Co-codamol (Kapake, Solpadol, Tylex)

Co-codamol is a type of painkiller. You might have it as a treatment for moderate pain. Co-codamol contains paracetamol. So don’t take co-codamol if you are already taking other medicines that contain paracetamol.

How co-codamol works

Co-codamol is a combination of two drugs – paracetamol and codeine.

Paracetamol controls pain by interfering with substances that the body makes in response to injury. These substances are called prostaglandins. Prostaglandins make nerves more sensitive, so you feel pain. By reducing the amount of prostaglandin you feel less pain, or none at all.

Codeine is a type of opioid. Opioids work by mimicking the body’s natural painkillers, endorphins. They control pain by blocking pain messages to the brain. There are different types of opioids – strong ones and weak ones. Codeine is a weak opioid.

How you have co-codamol

You take co-codamol as a:

• tablet that you swallow with water
• capsule that you swallow with water
• soluble tablet (effervescent or dispersible) that you dissolve in water

You should take the right dose, not more or less.

Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.

When you have co-codamol

Your doctor or nurse will tell you when to take co-codamol and how much to have. The normal dose for adults is 1 or 2 tablets every 4 to 6 hours. The maximum you should take is 8 in 24 hours.

Co-codamol is available in different doses. They all contain 500mg of paracetamol (the same as one regular paracetamol tablet or capsule) but the dose of codeine varies and can be 8mg, 15mg or 30 mg. The dose that is right for you will depend on the amount you need to control your pain. 

You can buy small packets of the lower dose preparations over the counter. But for larger packets and higher doses, you need a prescription from your doctor.

Side effects

How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having. 

When to contact your team

Your doctor, nurse, or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 
• your side effects aren’t getting any better
• your side effects are getting worse

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.

You might have one or more of these side effects. They include:

Bruising, bleeding gums or nose bleeds

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Increased risk of infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Mild allergic reaction

You might have a mild allergic reaction during or shortly after your treatment. This could be a rash, itching or a red face.

Mood changes

Mood changes can include feeling very sad or very happy. Tell your doctor or nurse if you’re having mood changes. They can arrange for you to talk to someone and give treatment if necessary.

You may also feel confused or anxious.

Drowsiness and dizziness

This drug may make you feel drowsy or dizzy. Don’t drive or operate machinery if you have this.

Headaches

Tell your doctor or nurse if you keep getting headaches.

Changes to your hearing

You might have some hearing loss, especially with high pitched sounds. Tell your doctor or nurse if you notice any changes.

Difficulty breathing

You may have difficulty breathing with wheezing and coughing. Let your healthcare team know straight away if this happens. 

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.

Constipation

Constipation is easier to sort out if you treat it early. Drink plenty of fluids and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your doctor, nurse or pharmacist if you are constipated for more than 3 days. They can prescribe a laxative.

Tummy (abdominal) cramps

Tell your treatment team if you have this. They can check the cause and give you medicine to help. 

Inflammation of the pancreas

This drug can cause inflammation of the pancreas (pancreatitis). Tell your doctor straight away if you have sudden and severe pain in your tummy (abdomen).

Difficulty passing urine

Skin problems

Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your nurse will tell you what products you can use on your skin to help.

You may also get hives which is a rash formed of pale red bumps on the skin.

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know?

Other medicines, foods and drinks

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Contraception and pregnancy  

It is unknown whether treatment may or may not harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment. Let your team know straight away if you or your partner falls pregnant while having treatment.

Talk to your doctor or nurse about effective contraception you can use during treatment. Ask how long you should use it before starting treatment and after treatment has finished.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment. For example, if you need treatment for anything else, including teeth problems.

Addiction

Taking codeine regularly for a long period of time can lead to addiction, which might cause you to feel restless and irritable when you stop taking the tablets.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

This page is due for review. We will update this as soon as possible.