Almus Co-Codamol 8/500mg Effervescent Tablets contain 500mg paracetamol and 8mg codeine phosphate hemihydrate per tablet. This pharmacy medicine is used for the short-term relief of acute moderate pain that has not been relieved by paracetamol, ibuprofen or aspirin alone.

Almus Co-Codamol Effervescent Tablets are indicated for pain associated with headaches, migraines, neuralgia, toothache, painful menstrual periods and rheumatic pain. Paracetamol and codeine are analgesics that act to relieve pain. Codeine belongs to a group of medicines known as opioid analgesics.

The effervescent formulation is designed to be dissolved in a glass of water before taking, providing an alternative to swallowing conventional tablets. Each pack contains 32 effervescent tablets.

This medicine is intended for adults and children aged 12 years and over, with specific dosing instructions and restrictions for different age groups.

For short-term use only. Do not take for more than three days. This medicine contains codeine, which can cause dependence and addiction. A pharmacist can provide advice about its appropriate use.

Patient Information Leaflet

Main ingredients: Each effervescent tablet contains Paracetamol 500mg and Codeine Phosphate Hemihydrate 8mg.

Excipients: Citric acid, sorbitol (E420), sodium hydrogen carbonate, povidone, simeticone, sodium carbonate, saccharin sodium, macrogol 6000.

Important ingredient information: Each tablet contains approximately 418.59mg sodium and 100mg sorbitol (E420).

Almus Co-Codamol 8/500mg Effervescent Tablets are used for the short-term relief of acute moderate pain that has not been relieved by paracetamol, ibuprofen or aspirin alone. This includes headache, migraine, neuralgia, toothache, period pain and rheumatic pain.

Adults and elderly patients: Dissolve 2 tablets in a glass of water every 4 to 6 hours when necessary. Do not take more than 8 tablets in 24 hours.

Children and adolescents aged 16 to 18 years: Dissolve 1 to 2 tablets in a glass of water every 6 hours when necessary. Do not take more than 4 doses in 24 hours, with a maximum of 8 tablets.

Children aged 12 to 15 years: Dissolve 1 tablet in a glass of water every 6 hours when necessary. Do not take more than 4 tablets in 24 hours.

Children under 12 years: Do not give this medicine to children under 12 years because of the risk of severe breathing problems.

How to take: Dissolve the required number of effervescent tablets completely in a glass of water before drinking. This medicine is for oral use only. Do not swallow the tablets whole.

Wait at least 4 hours after taking other painkillers before taking this medicine, as directed in the leaflet.

Duration of use: Use the lowest effective dose for the shortest possible period. Do not take continuously for more than 3 days. If pain persists, worsens or is not adequately relieved, speak to a doctor or pharmacist.

Missed dose: If you forget a dose, take it when you remember, provided the required interval between doses is maintained. Allow at least 4 hours between adult doses and 6 hours between doses for those aged 12 to 18 years. Do not take a double dose to compensate for a missed dose.

Important safety advice: Do not exceed the recommended dose. Do not take with any other medicine containing paracetamol. Codeine can cause dependence and addiction, particularly with repeated or prolonged use.

If you take more than the recommended dose, seek immediate medical attention, even if you feel well, because paracetamol overdose can cause delayed, serious liver damage.

Do not take Almus Co-Codamol 8/500mg Effervescent Tablets if you:

• Are allergic to paracetamol, codeine phosphate hemihydrate or any of the other ingredients.
• Are taking monoamine oxidase inhibitors (MAOIs), or have taken them within the previous 14 days.
• Are under 12 years of age.
• Are under 18 years of age and have had your tonsils or adenoids removed because of obstructive sleep apnoea syndrome.
• Are known to metabolise codeine into morphine very rapidly.
• Are breastfeeding.

Warnings and precautions

Speak to your doctor or pharmacist before taking this medicine if you have liver or kidney problems, alcohol-related liver disease, difficulty passing urine, prostate problems, bowel disorders, myasthenia gravis, hypothyroidism, Addison's disease or seizures.

Older patients and those taking medicines that cause drowsiness may be more sensitive to the effects of codeine.

Codeine dependence and addiction: This medicine contains codeine, an opioid that can cause tolerance, dependence and addiction. Do not use for longer than three days. Repeated use, particularly at higher doses or for longer periods, increases the risk of dependence and potentially life-threatening overdose.

Speak to a doctor if you feel unable to control how much medicine you take, need increasing doses or experience withdrawal symptoms when stopping.

Paracetamol warning: Do not take with other medicines containing paracetamol, including some cold, flu and pain relief products. Taking too much paracetamol can cause serious liver damage.

Pregnancy: Talk to your doctor before taking this medicine if you are pregnant, think you may be pregnant or are planning to become pregnant.

Breastfeeding: Do not take this medicine while breastfeeding. Codeine passes into breast milk and may cause serious adverse effects in breastfed infants.

Other medicines: Tell your doctor or pharmacist about any other medicines you are taking, including medicines obtained without a prescription or herbal products.

Important interactions include MAOIs, sedatives, benzodiazepines, sleeping tablets, certain antidepressants, antipsychotics, antihistamines, gabapentin, pregabalin, warfarin, flucloxacillin, metoclopramide, domperidone and colestyramine. This is not a complete list.

Combining codeine with sedative medicines may increase the risk of severe drowsiness, breathing difficulties, coma and death.

Alcohol: Do not drink alcohol while taking this medicine. Alcohol may increase the sedative and breathing-related risks associated with codeine.

Driving and operating machinery: This medicine may cause dizziness, drowsiness or impaired alertness. Do not drive or operate machinery if affected. Do not drive until you know how the medicine affects you.

Sodium and sorbitol: Each tablet contains approximately 418.59mg sodium. This medicine is high in sodium and should be used with caution by people following a restricted sodium diet.

Each tablet contains 100mg sorbitol (E420). Speak to your doctor before use if you have an intolerance to certain sugars. People with hereditary fructose intolerance should not take this medicine.

Serious reactions: Stop taking the medicine and seek immediate medical attention if you experience severe breathing difficulties, unusual sleepiness, confusion, very small pupils, swelling of the face or throat, or a serious allergic reaction.

Contact a doctor immediately if you develop severe upper abdominal pain spreading towards the back, possibly with nausea, vomiting or fever, as this may indicate inflammation of the pancreas or biliary tract.

Seek urgent medical advice if you experience deep, rapid breathing, severe drowsiness, nausea or vomiting, particularly if you have a serious underlying illness, as these may indicate metabolic acidosis.

Codeine may cause sleep-related breathing disorders, including breathing pauses during sleep. Contact your doctor if these symptoms occur.

Overdose: If more than the recommended dose is taken, seek immediate medical attention, even if there are no symptoms. Paracetamol overdose can cause delayed, severe liver damage.

Keep this medicine out of the sight and reach of children and store it securely to prevent access by others.

Always read the enclosed Patient Information Leaflet before use.

Like all medicines, Almus Co-Codamol 8/500mg Effervescent Tablets can cause side effects, although not everybody experiences them.

Important: Prolonged or frequent use of painkillers for headaches may make headaches worse.

Stop taking the medicine and seek immediate medical attention if you develop signs of a serious allergic reaction, severe breathing problems or other serious symptoms.

If any side effects become severe, persist or cause concern, speak to your doctor or pharmacist.