Common questions about ibuprofen and codeine - Brand name: Nurofen Plus

Ibuprofen belongs to a group of medicines called NSAIDs (non-steroidal anti-inflammatory drugs). It works by reducing hormones that cause pain and swelling in the body.

Codeine is from a group of medicines called opioids. It works in the central nervous system and the brain to block pain signals to the rest of the body. It also reduces the anxiety and stress caused by pain.

When codeine blocks the pain, there are other unwanted effects, including slow or shallow breathing. It also slows down digestion, which is why codeine can cause constipation.

Combined ibuprofen and codeine works in 30 to 60 minutes and keeps on working for about 4 to 6 hours.

The ibuprofen in this medicine can cause ulcers in your stomach or gut, especially if you take it for a long time or in big doses. However, if you take it correctly, with food, for short periods of time, the risk is very low.

If you buy combined ibuprofen and codeine 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 it for a long time your doctor may also prescribe a medicine to help protect your stomach.

If you need to take combined ibuprofen and codeine for a long time, your body can get used to codeine (known as tolerance). 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 this medicine. For this reason, your dose will be reviewed to make sure you're only taking the amount you need to control your pain.

Speak to your doctor if you're worried about tolerance, hyperalgesia or becoming addicted.

If you take combined ibuprofen and codeine 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 buy combined ibuprofen and codeine 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 ongoing pain relief.

If you're addicted to the codeine in combined ibuprofen and codeine, 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 can 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 the medicine

The ibuprofen in this medicine can cause ulcers in your stomach or gut, especially if you take it for a long time or in big doses.

However, if you take it correctly, with food, for short periods of time, the risk is very low. Always follow the instructions that come with your medicine.

Some painkillers work better than others for certain types of pain. For example, the best painkiller to ease your headache may not be the best one for your backache.

The ibuprofen in combined ibuprofen and codeine means it can be particularly effective for period pain, back pain, strains and sprains.

Before taking combined ibuprofen and codeine, try taking paracetamol to see if that helps your pain. Paracetamol can help relieve most types of pain.

Combined ibuprofen and codeine is meant to be taken for short periods only, of up to 3 days.

This means it may not be suitable for treating longer term conditions unless your doctor prescribes it.

If you need pain relief for a long-term condition or ongoing pain, your doctor will be able to discuss the best treatment options with you.

Combined ibuprofen and codeine does not affect any type of contraception, including the combined pill, progestogen-only pill and emergency contraception.

However, if combined ibuprofen and codeine makes you vomit, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

Combined ibuprofen and codeine can make you feel sleepy or dizzy. If this happens to you, do not drive, cycle or operate tools or machinery, until you feel better.

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 combined ibuprofen and codeine is in your body.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking combined ibuprofen and codeine.

GOV.UK has more information on the law on drugs and driving.

Drinking alcohol while you're taking combined ibuprofen and codeine can make you feel more sleepy or increase the risk of serious side effects.

It's best to stop drinking alcohol while taking combined ibuprofen and codeine.

If you do choose to drink and you feel sleepy, stop drinking alcohol until you finish taking this medicine.

Apart from avoiding alcohol, you can eat and drink normally while taking combined ibuprofen and codeine.

In fact it's best to take ibuprofen and codeine with, or just after, a meal so it does not upset your stomach. Do not take it on an empty stomach.

If you take recreational drugs, such as cannabis, cocaine and heroin, while you're taking combined ibuprofen and codeine, you're more likely to get side effects. This is because of the codeine in combined ibuprofen and codeine.

Side effects can include:

• breathing difficulties
• heart problems
• seizures or fits
• going into a coma
• feeling sleepy and dizzy

Taking heroin while you're taking ibuprofen and codeine is especially dangerous. You're more likely to get all the side effects of the codeine, including addiction.

Speak to your doctor if you think you might take recreational drugs while taking ibuprofen and codeine.

Find out more about the side effects of recreational drugs on the Frank website