Co-dydramol – Combination painkiller for moderate to severe pain relief.
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What is Co-dydramol?
Co-dydramol is a combination painkiller that provides effective relief for moderate to severe pain through the synergistic effects of paracetamol and dihydrocodeine. While effective for pain management, it requires careful use due to the opioid component and risk of dependence.
Book an online consultation if you’re experiencing moderate to severe pain that hasn’t responded to simple painkillers, need pain management assessment, or require guidance on appropriate pain relief options. Our GPs can evaluate your pain and determine if Co-dydramol or other pain management strategies are appropriate for your specific condition.
What is Co-dydramol used for?
- Moderate to severe pain
- Post-operative pain
- Chronic pain conditions
- Back pain and sciatica
- Arthritis pain
- Cancer-related pain
- Dental pain (severe)
- Pain not responding to paracetamol alone
How does Co-dydramol work?
Combines paracetamol (500mg) with dihydrocodeine (10mg or 20mg), providing dual pain relief through different mechanisms—paracetamol blocks pain signals and dihydrocodeine acts on opioid receptors in the brain.
Dosage and Administration
Adults
1-2 tablets every 4-6 hours as needed. Maximum 8 tablets daily. Available as 10/500mg or 20/500mg combinations.
Children
Not recommended for children under 12 years due to dihydrocodeine content.
Important Notes
- Take with or without food.
- Do not exceed maximum daily dose of paracetamol (4g from all sources).
- Take only when needed for pain—not for regular scheduled use unless advised.
- Allow at least 4 hours between doses.
Side Effects
Common Side Effects
- Constipation
- Nausea and vomiting
- Drowsiness
- Dizziness
- Dry mouth
- Headache
- Fatigue
Serious Side Effects
Seek immediate medical attention if you experience:
- Breathing difficulties (respiratory depression)
- Severe allergic reactions
- Liver damage (paracetamol overdose)
- Physical dependence and addiction
- Severe constipation or bowel obstruction
- Confusion (especially in elderly)
Important Warnings
- Contains an opioid—risk of dependence with regular use.
- Do not exceed stated dose—risk of paracetamol poisoning.
- May cause drowsiness—avoid driving or operating machinery.
- Tell your GP if you have liver problems, kidney disease, or breathing difficulties.
- Avoid alcohol as it increases drowsiness and liver toxicity risk.
Drug Interactions
Tell your GP if you're taking any of the following medications:
- Alcohol—dangerous increase in sedation and liver toxicity.
- Other paracetamol-containing medicines—risk of overdose.
- Warfarin—paracetamol may enhance anticoagulant effects with regular use.
- Other sedating medications—increased drowsiness and breathing depression.
- MAOIs—may enhance opioid effects.
Frequently Asked Questions
How is Co-dydramol different from Co-codamol?
Co-dydramol contains dihydrocodeine instead of codeine. Dihydrocodeine is considered more potent and may provide better pain relief for some people.
Can I become addicted to Co-dydramol?
Yes, the dihydrocodeine component can cause physical dependence with regular use. Use only as needed for pain and discuss with your GP if you need it regularly.
Why am I constipated when taking Co-dydramol?
Dihydrocodeine slows bowel movements, which is a common side effect of all opioid medications. Increase fluids, fiber, and consider a laxative if needed.
Can I take other paracetamol with Co-dydramol?
No, Co-dydramol already contains the maximum safe dose of paracetamol. Taking additional paracetamol could cause dangerous liver damage.
Medically Reviewed by: Mohammed Hassan - Independent Prescriber
Last Updated: 2025-01-14