Co-codamol 8/500mg Tablets

Always take this medicine exactly as described in this leaflet or as your doctor or pharmacist has told you.

Check with your doctor or pharmacist if you are not sure.

The recommended dose is:

Adults over 18 years: • The recommended dose is one or two tablets to be swallowed with water. • The dose should not be taken more frequently than every 4-6 hours and not more than 4 times in any 24-hour period. • The maximum daily dose is 8 tablets (4g of paracetamol and 64mg of codeine phosphate) in any 24-hour period in divided doses. Children aged 16 years to 18 years:

Children aged 16 years or above should take one or two tablets every 6 hours, as needed. Do not take more than 8 tablets in 24 hours.

Children aged 12 years to 15 years: The recommended dose for children aged 12 years to 15 years is 1 tablet every 6 hours when needed. Do not take more than 4 tablets in 24 hours.

Children aged less than 12 years: Co-codamol should not be given to children below the age of 12 years, due to the risk of severe breathing problems.

Do not take for more than 3 days. If you need to use this medicine for more than three days you must speak to your doctor or pharmacist. If you stop taking Co-codamol tablets • This medicine contains codeine and can cause addiction if you take it continuously for more than three days. When you stop taking it you may get withdrawal symptoms such as tremors, difficulty sleeping, feeling or being sick, sweating and increased heart rate, breathing or blood pressure. You should talk to your doctor or pharmacist if you think you are suffering from withdrawal symptoms. Do not exceed the stated dose.

If symptoms persist consult your doctor. If you take more Co-codamol tablets then you should seek immediate medical advice in the event of an overdose, even if you feel well, because of the risk of delayed, serious liver damage. If you (or someone else) swallow a lot of tablets at the same time, or you think a child may have swallowed contact your nearest hospital casualty department or tell your doctor immediately. Symptoms of an overdose include feeling or being sick, loss of appetite, stomach pain, coma, pale skin, low blood pressure, pinpoint pupils, fast heartbeat or difficulty breathing. Signs of overdose include feeling or being sick, loss of appetite, stomach pain, coma, pale skin, low blood pressure, pinpoint pupils, fast heartbeat or difficulty breathing.

 If you forget to take Co-codamol Tablets Do not take a double dose to make up for a forgotten dose. If you forget to take a dose take it as soon as you remember it and then take the next dose at the right time.

• This medicine contains paracetamol. Do not take anything else containing paracetamol while taking this medicine.
• This medicine contains codeine which can cause addiction if you take it continuously for more than 3 days. This can give you withdrawal symptoms from the medicine when you stop taking it.
• If you take a painkiller for headaches for more than 3 days it can make them worse.

Warnings and precautions
Do not take co-codamol and tell your doctor if:

• You are taking medicines to treat depression called MAOIs (monoamine oxidase inhibitors) or have taken them in the last 2 weeks. MAOIs are medicines such as moclobemide, phenelzine, tranylcypromine
• You are allergic to the active substances or any of the other ingredients in your medicine. Signs of an allergic reaction include a rash and breathing problems. There can also be swelling of the legs, arms, face, throat or tongue
• The person going to take the tablets is under 12 years of age. Co-codamol must not be given to children under 12 years of age
• You are under 18 years of age and have had your tonsils or adenoids removed due to obstructive sleep apnoea syndrome
• You know that you metabolise very rapidly codeine into morphine
• You are breastfeeding or planning to breastfeed

Do not take co-codamol if any of the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking co-codamol.

Take special care and check with your doctor before taking co-codamol if:

• You have severe kidney or liver problems
• You are taking a benzodiazepine
• You suffer from seizures

Codeine is transformed to morphine in the liver by an enzyme. Morphine is the substance that produces pain relief. Some people have a variation of this enzyme and this can affect people in different ways. In some people, morphine is not produced or produced in very small quantities, and it will not provide enough pain relief. Other people are more likely to get serious side effects because a very high amount of morphine is produced. If you notice any of the following side effects, you must stop taking this medicine and seek immediate medical advice: slow or shallow breathing, confusion, sleepiness, small pupils, feeling or being sick, constipation, lack of appetite.

Use in children and adolescents after surgery
Co-codamol should not be used for pain relief in children and adolescents after removal of their tonsils or adenoids due to Obstructive Sleep Apnoea Syndrome.

Use in children with breathing problems
Co-codamol is not recommended in children with breathing problems, since the symptoms of morphine toxicity may be worse in these children. If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before taking this medicine.