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Paramol Tablets

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Paramol tablets contain the active ingredients paracetamol and dihydrocodeine. They are used for the short-term treatment of acute moderate pain that is not relieved by paracetamol, ibuprofen, or aspirin alone. This includes conditions such as headaches, migraines, period pain, toothache and other dental pain, backache, muscular and joint aches and pains, and neuralgia.

Important Warnings:

  • This medicine can only be used for the short-term treatment of acute moderate pain when other painkillers have not worked.
  • You should only take this product for a maximum of three days at a time. If you need to take it for longer than three days, you should see your doctor or pharmacist for advice.
  • This medicine contains dihydrocodeine, which can cause addiction if taken continuously for more than three days. This can lead to withdrawal symptoms when you stop taking it.
  • If you take this medicine for headaches for more than three days, it can make them worse.

Read all of this leaflet carefully before taking the medication.

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Paramol Tablets
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Overview

Active ingredients

What is it for?

How does it work?

How do you use it?

Warnings and precautions

Side effects

Drug interactions

FAQs

Download patent leaflet

Written By
Shazlee Ahsan
BSc Pharmacy, Independent Prescriber, PgDip Endocrinology, MSc Endocrinology, PgDip Infectious Diseases

Independent prescriber, Superintendent pharmacist.


Checked By
Dr Sarah Thornton
MbChB, Coaching Academy diploma with distinction

Medical coaching


What are Paramol tablets?

Paramol is a brand of medication known as co-dydramol, which is a painkiller that combines the active ingredients paracetamol and dihydrocodeine. It is suitable for people over 12 years of age for the short-term relief of moderate pain that cannot be controlled using paracetamol, ibuprofen, or aspirin alone.

Dihydrocodeine is part of a group of medications called opioid analgesics, which work by blocking pain receptors in the body, thereby decreasing the severity of the pain.

As with all opioid analgesics, dihydrocodeine should not be taken for more than 3 consecutive days. If, after 3 days of taking Paramol, you continue to experience moderate pain that interferes with your daily activities, you should consult a doctor or pharmacist for advice.

 

What are the active ingredients in Paramol tablets?

Each Paramol tablet contains: Active Ingredients: 500mg of paracetamol and 7.46mg dihydrocodeine tartarate.

What is Paramol used for?

Paramol is a painkiller designed for short-term use, up to 3 days, to treat moderate pain when paracetamol, ibuprofen, or aspirin alone are insufficient. Paramol is effective for treating pain associated with the following conditions:
  • Headaches
  • Migraines
  • Period pain
  • Dental pain
  • Back pain
  • Muscular pain
  • Joint pain
  • Nerve pain

How does Paramol work?

Paramol is a fast-acting and powerful pain reliever that combines two separate painkillers: paracetamol and dihydrocodeine.
  • Paracetamol is one of the most widely used painkillers in the UK. It effectively reduces the sensation of mild to moderate pain within an hour.
  • Dihydrocodeine is a stronger painkiller known as an opioid. Unlike paracetamol, dihydrocodeine works by binding to the body's pain receptors, preventing pain messages from reaching the brain and thus reducing the severity of the pain felt.
By targeting pain through different mechanisms, the combination of paracetamol and dihydrocodeine in Paramol creates a highly effective painkiller that works quickly to relieve discomfort.

How do you take Paramol?

Dosage Instructions for Paramol Tablets Adults and Adolescents (16 years and over):
  • Take one or two tablets every four to six hours.
  • Do not take more than 8 tablets in any 24-hour period.
Adolescents (12–15 years old):
  • Take one tablet every four to six hours.
  • Do not take more than 4 tablets in any 24-hour period.
Children under 12 years:
  • Not recommended for children under 12 years.
Special Considerations:
  • Take Paramol Tablets during or after meals.
  • Use caution when increasing the dose in elderly patients.
  • If symptoms persist or worsen, consult your doctor or pharmacist.
  • Do not use this medicine for more than 3 consecutive days without medical review. If you need to use it for longer, speak to your doctor or pharmacist.
  • This medicine contains dihydrocodeine, which can cause addiction if taken continuously for more than three days. Stopping the medication may lead to withdrawal symptoms. Consult your doctor or pharmacist if you think you are experiencing withdrawal symptoms.
Overdose Instructions:
  • If you take too many tablets, seek immediate medical advice, even if you feel well, due to the risk of delayed, serious liver damage.

Who should not take Paramol?

This medicine contains dihydrocodeine, which can cause addiction if taken continuously for more than three days. This can lead to withdrawal symptoms when you stop taking it.
  • Taking a painkiller for headaches for more than three days can make them worse.
Do not take Paramol Tablets if you:
  • Are allergic to paracetamol, dihydrocodeine, or any other ingredients in the product (see section 6).
  • Are suffering from diarrhea caused by poisoning or have watery and severe diarrhea that may be bloody, especially if you have been taking antibiotics (pseudomembranous colitis).
  • Are dependent on alcohol.
  • Suffer from raised pressure within your head, convulsions, or acute abdominal conditions.
  • Are taking antidepressants from a group called Monoamine Oxidase Inhibitors (MAOIs) or have taken them in the last 14 days.
  • Are pregnant or breastfeeding.
  • Are suffering from breathing difficulties.
  • Suffer from delayed stomach emptying or decreased movement in your intestines.
  • Are under 18 years of age and have had your tonsils or adenoids removed for Obstructive Sleep Apnoea Syndrome.
  • Know that you metabolize codeine into morphine very rapidly.
Consult your doctor or pharmacist if you:
  • Have allergies.
  • Have asthma (do not take the tablets if you are having an asthma attack).
  • Have liver or kidney problems.
  • Have an underactive thyroid gland.
  • Have low blood pressure or if your adrenal glands are not functioning properly.
  • Have an enlarged prostate, bowel problems, recent surgery, gallstones, or difficulty passing urine.
  • Have myasthenia gravis, a history of arrhythmias, or a history of convulsions.
  • Have a history of drug use or mood swings.
  • Are elderly.
  • Before giving to a child with any sort of breathing problem.
Taking other medicines:
  • Monoamine oxidase inhibitors (e.g., Pethidine), warfarin (to thin the blood), domperidone or metoclopramide (to treat nausea and vomiting), cholestyramine (to reduce cholesterol).
  • Hydroxyzine (to treat anxiety), central nervous system depressants such as alcohol, anesthetics, hypnotics, and sedatives.
  • Phenothiazine (an antipsychotic), diuretics, and medicines taken to reduce high blood pressure.
  • Loperamide or kaolin (to treat diarrhea).
  • A drug from the antimuscarinic family (e.g., atropine) or any other kind of neuromuscular blocking medication (e.g., tracrium).
  • Quinidine (to treat malaria), mexiletine (to treat high blood pressure or irregular heartbeat), cisapride, and cimetidine (to treat reflux).
  • Naloxone (used to treat opioid addiction) or naltrexone (a drug used to treat alcohol addiction).
  • Benzodiazepines (to treat depression, anxiety) or related sedative medicines.
  • Flucloxacillin (antibiotic), due to a serious risk of blood and fluid abnormality (high anion gap metabolic acidosis) that requires urgent treatment. This may occur particularly in cases of severe renal impairment, sepsis, malnutrition, chronic alcoholism, and if the maximum daily doses of paracetamol are used.
Take special care:
  • If you take a painkiller for headaches for more than three days, it can make them worse.
If you are pregnant or breastfeeding:
  • Do not use this product if you are pregnant or breastfeeding.
Driving and using machines: These tablets can impair mental function and may cause blurred or double vision, hallucinations, convulsions, confusion, drowsiness, dizziness, and sleepiness.
  • Do not drive or operate machinery while taking this medicine until you know how it affects you.
  • If you feel affected, do not drive or operate machinery.
  • It may be an offense to drive while taking this medicine.
  • However, you would not be committing an offense if:
    • The medicine has been taken to treat a medical or dental problem.
    • You have taken it according to the information provided with the medicine.
    • It is not affecting your ability to drive safely.
Talk to your doctor or pharmacist if you are unsure whether it is safe for you to drive while taking this medicine. Details regarding the driving offense concerning drug use in the UK can be found here: UK Drug Driving Law.

What are the side effects of Paramol?

Like all medicines, this medicine can cause side effects, although not everyone will experience them. Stop taking the medicine and seek immediate medical help if you develop any of the following:
  • Signs of a serious allergic reaction, such as difficulties in breathing, faster heartbeat, severe skin reactions like itchiness, skin rash with redness, peeling, flaking or blistering, and swelling of the face.
Tell your doctor if you experience the following side effects:
  • Blood disorders resulting in unexplained or unusual bruising or bleeding, fever, sore throat, mouth ulcers.
  • Depression, hallucinations, confusion, changes in mood, restlessness, or nightmares.
  • Dizziness, spinning sensation, drowsiness, convulsions, uncontrollable twitching or jerking movements, headaches.
  • Blurred vision, double vision, reduction in pupil size.
  • Slow heartbeat, shortness of breath, cough suppression.
  • Stomach pain, nausea, constipation, vomiting, dry mouth, loss of bladder control, diarrhea.
  • Muscle stiffness.
  • Pain or difficulty in passing urine.
  • Loss of libido, reduction in body temperature, excessive sweating, tiredness, feeling unwell.
How do I know if I'm addicted? If you take the medicine according to the instructions on the pack, it is unlikely that you will become addicted. However, if the following apply to you, it is important to talk to your doctor:
  • You need to take the medicine for longer periods of time.
  • You need to take more than the recommended dose.
  • When you stop taking the medicine, you feel very unwell but feel better when you start taking it again.
Reporting Side Effects: If you experience any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.

Does Paramol interact with any medicines?

Interactions with Other Medicines:
  • Monoamine oxidase inhibitors: e.g., Pethidine, warfarin (to thin the blood), domperidone or metoclopramide (to treat nausea and vomiting), cholestyramine (to reduce cholesterol).
  • Hydroxyzine (to treat anxiety), central nervous system depressants such as alcohol, anesthetics, hypnotics, and sedatives.
  • Phenothiazine (an antipsychotic), diuretics, and medicines taken to reduce high blood pressure.
  • Loperamide or kaolin (to treat diarrhea).
  • Antimuscarinic drugs (a type of drug that temporarily blocks nerve endings) e.g., atropine or any other kind of neuromuscular blocking medication (e.g., tracrium).
  • Quinidine (to treat malaria), mexiletine (to treat high blood pressure or irregular heartbeat), cisapride and cimetidine (to treat reflux).
  • Naloxone (used to treat addiction to opioids) or naltrexone (a drug used to treat alcohol addiction).
  • Benzodiazepines (to treat depression, anxiety) or related sedative medicines.
  • Flucloxacillin (antibiotic), due to a serious risk of blood and fluid abnormality (high anion gap metabolic acidosis) that requires urgent treatment, particularly in cases of severe renal impairment, sepsis (when bacteria and their toxins circulate in the blood leading to organ damage), malnutrition, chronic alcoholism, and if the maximum daily doses of paracetamol are used.
Take Special Care:
  • If you take a painkiller for headaches for more than three days, it can make them worse.
Other Medicines and Paramol:
  • Inform your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.
  • Concomitant use of Paramol and opioids (strong painkillers, medicines for substitution therapy, and some cough medicines) or sedative medicines such as benzodiazepines or related drugs increases the risk of drowsiness, difficulties in breathing (respiratory depression), coma, and may be life-threatening. Because of this, concomitant use should only be considered when other treatment options are not possible.
  • If your doctor does prescribe Paramol together with opioids or sedative medicines, the dose and duration of concomitant treatment should be limited by your doctor.
  • Please tell your doctor about all opioid or sedative medicines you are taking and follow your doctor’s dose recommendations closely. It could be helpful to inform friends or relatives to be aware of the signs and symptoms stated above. Contact your doctor if you experience such symptoms.

Paramol FAQs

What is Paramol?

Paramol is a painkiller that combines paracetamol and dihydrocodeine. It is used for the short-term relief of moderate pain that cannot be controlled using paracetamol, ibuprofen, or aspirin alone.

What conditions can Paramol treat?

Paramol is effective for treating headaches, migraines, period pain, dental pain, back pain, muscular pain, joint pain, and nerve pain.

How should I take Paramol?

Adults and adolescents aged 16 years and over should take one or two tablets every four to six hours as needed, not exceeding 8 tablets in 24 hours. Adolescents aged 12-15 should take one tablet every four to six hours, not exceeding 4 tablets in 24 hours. Paramol is not recommended for children under 12 years.

Can I take Paramol if I am pregnant or breastfeeding?

No, Paramol should not be taken if you are pregnant or breastfeeding. Consult your doctor for alternative pain relief options.

What are the possible side effects of Paramol?

Common side effects include constipation, nausea, and drowsiness. Serious side effects may include allergic reactions, breathing problems, dizziness, and unusual bruising or bleeding. If you experience any severe side effects, seek medical attention immediately.

Can I drive or operate machinery while taking Paramol?

Paramol can impair mental function and cause drowsiness, dizziness, or blurred vision. Do not drive or operate machinery until you know how the medication affects you.

Can Paramol cause addiction?

Yes, Paramol contains dihydrocodeine, an opioid that can cause addiction if taken continuously for more than three days. Follow your doctor's instructions and do not exceed the recommended duration of use.

What should I do if I miss a dose of Paramol?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.

What should I do if I take too much Paramol?

If you overdose on Paramol, seek immediate medical advice, even if you feel well. Overdose symptoms may include drowsiness, nausea, and difficulty breathing. Excessive intake of paracetamol can cause serious liver and kidney damage.

Can I take Paramol with other medications?

Inform your doctor or pharmacist if you are taking any other medications, especially MAOIs, blood thinners, antiemetics, antidepressants, or sedatives. Some medications can interact with Paramol and increase the risk of side effects.

Can Paramol cause addiction?

Paramol is only suitable for up to 3 days of use as it contains dihydrocodeine, an opioid analgesic. Addiction is very unlikely if Paramol is taken as directed. Read the Patient Information Leaflet thoroughly for more information about how to take Paramol. If you think you may be addicted or are experiencing withdrawal symptoms, speak to a doctor or pharmacist as soon as possible.

What are the signs of addiction to Paramol?

Signs of addiction may include finding it difficult to stop taking Paramol, needing to take more Paramol for it to have an effect, and needing to take Paramol more often. Withdrawal symptoms may include feeling agitated, more nervous than usual, sweating more than usual, and shaking.

Can I drink alcohol while taking Paramol?

It is not recommended to drink alcohol when taking Paramol, as alcohol can increase the likelihood of drowsiness as a side effect of dihydrocodeine. Drinking alcohol while taking paracetamol can also increase your risk of liver damage.

Is Paramol safe to use during pregnancy and breastfeeding?

Paramol is not suitable for use during pregnancy or breastfeeding. If you are experiencing pain during this time, speak to a doctor or pharmacist for alternative pain relief options.

Can I drive while taking Paramol?

The dihydrocodeine in Paramol can impair mental function, cause blurred vision, and make you drowsy. It is not recommended to drive or operate heavy machinery until you know how this medication affects you. Under the Drug Driving Act, it is now an offense to drive if a medication affects your ability to drive. If you are concerned about your ability to drive when taking Paramol, speak to a doctor or pharmacist.

How long can I take Paramol?

Paramol should only be taken for up to 3 days. If pain persists beyond this period, consult your doctor or pharmacist for further advice.

What conditions can Paramol treat?

Paramol is effective for treating moderate pain associated with conditions such as headaches, migraines, period pain, dental pain, back pain, muscular pain, joint pain, and nerve pain.

How should I take Paramol?

Adults and adolescents aged 16 years and over should take one or two tablets every four to six hours as needed, not exceeding 8 tablets in 24 hours. Adolescents aged 12-15 should take one tablet every four to six hours, not exceeding 4 tablets in 24 hours. Paramol is not recommended for children under 12 years.

What are the possible side effects of Paramol?

Common side effects include constipation, nausea, and drowsiness. Serious side effects may include allergic reactions, breathing problems, dizziness, and unusual bruising or bleeding. If you experience any severe side effects, seek medical attention immediately.

Can I take Paramol with other medications?

Inform your doctor or pharmacist if you are taking any other medications, especially MAOIs, blood thinners, antiemetics, antidepressants, or sedatives. Some medications can interact with Paramol and increase the risk of side effects.

Can I take Paramol with Ibuprofen?

Yes, it is safe to take Paramol with Ibuprofen or Aspirin. However, do not take Paramol with any other products that contain paracetamol, as Paramol already includes your total paracetamol dose. Be aware that many over-the-counter cold and flu medications contain paracetamol.

Can I take Paramol with Amoxicillin?

Yes, it is safe to take Paramol with amoxicillin and other antibiotics. However, several other medications may not be suitable to take at the same time as Paramol. Please refer to the Warnings section for a list of these medications.

What conditions can Paramol treat?

Paramol is effective for treating moderate pain associated with conditions such as headaches, migraines, period pain, dental pain, back pain, muscular pain, joint pain, and nerve pain.

What should I do if I overdose on Paramol?

Like with all medications, taking more than the recommended dose of Paramol can be harmful. If you think you have taken too much, stop taking the medication immediately and speak to a doctor or pharmacist. Seek medical advice immediately if you experience any of the following side effects:
  • Becoming very sleepy
  • Becoming dizzy
  • Difficulty breathing
  • Becoming unconscious
 

Download patient leaflet

Paramol PIL Medicalmojo.co.uk

Checked By
Dr Sarah Thornton
MbChB, Coaching Academy diploma with distinction

Medical coaching


Written By
Shazlee Ahsan
BSc Pharmacy, Independent Prescriber, PgDip Endocrinology, MSc Endocrinology, PgDip Infectious Diseases

Independent prescriber, Superintendent pharmacist.


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