PATIENT INFORMATION LEAFLET
Co-dydramol tablets 10/500mg
(dihydrocodeine tartrate and paracetamol)
Read all of this leaflet carefully before you start taking this medicine.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or pharmacist.
- This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as
1 What Co-dydramol tablets are and what they are used for
2 Before you take
3 How to take
4 Possible side effects
5 How to store
6 Further information
2 Before you take
Do not take Co-dydramol tablets and tell your doctor if you:
- are allergic (hypersensitive) to paracetamol, dihydrocodeine or other opioids, or any of the ingredients in the tablet
(see section 6)
- have diarrhoea caused by poisoning or severe bloody diarrhoea (pseudomembranous colitis)
- have difficulty breathing, or other chronic lung disease
- are having an asthma attack.
Check with your doctor or pharmacist before taking Co-dydramol tablets if you have:
liver or kidney problems
- diseased adrenal glands (Addison’s disease) or high blood pressure caused by a tumour near a kidney
inflammatory bowel disease
gall bladder disease or gall stones
- recently had surgery on your gastro-intestinal tract or urinary system
- an enlarged prostate gland and have difficulty urinating and are male
epilepsy or suffered head injury or raised pressure in the skull (may cause painful eyes, changes in vision
or headache behind the eyes)
- an underactive thyroid gland
- muscle weakness (myasthenia gravis)
low blood pressure or are in shock
- suffered from alcoholism, drug abuse or dependence or mental illness.
Other important warnings:
do not take for longer than directed by your prescriber
taking dihydrocodeine regularly for a long time can lead to addiction, which might cause you to feel restless and irritable
when you stop the tablets
taking a painkiller for headaches too often or for too long can make them worse.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained
without a prescription. Especially:
- ciprofloxacin (antibacterial medicine)
- Monoamine Oxidase Inhibitors (MAOIs, e.g. moclobemide or have taken these within the last 2 weeks)
- oral contraceptives (the “pill”)
- medicines to prevent blood clotting such as warfarin
- cyclizine, metoclopramide or domperidone (to prevent sickness)
- guanethidine or diuretics (“water tablets”) e.g. spironolactone, furosemide (to treat high blood pressure)
- mexiletine (to treat irregular heartbeats)
- loperamide or kaolin (to treat diarrhoea)
- selegiline (for Parkinson’s disease)
- phenytoin (to treat epilepsy)
- cimetidine (to treat stomach ulcers)
- atropine or hyoscine (anticholinergic medicines)
- cisapride (to treat gastro-oesophageal reflux disease)
- ritonavir (antiviral medicine)
- medicines which affect the nervous system such as sleeping tablets, diazepam, hydroxyzine and medicines to
treat mental illness
- medicines to treat depression (e.g. tranylcypromine, amitriptyline)
- medicines which affect the liver (e.g. primidone and rifampicin)
- colestyramine (to treat high cholesterol levels)
- muscle relaxants
- barbiturates (e.g. phenobarbital)
- opioid antagonists (buprenorphine, naltrexone, naloxone)
If your diet is poor or you have a low protein intake, you may be at a higher risk of serious paracetamol poisoning when taking
Driving and using machines
Co-dydramol tablets may cause dizziness, blurred vision or the inability to think clearly. Make sure you are not affected before you
drive or operate machinery.
The medicine can affect your ability to drive as it may make you sleepy or dizzy.
- Do not drive while taking this medicine until you know how it affects you.
- It is an offence to drive if this medicine affects your ability to drive.
- However, you would not be committing an offence if:
- The medicine has been prescribed to treat a medical or dental problem and
- You have taken it according to the instructions given by the prescriber or in the information provided with the medicine
- It was not affecting your ability to drive safely
Talk to your doctor or pharmacist if you are not sure whether it is safe for you to drive while taking this medicine.
Pregnancy and breast-feeding
Do not take Co-dydramol tablets during pregnancy or whilst breast-feeding, unless advised by your doctor. Regular use during
pregnancy may cause withdrawal symptoms in the newborn.
3 How to take
Always take Co-dydramol tablets exactly as your doctor has told you. If you are not sure, check with your doctor or pharmacist.
Do not drink alcohol whilst taking Co-dydramol tablets.
Swallow the tablets with water, during or after meals.
Co-dydramol tablets are normally used only for short-term relief of symptoms, take this medicine for as long as your doctor tells you
to, it may be dangerous to stop without their advice.
- Adults and children over 12 years: 1-2 tablets every 4 hours up to a maximum of 8 tablets in a day
- Children under 12 years: Not recommended
- Elderly: Dosage is usually reduced in the elderly
If you take more than you should
Immediate medical advice should be sought 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 any 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 or liver damage, coma, clammy skin, fits, confusion, drowsiness, tiredness, low blood pressure, pinpoint pupils, slow heart
beat or breathing rate.
If you forget to take the 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 least 4 hours later.
If you stop taking the tablets
If you stop taking the tablets you may develop the following withdrawal symptoms tremor, difficulty sleeping, feeling or being sick,
sweating and increased heart rate, breathing or blood pressure.
4 Possible side effects
Like all medicines, Co-dydramol tablets can cause side effects, although not everybody gets them. Please tell your doctor or pharmacist
if you notice any of the following effects or any effects not listed.
Contact your doctor at once if the following side effects occur:
Allergic Reactions - skin rash or itchy skin, difficulty breathing, increased sweating, redness or flushed face, mucosal
lesions (such as mouth ulcers), drug fever
Abdominal pain - may be caused by spasm of the bile ducts and inflammation of the liver or pancreas
Tell your doctor if you notice any of the following side effects or notice any other effects not listed:
Gastrointestinal system - stomach irritation (mild stomach pain, heartburn and feeling sick), constipation, feeling or
being sick, loss of appetite, dry mouth, difficulty in the passage of food through guts.
Heart - slow heart rate, palpitations, low blood pressure especially on standing, inflammation of the heart
Blood - anaemia, changes in numbers and types of blood cells. If you have an increase in number of nose bleeds or notice
that you bruise more easily or have more infections talk to your doctor
Urinary system - pain and difficulty in passing urine and a less frequent need to do so, kidney problems.
Nervous system - confusion, drowsiness, dizziness, ‘spinning’ sensation, mood changes, depression, hallucinations (seeing
or hearing things that are not real), restlessness, excitation, fits, increased pressure in the skull (painful eyes, changes in vision or
headache behind the eyes), headache, difficulty sleeping, nightmares, reduced alertness. Tolerance (medicine has less effect) or
dependence (suffer from withdrawal symptoms e.g. tremor, sweating, increased heart rate, increased breathing rate, raised blood
pressure and feeling or being sick if the medicine is stopped too quickly)
Eyes - blurred or double vision, extremely small pupils
Others - trembling, unusual tiredness or weakness, malaise, low body temperature, breathing difficulties, muscle
stiffness, changes in sex drive
If you notice any side effects, they get worse, or if you notice any not listed, please tell your doctor or pharmacist.
5 How to store
Keep out of the reach and sight of children.
Store below 25°C in a dry place, protected from light
Do not use Co-dydramol tablets after the expiry date stated on the label/carton/bottle. The expiry date refers to the last day of that
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer
required. These measures will help to protect the environment.