Editing Codeine/paracetamol

{{Short description|Compound medication}}
{{More citations needed|date=July 2012}}
{{Use dmy dates|date=January 2023}}
{{cs1 config |name-list-style=vanc |display-authors=6}}
{{Infobox drug
| Verifiedfields     = changed
| Watchedfields      = changed
| verifiedrevid      = 455046896
| type               = combo
| image              = Codeine and paracetamol.svg
| image_class        = skin-invert-image
| width              = 165
| alt                =

<!-- Combo data -->
| component1         = Codeine
| class1             = [[Opioid]] [[analgesic]]
| component2         = Paracetamol
| class2             = [[Anilide]] analgesic

<!-- Clinical data -->
| tradename          = Tylenol with codeine, others
| Drugs.com          = 
| MedlinePlus        = a601005
| DailyMedID         = Acetaminophen codeine
| pregnancy_AU       = <!-- A / B1 / B2 / B3 / C / D / X -->
| pregnancy_AU_comment = 
| pregnancy_category = 
| dependency_liability = 
| addiction_liability = 
| routes_of_administration = [[Oral administration|By mouth]]
| ATC_prefix         = N02
| ATC_suffix         = BE51
| ATC_supplemental   =

<!-- Legal status -->
| legal_AU           = S4
| legal_AU_comment   = 
| legal_BR           = <!-- OTC, A1, A2, A3, B1, B2, C1, C2, C3, C4, C5, D1, D2, E, F -->
| legal_BR_comment   = 
| legal_CA           = Schedule I
| legal_CA_comment   = <ref>{{cite web | title=Acetaminophen with Codeine Product information | website=Health Canada | date=25 April 2012 | url=https://health-products.canada.ca/dpd-bdpp/info.do?lang=en&code=31568 | access-date=13 September 2022 | archive-date=13 September 2022 | archive-url=https://web.archive.org/web/20220913075059/https://health-products.canada.ca/dpd-bdpp/info.do?lang=en&code=31568 | url-status=live }}</ref>
| legal_DE           = <!-- Anlage I, II, III or Unscheduled -->
| legal_DE_comment   = 
| legal_NZ           = <!-- Class A, B, C -->
| legal_NZ_comment   = 
| legal_UK           = POM
| legal_UK_comment   = /&nbsp;P<ref name="Boots PIL">{{cite web | title=Boots Paracetamol & Codeine 500mg/8mg Tablets - Patient Information Leaflet (PIL) | website=(emc) | date=30 November 2021 | url=https://www.medicines.org.uk/emc/product/13090/pil | access-date=17 July 2022 | archive-date=18 July 2022 | archive-url=https://web.archive.org/web/20220718044159/https://www.medicines.org.uk/emc/product/13090/pil | url-status=live }}</ref><ref name="Co-Codamol SmPC">{{cite web | title=Co-Codamol 15/500 Tablets - Summary of Product Characteristics (SmPC) | website=(emc) | date=25 March 2021 | url=https://www.medicines.org.uk/emc/product/4051/smpc | access-date=17 July 2022 | archive-date=5 August 2021 | archive-url=https://web.archive.org/web/20210805074246/https://www.medicines.org.uk/emc/product/4051/smpc | url-status=live }}</ref>
| legal_US           = Schedule III
| legal_US_comment   = /&nbsp;Schedule V<ref>{{Cite web |url=https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf |title=Controlled Substances - Alphabetical Order |access-date=29 June 2024 |archive-date=21 April 2021 |archive-url=https://web.archive.org/web/20210421180644/https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf |url-status=live }}</ref><ref>{{cite web | title=Acetaminophen and Codeine Phosphate tablet | website=DailyMed | date=31 July 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a9b11cbf-7585-4532-868f-5686f028679f | access-date=17 July 2022 | archive-date=18 March 2022 | archive-url=https://web.archive.org/web/20220318083011/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a9b11cbf-7585-4532-868f-5686f028679f | url-status=live }}</ref><ref>{{cite web | title=Acetaminophen and Codeine Phosphate solution | website=DailyMed | date=25 May 2022 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=83a536d8-385d-46ed-9cd2-47b7efe96ccf | access-date=17 July 2022 | archive-date=11 May 2021 | archive-url=https://web.archive.org/web/20210511045036/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=83a536d8-385d-46ed-9cd2-47b7efe96ccf | url-status=live }}</ref>
| legal_EU           = 
| legal_EU_comment   = 
| legal_UN           = <!-- N I, II, III, IV / P I, II, III, IV -->
| legal_UN_comment   = 
| legal_status       = <!-- For countries not listed above -->

<!-- Identifiers -->
| CAS_number         = 67889-72-9
| PubChem            = 11949633
| IUPHAR_ligand      = 
| DrugBank           = 
| ChemSpiderID_Ref   = {{chemspidercite|correct|chemspider}}
| ChemSpiderID       = 10123946
| UNII               = 
| KEGG               = D02146
| ChEBI              = 
| ChEMBL             = 
| synonyms           =

<!--Chemical data-->
}}

'''Codeine/paracetamol''', also called '''codeine/acetaminophen''' and '''co-codamol''', is a [[compound analgesic]], comprising [[codeine phosphate]] and [[paracetamol]] (acetaminophen). Codeine/paracetamol is used for the relief of mild to moderate [[pain]] when paracetamol or [[non-steroidal anti-inflammatory drug]]s (NSAIDs; such as [[ibuprofen]], [[aspirin]], and [[naproxen]]) alone do not sufficiently relieve symptoms.<ref name="Boots PIL" /><ref name="Co-Codamol SmPC" />

In 2022, it was the 166th most commonly prescribed medication in the United States, with more than 3{{nbsp}}million prescriptions.<ref>{{cite web | title=The Top 300 of 2022 | url=https://clincalc.com/DrugStats/Top300Drugs.aspx | website=ClinCalc | access-date=30 August 2024 | archive-date=30 August 2024 | archive-url=https://web.archive.org/web/20240830202410/https://clincalc.com/DrugStats/Top300Drugs.aspx | url-status=live }}</ref><ref>{{cite web | title = Acetaminophen; Codeine Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/AcetaminophenCodeine | access-date = 30 August 2024 }}</ref>

==Side effects==
The most common side effects include constipation, nausea and drowsiness.<ref name="NHS">{{cite web |url=https://www.nhs.uk/medicines/co-codamol-adults/ |title=Co-codamol for adults: painkiller containing paracetamol and codeine |newspaper=National Health Service |date=19 December 2018 |access-date=16 April 2021 |archive-date=14 January 2022 |archive-url=https://web.archive.org/web/20220114124849/https://www.nhs.uk/medicines/co-codamol-adults/ |url-status=live }}</ref>
Others include [[hemoptysis|coughing up blood from the lungs]], [[Rash|skin rashes]], [[dizziness]], [[sedation]], shortness of breath, [[hypersensitivity]] reaction, [[fainting]] (syncope or near syncope), [[confusion]], loss of [[short-term memory]], changes in [[blood]], allergic reactions, [[euphoria]], [[dysphoria]], abdominal pain, itchiness, easy [[bruise|bruising]], bleeding [[Gingiva|gums]], [[vivid dream]]s, dry mouth and addiction.<ref>{{cite book | vauthors = Nielsen S, Van Hout MC | title = Over-the-Counter Codeine-from Therapeutic Use to Dependence, and the Grey Areas in Between | series = Current Topics in Behavioral Neurosciences| volume = 34 | pages = 59–75 | date = 2017 | pmid = 26768736 | doi = 10.1007/7854_2015_422 | isbn = 978-3-319-60014-7 | hdl = 1959.4/unsworks_62273 | hdl-access = free }}</ref>

Genetic differences between people cause differing rates of metabolism of codeine to [[morphine]]. In about 5 percent of people this may happen particularly fast, causing morphine to be passed through breast milk in amounts that may cause fatal [[respiratory depression]] in a breastfed baby.<ref>{{cite news|title=Codeine Use While Breastfeeding May Be Dangerous|url=https://www.ctvnews.ca/codeine-use-while-breastfeeding-may-be-dangerous-1.317673|work=CTV News|date=20 August 2008|access-date=13 August 2020|archive-date=1 September 2008|archive-url=https://web.archive.org/web/20080901210431/https://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080820/tylenol_3_breastfeeding_080820/20080820|url-status=live}}</ref>

== Society and culture ==
=== Availability ===
Of the European Union member states, eleven allow [[Over-the-counter drug|over-the-counter]] sale of solid dosage forms of codeine, including codeine/paracetamol: Bulgaria, Cyprus, Denmark, France, Ireland, Latvia, Lithuania, Malta, Poland, Romania, and Slovenia.<ref>{{Cite journal|vauthors = Foley M, Harris R, Rich E, Rapca A, Bergin M, Norman I, Van Hout MC |title=The availability of over-the-counter codeine medicines across the European Union|url=https://www.academia.edu/19659390|journal=Public Health|date = November 2015|volume=129|issue=11|pages=1465–1470|doi=10.1016/j.puhe.2015.06.014|pmid=26215740|access-date=8 July 2020|archive-date=25 March 2022|archive-url=https://web.archive.org/web/20220325081404/https://www.academia.edu/19659390|url-status=live }}</ref>

==References==
{{Reflist}}

{{Analgesics}}
{{Anti-inflammatory products}}
{{Opioidergics}}
{{Portal bar | Medicine}}
{{Authority control}}

[[Category:Combination analgesics]]
[[Category:Hepatotoxins]]
[[Category:Opiates]]