Can I take Codeine and Paracetamol together?

It is generally considered safe to take codeine and paracetamol together as these medicines work in different ways to stop pain.

Paracetamol works mainly in the central nervous system to reduce pain signals and lower fevers, while codeine is an opioid that changes how your brain and nervous system respond to pain.

Because they use different pathways, their effects are 'additive', meaning they provide a stronger combined effect.

How to take codeine and paracetamol together safely

• Do not exceed the maximum dose for either medicine.

• Check other cold or pain medicines to make sure they don’t already have paracetamol or codeine, as too much paracetamol can seriously damage your liver.

Important precautions

Liver disease or heavy alcohol consumption

Taking paracetamol if you have liver problems or drink more than 14 units of alcohol per week significantly increases the risk of life-threatening liver damage, even at standard doses.

Asthma or breathing problems

Codeine can dangerously slow your breathing. You must not take it if you have severe asthma or chronic obstructive pulmonary disease (COPD), as it can lead to respiratory failure.

Opioid addiction or long-term use

Codeine is highly addictive. Using it for more than 3 days can lead to physical dependence and withdrawal symptoms; it should only be used for short-term pain relief.

Breastfeeding

Do not take codeine while breastfeeding. It passes into breast milk and can cause life-threatening breathing problems or extreme sleepiness in your baby.

Food and drink warnings

Alcohol

It is best to avoid or strictly limit alcohol when taking paracetamol and codeine. Combining alcohol with paracetamol increases the risk of serious liver damage. Combining alcohol with codeine can increase the sedative effects of the medicine, making you feel excessively sleepy, dizzy, or confused, and can lead to dangerous breathing difficulties.

Grapefruit juice

Grapefruit juice can interfere with how your body processes codeine. This may reduce the effectiveness of the pain relief or, in some people, increase the risk of side effects. It is best to avoid drinking large amounts of grapefruit juice while taking this medicine.

Caffeine (coffee, tea, energy drinks)

Be cautious with caffeine if you are taking 'co-codamol' (a combination of codeine and paracetamol) that already contains caffeine. Too much caffeine can cause tremors, a racing heart, and difficulty sleeping. If your medicine does not already contain caffeine, normal intake is usually fine.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.