enhanced hypotensive and sedative effects when opioid analgesics given with antipsychotics
Increased risk of toxicity with myelosuppressive drugs
increased sedative effect when opioid analgesics given with anxiolytics and hypnotics
metabolism of opioid analgesics inhibited by cimetidine (increased plasma concentration)
avoidance of premedication with opioid analgesics advised by manufacturer of ciprofloxacin (reduced plasma concentration of ciprofloxacin) when ciprofloxacin used for surgical prophylaxis
opioid analgesics antagonise effects of domperidone on gastro-intestinal activity
By mouth, 30–60 mg every 4 hours when necessary, to a max. of 240 mg daily; child 1–12 years, 3 mg/kg daily in divided doses
By intramuscular injection, 30–60 mg every 4 hours when necessary
Compound analgesic agents by Alan McLeod
The compound agents are preparations that include paracetamol (or aspirin) and a weak opioid. Caffeine is sometimes added to increase effectiveness but has no proven effect and may actually worsen headache.
No proven to reduce pain more than simple paracetamol
Reduce scope for titration of individual components
May get opioid side effects (e.g. constipation)
Co-proxamol has been withdrawn and should no longer be prescribed – patients should be switched to an alternative
Co-codamol tablets are used for the relief of mild/moderate (or in the case of 30/500mg - severe) pain.
Co-dydramol tablets are used for the relief of mild/moderate pain.
Codeine phosphate 8 mg; Paracetamol 500 mg
Codeine phosphate 15 mg; Paracetamol 500 mg
Codeine phosphate 30 mg; Paracetamol 500 mg
Di-hydrocodeine tartrate 10 mg, Paracetamol 500 mg
Di-hydrocodeine tartrate 20 mg, Paracetamol 500 mg
Di-hydrocodeine tartrate 30 mg, Paracetamol 500 mg