Panadol ultra

How does it work?

Panadol ultra tablets contain two active ingredients: paracetamol and codeine. This combination of medicines is often referred to as co-codamol. (NB. Co-codamol is also available without a brand name, ie as the generic medicine.)

Paracetamol is a simple painkilling medicine used to relieve mild to moderate pain and fever. Despite its widespread use for over 100 years, we still don't fully understand how paracetamol works to relieve pain and reduce fever. However, it is now thought that it works by reducing the production of prostaglandins in the brain and spinal cord.

The body produces prostaglandins in response to injury and certain diseases. One of the effects of prostaglandins is to sensitise nerve endings, causing pain (presumably to prevent us from causing further harm to the area). As paracetamol reduces the production of these nerve sensitising prostaglandins it is thought it may increase our pain threshold, so that although the cause of the pain remains, we can feel it less.

It is thought paracetamol reduces fever by affecting an area of the brain that regulates our body temperature (the hypothalamic heat-regulating center).

Paracetamol is about as effective as aspirin at relieving mild to moderate pain and fever, but unlike aspirin it has no anti-inflammatory effect.

Codeine is a slightly stronger painkiller known as an opioid. 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.

Codeine 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.

Panadol ultra tablets contain 12.8mg of codeine, which in combination with the paracetamol, is effective at relieving mild to moderate pain.

What is it used for?

Mild to moderate pain, such as headache, migraine, sinusitis, toothache, arthritic and rheumatic pain, sciatica and backache, strains and sprains and period pain.

Relieving aches, pains, sore throat and fever associated with colds and flu.

Warning!

Codeine can cause drowsiness, although at the dose contained in this medicine this is very unlikely. However, if you do find this medicine makes you feel sleepy or dizzy you should not drive or operate machinery and avoid alcoholic drink.

Do not take this medicine with any other products that contain paracetamol. Many over-the-counter painkillers and cold and flu remedies contain paracetamol. It is important to check the ingredients of any medicines you buy without a prescription before taking them in combination with this medicine. Seek further advice from your pharmacist.

An overdose of paracetamol is dangerous and capable of causing serious damage to the liver and kidneys. You should never exceed the dose stated in the information leaflet supplied with this medicine. Immediate medical advice should be sought in the event of an overdose with this medicine, even if you feel well, because of the risk of delayed, serious liver damage.

Alcohol increases the risk of liver damage that can occur if an overdose of paracetamol is taken. The hazards of paracetamol overdose are greater in persistant heavy drinkers and in people with alcoholic liver disease.

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 codeine. As a result, when you then stop taking the medicine you may get withdrawal symptoms such as restlessness and irritability. Do not take this medicine for longer than three days without consulting your doctor. If you find you need to use this medicine all the time you should consult your doctor for advice.

Taking a painkiller for headaches too often or for too long can make them worse.

Use with caution in

Decreased kidney function

Decreased liver function

Not to be used in

Children under 12 years of age

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.

Paracetamol is not known to be harmful when used during pregnancy. However, the safety of codeine has not been established. If codeine is used in the third trimester it may cause withdrawal symptoms in the baby after birth. As a result, this medicine should be used with caution during pregnancy, and only if the expected benefit to the mother outweighs any potential risk to the infant. Seek medical advice from your doctor before using this medicine if you are pregnant.

Paracetamol and codeine may pass into breast milk in amounts that are probably too small to be harmful in most people. However, as with all medicines, you should always seek medical advice from your doctor or pharmacist before taking this medicine if you are breastfeeding.

Label warnings

Do not take more than 2 at any one time. Do not take more than 8 in 24 hours.

Do not take this medication with any other products containing paracetamol.

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