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.

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.

Alcohol

You must avoid drinking alcohol while taking codeine. Alcohol increases the sedative effects of codeine, which can lead to extreme sleepiness, breathing difficulties, and a higher risk of overdose.

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.

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.