Co-dydramol tablets for pain relief
Paramol, Remedeine
Peer reviewed by Dr Krishna Vakharia, MRCGPAuthored by Michael Stewart, MRPharmSOriginally published 18 Mar 2023
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Co-dydramol contains both paracetamol and dihydrocodeine. Do not take any other preparation which contains paracetamol while you are taking co-dydramol.
The usual dose for an adult is one or two co-dydramol tablets every 4-6 hours if needed. Do not take more than two tablets at a time or more than eight tablets in 24 hours.
Co-dydramol is likely to affect your reactions and your ability to drive. Do not drive until you know how it affects you.
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About co-dydramol tablets
Tipo de medicamento | A combination painkiller (analgesic) |
Utilizado para | Pain relief (analgesia) |
También llamado | Paramol®; Remedeine® |
Disponible como | Tabletas |
Co-dydramol contains two painkilling ingredients: paracetamol and dihydrocodeine. It is given to relieve short-lasting painful conditions where paracetamol alone is not sufficient. There are four different strengths of co-dydramol available, only one of which can be bought without a prescription at a pharmacy. The amount of paracetamol in the four different strengths is the same (500 mg), but the amount of dihydrocodeine differs and this determines the strength of the preparation.
The three main tablet strengths are: 10 mg/500 mg, 20 mg/500 mg, and 30 mg/500 mg, where the first number relates to how much dihydrocodeine is in the tablet, and the second is the amount of paracetamol present. Co-dydramol 7.46 mg/500 mg tablets can be bought from pharmacies as the brand Paramol®.
Combination painkillers like co-dydramol can be useful to reduce the total number of tablets that need to be taken in a day, but they may not always offer the best pain control. This is because it is difficult to adjust the dose to suit the level of your pain without increasing the risk of side-effects. Consequently, many doctors prefer not to prescribe combination painkillers.
Before taking co-dydramol tablets
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking co-dydramol it is important that your doctor knows:
Si está embarazada, esperando un bebé o en período de lactancia.
Si tiene algún problema con el funcionamiento del hígado o de los riñones.
Si tiene problemas de próstata o dificultades para orinar.
Si tiene algún problema respiratorio, como asma o enfermedad pulmonar obstructiva crónica (EPOC).
If you have been told you have low blood pressure or an abnormal heart rhythm.
Si tiene problemas de tiroides o glándulas suprarrenales.
Si padece epilepsia.
If you have gallstones or a problem with your gallbladder or bile duct.
Si ha estado estreñido durante más de una semana o tiene un problema inflamatorio intestinal.
Si padece una enfermedad que causa debilidad muscular, llamada miastenia gravis.
Si ha sufrido recientemente un traumatismo craneoencefálico grave.
If you have ever been dependent on drugs or alcohol.
Si alguna vez ha tenido una reacción alérgica a un medicamento.
Si está tomando otros medicamentos. Esto incluye cualquier medicamento que esté tomando y que pueda adquirirse sin receta, así como medicamentos a base de plantas y complementarios.
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How to take co-dydramol tablets
Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The manufacturer’s leaflet will give you more information about co-dydramol and a full list of side-effects which you may experience from taking it.
The usual dose for adults is one or two tablets every 4-6 hours if needed. Remember to leave at least four hours between doses and do not take more than two tablets at any one time or more than eight tablets in any 24-hour period. This maximum recommended dose for all strengths of co-dydramol is due to the paracetamol content of the tablets.
Swallow the tablets with a drink of water. You can take co-dydramol either before or after food, but taking your doses after food can help prevent feelings of sickness (nausea) which can occur with the first few doses.
If you forget to take a dose, take it when you next need pain relief and then continue as before, taking your doses every four to six hours if needed. Do not take two doses together to make up for a forgotten dose.
Aproveche al máximo su tratamiento
You can take co-dydramol that you have bought without a prescription, for up to three days. Do not take it for longer than this. If you are still in pain after the three days, speak with your doctor or pharmacist for further advice. You should also speak with your pharmacist or doctor for further advice if the co-dydramol does not relieve your pain.
Taking co-dydramol regularly to relieve a headache can actually make your headaches worse or more frequent. This is known as medication-overuse headache (also known as medication-induced headache). This can happen even when using co-dydramol at the recommended dose. General advice is that you should not take painkillers for a headache for more than two days at a time. Also you should not take them for more than two days in any week. Speak with a pharmacist or your doctor if you are worried about medication-overuse headache.
It is important that you do not take any other medicines which contain paracetamol while you are taking co-dydramol. Always check the label of any preparation you buy or take, as many painkillers and cold and flu preparations which can be bought over the counter contain paracetamol. Alternatively, ask your pharmacist to advise you on which preparations are safe for you to take alongside co-dydramol.
You should not drink alcohol while you are taking co-dydramol. This is because the dihydrocodeine it contains will increase the risk of side-effects from the alcohol.
You will not be given co-dydramol for longer than is necessary. This is because when you take medicines containing dihydrocodeine repeatedly over a period of time and then stop, it can cause withdrawal symptoms. These symptoms include restlessness and feeling irritable. If you have already been taking it for some time and want to stop, your doctor will recommend that you reduce your dose slowly in order to avoid the risk of these effects.
Medicines which contain dihydrocodeine are normally prescribed for short periods of time. If you take dihydrocodeine over a long period of time, your body can become used to it and it will not work as well. This is called tolerance.
Never take more than the dose recommended on the label. If you suspect that you or someone else might have taken an overdose, go to the accident and emergency department of your local hospital straightaway, even if you/they feel well. This is because taking too much co-dydramol can cause serious damage to your liver and possibly death in severe cases. Take the container with you so that the doctor knows what has been taken.
If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking a painkiller.
If you buy any medicines, check with a pharmacist that they are safe to take with co-dydramol.
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Can co-dydramol tablets cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with co-dydramol. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
Common co-dydramol side-effects | ¿Qué puedo hacer si me ocurre esto? |
Sentirse mal (náuseas) o estar enfermo (vómitos) | Comidas sencillas: evite los alimentos ricos o picantes. |
Estreñimiento | Seguir una dieta equilibrada y beber mucha agua. |
Dolor de cabeza | Make sure you are drinking enough fluids and be aware of medication-overuse headaches (see above) |
Sensación de sueño o somnolencia | Si esto ocurre, no conduzca ni utilice herramientas o máquinas. No bebas alcohol |
Important: people taking opioid medicines, and their family and friends, should be aware of the risk of accidental overdose and know when to seek medical help. The risk is higher if you also take other medicines that make you feel drowsy. Signs you have taken too much medicine include:
Sentirse muy somnoliento o mareado.
Sentirse enfermo (náuseas) o estar enfermo (vómitos).
Dificultades respiratorias.
Pérdida de conocimiento.
Overdose with co-dydramol has the extra complication of a paracetamol overdose, which can cause liver damage, kidney failure and death.
If you have taken more co-dydramol than you should or someone else accidentally swallows your medication, call for an ambulance and tell them the name of your medicine.
Si experimenta cualquier otro síntoma que considere que puede deberse a este medicamento, consulte a su médico o farmacéutico.
How to store co-dydramol
Mantenga todos los medicamentos fuera del alcance y de la vista de los niños.
Almacenar en un lugar fresco y seco, lejos del calor y la luz directos.
Información importante sobre todos los medicamentos
Información importante sobre todos los medicamentos
No tome nunca más de la dosis prescrita. Si sospecha que usted u otra persona ha tomado una sobredosis de este medicamento, acuda al servicio de urgencias de su hospital. Llévese el envase, aunque esté vacío.
Este medicamento es para usted. Nunca se lo dé a otras personas aunque su enfermedad parezca ser la misma que la suya.
No guarde medicamentos caducados o que no desee. Llévelos a su farmacia local, que se encargará de eliminarlos por usted.
Si tiene cualquier duda sobre este medicamento pregunte a su farmacéutico.
Informar de los efectos secundarios de un medicamento o vacuna
Si experimenta efectos secundarios, puede notificarlos en línea a través del sitio web de la Tarjeta Amarilla.
Lecturas complementarias y referencias
- Medicamentos BNF completa 89ª edición; Asociación Médica Británica y Real Sociedad Farmacéutica de Gran Bretaña, Londres.
- Manufacturer's PIL, Co-dydramol 10 mg/500 mg tablets; Zentiva, The electronic Medicines Compendium. Dated November 2022.
Historia del artículo
La información de esta página ha sido redactada y revisada por médicos cualificados.
Fecha prevista para la próxima revisión: 17 mar 2026
18 Mar 2023 | Originally published
Autores:
Michael Stewart, MRPharmSRevisado por expertos
Dr. Krishna Vakharia, MRCGP

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