What you need to know about the painkiller Acetaminophen and Codeine

Sometimes, when you have severe pain that cannot be controlled with regular painkillers, your doctor may prescribe a special painkiller. This liquid medicine, which is a combination of two drugs called Acetaminophen and Codeine, is one of them. It is usually prescribed if you cannot tolerate other painkillers or if they do not relieve the pain. So today, let's talk about this medicine in a little more detail and simply about the things you need to be careful about when using it.

What kind of medicine is this?

Simply put, this is a combination of two main types of drugs.

1. Acetaminophen: A common painkiller that many of us know from medicines like 'Panadol', reduces fever and pain.

2. Codeine: This is a powerful painkiller that belongs to the opioid class. It acts directly on the brain, blocking the transmission of pain signals.

When these two are combined, they provide good control over moderate to severe pain. Since this medicine comes in a solution, it is especially easy to use for those who have difficulty swallowing pills.

Things you need to tell your doctor before taking this medicine

It is very important that your doctor has a complete picture of your health. Therefore, before starting this medication, be sure to tell your doctor if you have any of the following conditions:

• If you have had an allergic reaction to acetaminophen, codeine or other opioids, other medicines, foods, dyes or preservatives.
• If you are a regular drinker.
• If you have any liver or kidney disease .
• If you have lung disease, asthma, or other breathing problems .
• If you have a condition such as a head injury, brain tumor, or seizures.
• If you have a history of drug addiction .
• Low adrenal gland function.
• If you have stomach or intestine problems.
• If you are pregnant or trying to get pregnant.
• If you are a mother who is breastfeeding.
• If you have taken an MAOI (Monoamine Oxidase Inhibitor) antidepressant such as Marplan, Nardil, or Parnate within the past 14 days.

Based on this information, your doctor will decide whether this medication is right for you or whether the dosage needs to be changed.

How should I use the medicine?

You need to be very careful when using this medicine.

• Measure accurately:Since this is a liquid, you need to measure the exact dose prescribed by your doctor. Use the special spoon or cup that comes with the medicine for this. Do not use teaspoons or tablespoons that you have at home , as their measurements are not accurate.
• Take with food: Some people may experience stomach upset when taking this medication. If this happens, take the medication with or after a meal.
• Take only at the prescribed time: Do not take more than the doctor has prescribed, nor take the medicine earlier than the prescribed time.

Be very careful when giving to children.

What to do if you take too much medicine? (Overdose)

If you have any suspicion that you have taken too much of this medicine, do not take it lightly. Immediately call the National Poisons Information Centre at the Colombo National Hospital, or go to the Emergency Department (ETU) of the nearest hospital. This medicine is for you only. Never give your medicine to anyone else.

Other drugs that may interact with this medicine (Drug Interactions)

This medicine may interact with other medications and cause dangerous side effects. Therefore, it is essential to tell your doctor about all medications you are taking (including vitamins and herbal remedies).

In particular, never take this medicine with the following medications:

• Linezolid
• MAOIs (e.g. Marplan, Nardil, Parnate)
• Methylene blue
• Ozanimod
• Samidorphan

Also, please inform your doctor if you are taking the following medications, as they may cause problems:

• Alcohol
• Antihistamines (medicines for colds, coughs, and allergies)
• Medications for depression, anxiety, or sleep
• Anticonvulsant medications (e.g. carbamazepine, phenytoin)
• Antifungals (e.g. ketoconazole)
• Some antibiotics (e.g. erythromycin)
• Muscle relaxants
• Any other pain reliever containing acetaminophen (paracetamol).

This list is not complete, so tell your doctor about all the medications you are taking.

The most important things to consider when taking medication

What if the pain doesn't subside?

When you take this medicine for a long time, your body can get used to it. We call this 'tolerance'. This means that the dose you used to take to relieve pain may no longer be enough. This is normal. If this happens, if your pain does not decrease or increases, do not increase the dose yourself and talk to your doctor.

Addiction and body habituation

Many people are afraid of becoming addicted to such powerful painkillers. However, there are two things that are called physical dependence and addiction. When you take medication for a medical reason such as pain, your body gets used to it over time. It is not an addiction. Never stop taking the medication suddenly without your doctor's advice. Doing so can cause withdrawal symptoms. When you need to stop taking the medication, your doctor will gradually reduce the dose and tell you how to stop.

Be careful with other Acetaminophen medications.

Drowsiness and dizziness

This medicine may make you feel drowsy or dizzy. Therefore, do not drive or operate machinery until you know how it affects you. Especially if you are elderly, do not get up suddenly from a sitting position.

Constipation and dry mouth

A common side effect of this medication is constipation. If you don't have a bowel movement after about 3 days, tell your doctor. Also, if your mouth feels dry, drink plenty of water and chew sugar-free gum.

Side effects that may occur due to medication