Paracodin tablets contain the active ingredient dihydrocodeine, which is a type of medicine called an opioid painkiller. 

What is Paracodin used for?

  • Paracodin tablets are used to relieve severe and chronic pain.

How does Paracodin work?

  • Paracodin tablets contain the active ingredient dihydrocodeine, which is a type of medicine called an opioid painkiller.
  • Opioid painkillers work by mimicking the action of naturally occurring pain-reducing chemicals called endorphins. Endorphins are found in the brain and spinal cord and reduce pain by combining with opioid receptors.
  • Dihydrocodeine mimicks the action of natural endorphins by combining with the opioid receptors in the brain and spinal cord. This blocks the transmission of pain signals sent by the nerves to the brain.
Therefore, even though the cause of the pain may remain, less pain is actually felt.
  • Dihydrocodeine works to relieve moderate to severe pain.
  • How do I take Paracodin?

    • This depends on your individual circumstances and level of pain. Always follow the instructions given by your doctor. These will also be printed on the dispensing label that your pharmacist has put on the packet of medicine. Do not exceed the dose prescribed by your doctor.
    • The usual dose for adults and adolescents over 12 years of age is one or two Paracodin tablets taken three times a day.
    • Do not take more than six tablets in 24 hours.
    • The tablets should be taken with or after food.
    • Consult your doctor if your pain is not relieved by taking this medicine.
    • Do not exceed the dose prescribed by your doctor, or take this medicine more often or for longer than prescribed by your doctor.

    Important information about Paracodin

    • This medicine may cause drowsiness and dizziness and can affect your ability to concentrate. This could affect your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure you can do so safely.
    • You should avoid drinking alcohol while taking this medicine as this will increase the chance of you feeling drowsy or dizzy.
    • From March 2015 a new 'drug driving' law comes into force, which makes it an offence to drive with certain drugs or prescription medicines above specified limits in your body. Dihydrocodeine is in the same class of medicines as some of the medicines on the list, which means it may be an offence to drive while you are taking this medicine. The new law will allow police to use roadside drug tests to check for the presence of the prohibited drugs in a driver's saliva. There are very low limits for illegal drugs, but higher limits for prescribed medicines. This means most people taking dihydrocodeine as prescribed will not be breaking the law, provided they are not driving dangerously. If you test positive for one of the medicines there is a medical defence if you are taking it as prescribed, as long as your driving is not impaired. If you are taking a high dose of dihydrocodeine it may therefore be sensible to carry your prescription with you if you feel you are safe to drive, in case you are asked to take a test by the police. You should not drive if you think this medicine affects your ability to drive safely, for example if it makes you feel sleepy, dizzy, unable to concentrate or make decisions, or if you have blurred or double vision. If you are driving dangerously while taking this medicine you will be breaking the law.
    • If this medicine is taken regularly for long periods of time, the body can become tolerant to it and it may become less effective at relieving pain. With prolonged use, the body may also become dependent on the dihydrocodeine. As a result, withdrawal symptoms such as restlessness and irritability can occur if the medicine is stopped suddenly. For this reason, when a person no longer needs this medicine it may be necessary to reduce treatment gradually to avoid withdrawal symptoms.

    Paracodin should be used with caution in

    • Elderly people.
    • People with decreased kidney or liver function.
    • People with decreased lung function or breathing difficulties, for example asthma (see also below).
    • People with heart failure secondary to chronic lung disease.
    • People with low blood pressure (hypotension).
    • People with an underactive thyroid gland (hypothyroidism).
    • Men with an enlarged prostate gland (prostatic hypertrophy).
    • People who are constipated.
    • People with inflammatory bowel disorders such as Crohn's disease or ulcerative colitis.
    • People with diseases of the bile ducts.
    • Inflammation of the pancreas (pancreatitis).
    • People with a history of convulsions (fits), eg epilepsy.
    • A condition involving abnormal muscle weakness called myasthenia gravis.
    • People with a history of drug or alcohol abuse or dependence.

    Paracodin should not be used in

    • Children under 12 years of age.
    • People with very slow, shallow breathing (respiratory depression).
    • Chronic obstructive pulmonary disease (COPD).
    • People having an asthma attack.
    • People who have or who are at risk of getting a blockage in the gut (paralytic ileus).
    • People with a head injury or raised pressure inside the skull (raised intracranial pressure).
    • People who are intoxicated with alcohol.

    This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

    If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

    Pregnancy and breastfeeding

    Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

    • This medicine is not recommended for use during pregnancy, particularly in the third trimester, unless the benefits to the mother outweigh any potential risks to the baby. If used during labour it may cause breathing difficulties in the baby after the birth. Babies born to mothers who have been taking this medicine for a long time may have withdrawal symptoms after the birth. Seek further medical advice from your doctor.
    • Small amounts of this medicine may pass into breast milk. It should be used with caution in women who are breastfeeding because it can potentially cause problems in the nursing baby, such as breathing or feeding problems. If used during breastfeeding the nursing infant may need to be monitored. Seek further medical advice from your doctor.

    Possible side effects of Paracodin

    Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

    • Drowsiness.
    • Constipation.
    • Nausea and vomiting.
    • Abdominal pain.
    • Dry mouth.
    • Blurred vision.
    • Headache.
    • Dizziness.
    • Low blood pressure (hypotension).
    • Pins and needles sensations.
    • Confusion.
    • Rash or itching.
    • Sweating.
    • Flushing.
    • Difficulty passing urine (urinary retention).
    • Mood changes.
    • Decreased sex drive.
    • Hallucinations.
    • Slow, shallow breathing (respiratory depression).
    • Convulsions.

    The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

    If you think you have experienced a side effect from a medicine or vaccine you should check the patient information leaflet. This lists the known side effects and what to do if you get them. You can also get advice from your doctor, nurse or pharmacist. If they think it's necessary they'll report it for you.

    How can Paracodin affect other medicines?

    It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you take this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

    There may be an increased risk of side effects such as drowsiness, sedation and slow, shallow breathing, if this medicine is used with other medicines that have a sedative effect on the central nervous system. These include the following:

    • alcohol
    • antipsychotics, eg haloperidol, chlorpromazine
    • barbiturates, eg phenobarbital, amobarbital
    • benzodiazepines, eg diazepam, temazepam
    • muscle relaxants, eg baclofen
    • other opioids, eg codeine, tramadol, morphine
    • sedating antihistamines, eg chlorphenamine, hydroxyzine
    • sleeping tablets, eg zopiclone
    • tricyclic antidepressants, eg amitriptyline.

    This medicine should be used with caution in people taking a monoamine oxidase inhibitor antidepressant (MAOI), for example phenelzine, tranylcypromine or isocarboxazid. Ask your doctor or pharmacist for advice if you are taking one of these medicines, or you have taken one in the last two weeks.

    References:

    http://www.dokteronline.com/en/paracodin/

    http://www.netdoctor.co.uk/medicines/aches-and-pains/a6551/df118-forte-dihydrocodeine/

    https://webmduk.net/pdf/products/paracodin.pdf

    https://www.hpra.ie/img/uploaded/swedocuments/PA1235-4-3%20PIL-2164075-25062015102254-635708245757701250.pdf

    http://www.hpra.ie/img/uploaded/swedocuments/LicenseSPC_PA1235-004-003_29042014125106.pdf