All formulations of co-dydramol contain 500 mg of paracetamol per tablet and may only be sold at a pharmacy as an over-the-counter item without prescription (a P medicine) if containing less than 7.5 mg of dihydrocodeine per tablet. Higher strengths are prescription only medicines. There are no GSL formulations of co-dydramol, as it is a Schedule 5 controlled drug. Four strengths of dihydrocodeine tartrate in each tablet are available:
7.46 mg dihydrocodeine as co-dydramol 7.46/500 (e.g. in the branded product Paramol).
10 mg dihydrocodeine as co-dydramol 10/500, this is also the preparation to be dispensed if no strength is specified on a prescription.
20 mg dihydrocodeine as co-dydramol 20/500 (e.g. branded products Paracod 500/20 and Remedeine).
30 mg dihydrocodeine as co-dydramol 30/500 (e.g. branded products Paracod 500/30 and Remedeine Forte).
Allergic reactions - skin rash or itchy skin, difficulty breathing, increased sweating, redness or flushed face, mucosal lesions (such as mouth ulcers), drug fever.
Abdominal pain - may be caused by spasm of the bile ducts and inflammation of the liver or pancreas.
Gastrointestinal system - stomach irritation (mild stomach pain, heartburn and feeling sick), constipation, feeling or being sick, loss of appetite, dry mouth, difficulty in passage of food through the gut.
Blood - anaemia, changes in numbers and types of blood cells, nose bleeds, increased risk of infection, bruising.
Urinary system - pain or difficulty in passing urine.
Nervous system - confusion, drowsiness, dizziness, 'spinning' sensation, mood changes, depression, hallucinations, restlessness, excitation, fits, increased pressure in the skull (painful eyes, changes in vision), headache, difficulty sleeping, nightmares, reduced alertness. Tolerance or dependence.
Eyes - blurred or double vision, extremely small pupils.
Other - trembling, unusual tiredness or weakness, malaise, low body temperature, breathing difficulties, muscle stiffness, changes in sex drive.