▶Tephine(Sandoz Ltd)
Buprenorphine (as Buprenorphine hydrochloride)
200 microgramTephine 200 microgram sublingual tablets sugar-free
| 50 tabletP£ 4. 27 DT = £ 5. 04 c
Buprenorphine (as Buprenorphine hydrochloride)
400 microgramTephine 400 microgram sublingual tablets sugar-free
| 50 tabletP£ 8. 54 DT = £ 10. 07 ceiiiiF 273Co-codamol
The properties listed below are those particular to the
combination only. For the properties of the components
please consider, paracetamol p. 271.
lINDICATIONS AND DOSE
Short-term treatment of acute moderate pain (using co-
codamol 8 / 500 preparations only)
▶BY MOUTH
▶Child 12–15 years: 8 / 500 mg every 6 hours as required for
maximum 3 days; maximum 32 / 2000 mg per day
▶Child 16–17 years: 8 / 500 – 16 / 1000 mg every 6 hours as
required for maximum 3 days; maximum 64 / 4000 mg
per day
Short-term treatment of acute moderate pain (using co-
codamol 15 / 500 preparations only)
▶BY MOUTH
▶Child 12–15 years: 15 / 500 mg every 6 hours as required
for maximum 3 days; maximum 60 / 2000 mg per day
▶Child 16–17 years: 15 / 500 – 30 / 1000 mg every 6 hours as
required for maximum 3 days; maximum 120 / 4000 mg
per day
Short-term treatment of acute moderate pain (using co-
codamol 30 / 500 preparations only)
▶BY MOUTH
▶Child 12–15 years: 30 / 500 mg every 6 hours as required
for maximum 3 days; maximum 120 / 2000 mg per day
▶Child 16–17 years: 30 / 500 – 60 / 1000 mg every 6 hours as
required for maximum 3 days; maximum 240 / 4000 mg
per day
KAPAKE®15/500
Short-term treatment of acute pain
▶BY MOUTH
▶Child 12–15 years: 1 tablet every 6 hours as required for
maximum 3 days; maximum 4 tablets per day
▶Child 16–17 years: 2 tablets every 6 hours as required for
maximum 3 days; maximum 8 tablets per dayIMPORTANT SAFETY INFORMATION
See codeine phosphate p. 276 for MHRA/CHM advice for
restrictions on the use of codeine as an analgesic in
children.lCONTRA-INDICATIONSAcute ulcerative colitis.antibiotic-
associated colitis.children who undergo the removal of
tonsils or adenoids for the treatment of obstructive sleep
apnoea.conditions where abdominal distention develops.
conditions where inhibition of peristalsis should be
avoided.known ultra-rapid codeine metabolisers
lCAUTIONSAcute abdomen.alcohol dependence.avoid
abrupt withdrawal after long-term treatment.cardiac
arrhythmias.chronic alcoholism.chronic dehydration.
chronic malnutrition.convulsive disorders.gallstones.
hepatocellular insufficiency
CAUTIONS, FURTHER INFORMATION
▶Variation in metabolismThe capacity to metabolise codeine
to morphine can vary considerably between individuals;
there is a marked increase in morphine toxicity in patients
who are ultra-rapid codeine metabolisers (CYP 2 D 6 ultra-
rapid metabolisers) and a reduced therapeutic effect in
poor codeine metabolisers.
lINTERACTIONS→Appendix 1 : opioids.paracetamol
lSIDE-EFFECTSAbdominal pain.addiction.
agranulocytosis.blood disorder.irritability.pancreatitis.
restlessness.severe cutaneous adverse reactions (SCARs).
thrombocytopenia
Overdose Important: liver damage (and less frequently
renal damage) following overdosage with paracetamol.
lBREAST FEEDINGAvoid—although amount of codeine
usually too small to be harmful, mothers vary considerably
in their capacity to metabolise codeine—risk of morphine
overdose in infant.
lHEPATIC IMPAIRMENT
Dose adjustmentsDose-related toxicity with
paracetamol—avoid large doses.
lRENAL IMPAIRMENTReduce dose or avoid codeine;
increased and prolonged effect; increased cerebral
sensitivity.
lPRESCRIBING AND DISPENSING INFORMATIONCo-codamol
is a mixture of codeine phosphate and paracetamol; the
proportions are expressed in the form x/y, where x and y
are the strengths in milligrams of codeine phosphate and
paracetamol respectively.
When co-codamol tablets, dispersible (or effervescent)
tablets, or capsules are prescribed andno strength is
stated, tablets, dispersible (or effervescent) tablets, or
capsules, respectively, containing codeine phosphate 8 mg
and paracetamol 500 mg should be dispensed.
The Drug Tariff allows tablets of co-codamol labelled
‘dispersible’to be dispensed against an order for
‘effervescent’andvice versa.
lLESS SUITABLE FOR PRESCRIBINGCo-codamol is less
suitable for prescribing.
lEXCEPTIONS TO LEGAL CATEGORYCo-codamol 8 / 500 can
be sold to the public in certain circumstances; for
exemptions seeMedicines, Ethics and Practice,London,
Pharmaceutical Press (always consult latest edition).lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution
Tablet
CAUTIONARY AND ADVISORY LABELS2(does not apply to the
8/500 tablet), 29, 30
▶Co-codamol (Non-proprietary)
Codeine phosphate 8 mg, Paracetamol 500 mgCo-codamol
8 mg/ 500 mg tablets| 100 tabletP£ 2. 70 DT = £ 1. 97 m|
500 tabletP£ 5. 70 – £ 9. 85 m| 1000 tabletP£ 19. 70 m
Codeine phosphate 15 mg, Paracetamol 500 mgCo-codamol
15 mg/ 500 mg tablets| 100 tabletP£ 15. 00 DT = £ 4. 93 m
Codeine phosphate 30 mg, Paracetamol 500 mgCo-codamol
30 mg/ 500 mg caplets| 100 tabletP£ 3. 90 DT = £ 2. 83 m
Co-codamol 30 mg/ 500 mg tablets| 30 tabletP£ 1. 17 DT =
£ 0. 85 m| 100 tabletP£ 7. 53 DT = £ 2. 83 m
Codeine phosphate 60 mg, Paracetamol 1 gramCo-codamol
60 mg/ 1000 mg tablets| 100 tabletP£ 11. 50 m
▶Codipar(AMCo)
Codeine phosphate 15 mg, Paracetamol 500 mgCodipar
15 mg/ 500 mg tablets| 100 tabletP£ 8. 25 DT = £ 4. 93 m
▶Kapake(Galen Ltd)
Codeine phosphate 30 mg, Paracetamol 500 mgKapake
30 mg/ 500 mg tablets| 100 tabletP£ 7. 10 DT = £ 2. 83 m
▶Migraleve Yellow(McNeil Products Ltd)
Codeine phosphate 8 mg, Paracetamol 500 mgMigraleve Yellow
tablets| 16 tabletPsm
▶Panadol Ultra(GlaxoSmithKline Consumer Healthcare)
Codeine phosphate 12.8 mg, Paracetamol 500 mgPanadol Ultra
12. 8 mg/ 500 mg tablets| 20 tabletp£ 2. 61 DT = £ 3. 61 m
▶Solpadeine Max(Omega Pharma Ltd)
Codeine phosphate 12.8 mg, Paracetamol 500 mgSolpadeine Max
12. 8 mg/ 500 mg tablets| 20 tabletp£ 3. 61 DT = £ 3. 61 m|
30 tabletp£ 4. 65 DT = £ 4. 65 mBNFC 2018 – 2019 Pain 275
Nervous system4