeine in it. That means you need higher doses to control your pain over time.
Some people can become more sensitive to pain (hyperalgesia). If this happens, your doctor will reduce your dose gradually to help these symptoms.
It's possible to become addicted to the codeine in co-codaprin. For this reason, your dose will be reviewed to make sure you're only taking the amount you need to control your pain.
Your treatment plan may include details of how and when you'll stop taking co-codaprin.
If you're having treatment for cancer pain or other severe pain, your pain control will be carefully monitored. Speak to your doctor if you're worried about tolerance, hyperalgesia or becoming addicted.
Other side effects
These are not all the side effects of co-codaprin. For a full list, see the leaflet inside your medicine packet.
Reporting side effects
You can report any suspected side effect using the Yellow Card safety scheme.
Visit the Yellow Card website for more information about reporting side effects.
7. How to cope with side effects of co-codaprin
What to do about:
- mild indigestion – take your co-codaprin with food or just after a meal. If the indigestion still does not go away, it could be a sign that the co-codaprin has caused a stomach ulcer. Talk to your doctor, as they may prescribe something to protect your stomach or switch you to a different medicine.
- feeling or being sick (nausea or vomiting) – take co-codaprin with or just after a meal or snack. Feelings of sickness should normally wear off after a few days. Talk to your doctor about taking an anti-sickness medicine if it carries on for longer.
- constipation – get more fibre into your diet, such as fresh fruit and vegetables and cereals. Try to drink several glasses of water or another non-alcoholic liquid each day. If you can, it may also help to increase your level of exercise.
- feeling sleepy or tired – do not drive, cycle or use tools or machinery if you're feeling this way. Do not drink any alcohol, as this will make you feel more tired.
- bleeding more easily than normal – be careful when doing activities that may cause an injury or a cut as it may take longer than usual for any bleeding to stop.
- dizziness and vertigo – if you feel dizzy or unsteady, stop what you're doing and sit or lie down until you feel better. Do not drive, cycle or use tools or machinery if you're feeling dizzy. Do not drink alcohol, as it will make you feel worse.
- headaches – make sure you rest and drink plenty of fluids. It's best not to drink too much alcohol. Talk to your doctor if the headaches last longer than a week or are severe.
8. Pregnancy and breastfeeding
Co-codaprin and pregnancy
Co-codaprin is not recommended during pregnancy. There are safer medicines you can take. Ask your doctor or pharmacist for advice.
For most women, paracetamol is the best painkiller to take in pregnancy.
Co-codaprin and breastfeeding
Co-codaprin is not recommended while breastfeeding.
For most women it's better to take paracetamol or ibuprofen for pain or a high temperature while you're breastfeeding.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
- pregnant
- breastfeeding
For more information about how pain relief can help you during pregnancy, visit the Best Use of Medicines in Pregnancy (BUMPS) website.
9. Cautions with other medicines
Some medicines can affect the way co-codaprin works. And co-codaprin can affect the way some medicines work.
Tell your doctor if you're taking any other medicines, especially:
- medicines that help to prevent blood clots such as warfarin and clopidogrel
- medicines for pain and swelling (inflammation), such as ibuprofen and naproxen
- sleeping pills, antidepressants or lithium (a medicine for mental health problems)
- medicines to stop you feeling or being sick, such as domperidone or metoclopramide
- medicines to treat infection, particularly rifampicin and ciprofloxacin
- epilepsy medicines
- medicines to prevent organ rejection after transplant, such as ciclosporin and tacrolimus
- steroids, such as prednisolone
- medicines to treat high blood pressure, such as ramipril
- diuretics (medicines to make you pee more), such as bendroflumethiazide and furosemide
- digoxin, a medicine for heart problems
- acetazolamide, for an eye problem called glaucoma
- methotrexate, a medicine used to calm your immune system and treat some types of cancer
- diabetes medicines, such as gliclazide
- antihistamines that make you feel drowsy, like chlorphenamine
Mixing co-codaprin with herbal remedies and supplements
It's not possible to say that herbal remedies or supplements are safe to take with co-codaprin.
They are 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: Medicine safety
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
10. Common questions about co-codaprin
How does co-codaprin work?
Co-codaprin contains aspirin and codeine. These 2 painkillers work in different ways to relieve pain.
Aspirin belongs to a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs).
If you have been hurt or have an infection, your body makes hormones called prostaglandins. The prostaglandins cause swelling and sometimes a high temperature, and they send pain signals to the brain.
This is all part of your body's natural response to injury. The swelling and high temperature can help your body heal.
Aspirin stops your body making prostaglandins, and this reduces the pain, swelling and high 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 I feel better?
Co-codaprin takes up to 1 hour to work. It keeps on working for about 4 hours.
Are there any long-term side effects?
If you've bought co-codaprin from a pharmacy, do not use it for more than 3 days. If your pain has not gone away, talk to a pharmacist or doctor.
If you need to take co-codaprin for a long time, your body can become tolerant to the codeine in it. That means you need higher doses to control your pain over time.
Some people can become more sensitive to pain (hyperalgesia). If this happens, your doctor will reduce your dose gradually to help these symptoms.
It's possible to become addicted to the codeine in co-codaprin. For this reason, your dose will be reviewed to make sure you're only taking the amount you need to control your pain.
Your treatment plan may include details of how and when you'll stop taking co-codaprin.
If you're having treatment for cancer pain or other severe pain, your pain control will be carefully monitored. Speak to your doctor if you're worried about tolerance, hyperalgesia or becoming addicted.
Can I become addicted to co-codaprin?
If you take co-codaprin regularly for a long time, you can become addicted to the codeine in it.
You're unlikely to become addicted if you follow your doctor's advice carefully about how long to take it for.
If you've bought co-codaprin at a pharmacy, follow the instructions that come with the medicine and only take it for up to 3 days at a time. If your pain is not better after 3 days, it's important to ask your doctor for advice about further pain relief.
How will I know if I'm addicted?
If you're addicted to the codeine in co-codaprin, you may find it difficult to stop taking it or feel you need to take it more often than necessary.
If you stop taking codeine suddenly, you may get withdrawal symptoms.
These can include:
- feeling agitated or anxious
- panic attacks
- feeling your heartbeat (palpitations)
- difficulty sleeping
- shaking
- sweating
- body aches
- feeling restless
Talk to your doctor if you:
- are worried about addiction
- need help with addiction
- want to stop taking codeine
Can I take co-codaprin for a long time?
It's not usually recommended to take co-codaprin that you have bought from a pharmacy for longer than 3 days.
It's best to take the lowest dose that works for you for the shortest possible time.
That way there's less chance that you'll get unwanted side effects like stomach ache.
If you need to take co-codaprin for longer than 3 days, ask your doctor or pharmacist for advice.
Is co-codaprin better than paracetamol or ibuprofen for pain relief?
Not necessarily. Paracetamol, ibuprofen, aspirin and codeine are all effective painkillers.
Some painkillers work better than others for certain pains. For example, the best painkiller to ease your headache may not be the best one for your backache.
Try taking one of these painkillers before trying co-codaprin to see if it helps your pain:
- Paracetamol can relieve most types of pain. It's typically used for mild or moderate pain. It may be better than aspirin for headaches, toothache, sprains, stomach ache, and nerve pain like sciatica.
- Ibuprofen works in a similar way to aspirin. It can be used for back pain, strains and sprains, as well as pain from arthritis. It's also good for toothache and period pain.
- Aspirin may be better than paracetamol for some pains, such as period pain or migraines. But if you have heavy periods, aspirin can make them heavier. Some people find aspirin better than paracetamol for back pain.
- Codeine should only be used if aspirin, ibuprofen or paracetamol alone have not been effective. This is because it's used to treat moderate to severe pain – for example, after an operation or injury.
Can I drive or ride a bike with it?
Do not drive a car or ride a bike if co-codaprin makes you sleepy during the daytime, gives you blurred vision or makes you feel dizzy, clumsy or unable to concentrate or make decisions.
This may be more likely when you first start taking co-codaprin, but could happen at any time – for example, when starting another medicine.
It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
Even if your ability to drive is not affected, the police have the right to request a saliva sample to check how much co-codaprin is in your body.
GOV.UK has more information on the law on drugs and driving.
Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking co-codaprin.
Can I drink alcohol with it?
Drinking alcohol while you're taking co-codaprin can irritate your stomach and make you feel more sleepy.
It's best to stop drinking alcohol during the first few days of treatment until you see how the co-codaprin affects you.
If you feel sleepy with co-codaprin, stop drinking alcohol while you're taking it.
Is there any food or drink I need to avoid?
Apart from limiting alcohol, you can eat and drink normally while taking co-codaprin.
Can co-codaprin make you put on weight?
There's no evidence that taking co-codaprin will make you put on weight or lose it.
Will it affect my contraception?
Co-codaprin does not affect any type of contraception, including the combined pill or emergency contraception.
Will it affect my fertility?
If you're taking co-codaprin for a short time and at normal doses, there's no clear evidence that it can reduce fertility.
But if you have been taking it for a long time and you're concerned about your fertility, or you're trying to get pregnant, speak to a pharmacist or your doctor.
Will recreational drugs affect it?
If you take recreational drugs, such as cannabis, cocaine and heroin, while you're taking co-codaprin, you're more likely to get the serious side effects of the codeine in co-codaprin.
These include breathing difficulties, heart problems, fits or seizures, and even going into a coma.
Some recreational drugs, such as cannabis, make you more likely to have side effects from the codeine. These include sleepiness and dizziness.
Taking heroin while you're on prescribed co-codaprin is especially dangerous. You're more likely to get all the side effects of the codeine in co-codaprin, including addiction.
Speak to your doctor if you think you might take recreational drugs while taking co-codaprin.