Page 31 - PBA Medicine list - edition 5_SW_Neat

By Sara Assaad

Generic Name: Paracetamol/Codeine phosophate hemihydrate

Brand names: APO-Paracetamol/Codeine 500/30

Side effects/precautions:
Cardiac, hepatic, renal impairment; viral hepatitis, hepatic disease (monitor LFTs); aspirin, NSAID
hypersensitivity; recent alcohol intake cessation; low glutathione reserves; Gilbert’s syndrome; acute
abdominal conditions; severe IBD (incr toxic megacolon risk with repeat dosing); chronic constipation;
analgesic intolerance; recent GI, urinary tract surgery; urethral stricture, stenosis; prostate
hypertrophy; high dose; prolonged use (monitor FBC, renal, hepatic function; disc gradually); drug,
alcohol abuse history; convulsive disorder history; CNS depression; head injury, brain tumour, incr ICP;
impaired consciousness; bronchial asthma; decr respiratory reserve eg emphysema, kyphoscoliosis,
hypoxia, hypercapnia, severe obesity, cor pulmonale, COPD; chronic ulcerative colitis; gallbladder
condition; MS; hypothyroidism; adrenocortical insufficiency eg Addison's disease; shock; myxoedema;
acute alcohol intoxication; delirium tremens; cholecystectomy; poor CYP2D6 metabolisers; North
African, Ethiopian Arab populations (higher prevalence of CYP2D6 ultrarapid metabolisers); elderly;
debility; pregnancy (avoid in 3rd trimester, labour).

Interactions:

RIMAs; salicylates, NSAIDs incl diflunisal; CNS depressants eg general anaesthetics, tranquillisers,
sedatives, hypnotics, other opioid analgesics; benzodiazepines; anticholinergics; hepatic enzyme
inducers eg alcohol, barbiturates, antiepileptics; hepatotoxics; coumarins (monitor coagulation);
chloramphenicol; antihypertensives; antiperistaltic antidiarrhoeals eg kaolin, pectin, loperamide;
metoclopramide; neuromuscular blockers; colestyramine (within 1 hr); chelating resin; rifampicin;
zidovudine; domperidone; morphinic agonist (eg buprenorphine), antagonist (eg naltrexone); TCAs;
lab tests: plasma amylase/ lipase, gastric emptying studies; uric acid/ BGL

Reasons for interactions:
Not provided

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