Zapain 30Mg 500Mg Tabletės What For?

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What are Zapain 30mg used for?

Zapain Tablets can be used in children over 12 years of age for the short-term relief of moderate pain that is not relieved by other painkillers such as paracetamol or ibuprofen alone. It contains codeine, which belongs to a class of medicines called opioids, which are ‘pain relievers’.

What is the use of Zapain 500mg?

1. WHAT ZAPAIN CAPSULES ARE AND WHAT THEY ARE USED FOR – Zapain Capsules contain paracetamol and codeine. Paracetamol is an analgesic (relieves pain) and an antipyretic (lowers raised temperatures). Codeine is a strong painkiller. Zapain Capsules are used for the relief of severe pain.

Does Zapain put you to sleep?

Common side effects of Zapain include: Sleepiness. Headaches. Feeling or being sick (nausea or vomiting) Dizziness.

How many zapain 30mg 500mg tablets can I take?

My Account Area – 1. Name of the medicinal product Zapain 30mg/500mg Tablets and/or Co-Codamol 30mg/500mg Tablets 2. Qualitative and quantitative composition Each tablet contains Paracetamol Ph. Eur 500mg, and Codeine Phosphate BP 30mg For full list of excipients, see section 6.1 3.

Pharmaceutical form Caplet-shaped, white film-coated tablet. Each film coated tablet is of 16.6 mm – 18.4 mm x 7.1 mm -7.9 mm x 5.8 mm – 6.5 mm.4. Clinical particulars 4.1 Therapeutic indications For the relief of severe pain Codeine is indicated in patients older than 12 years of age for the treatment of acute moderate pain which is not considered to be relieved by other analgesics such as paracetamol or ibuprofen (alone).4.2 Posology and method of administration Posology Prior to starting treatment with opioids, a discussion should be held with patients to put in place a strategy for ending treatment with codeine in order to minimise the risk of addiction and drug withdrawal syndrome (see section 4.4).

Adults : The usual dose is one or two tablets every four to six hours when needed, up to a maximum of 8 tablets in any 24 hour period. Codeine should be used at the lowest effective dose for the shortest period of time. This dose may be taken, up to 4 times a day at intervals of not less than 6 hours.

  1. Maximum daily dose should not exceed 240 mg.
  2. The duration of treatment should be limited to 3 days and if no effective pain relief is achieved the patients/carers should be advised to seek the views of a physician.
  3. Elderly : A reduced dosage may be necessary.
  4. Paediatric population: Children aged 16-18 years: one to two tablets every 6 hours when necessary up to a maximum of 8 tablets in 24 hours.

Children aged 12 – 15 years: one tablet every 6 hours when necessary up to a maximum of 4 tablets in 24 hours. Children aged less than 12 years: “Codeine should not be used in children below the age of 12 years because of the risk of opioid toxicity due to the variable and unpredictable metabolism of codeine to morphine (see sections 4.3 and 4.4).

  • Dosage needs to be adjusted according to the severity of pain and the response of the patient.
  • Doses of Codeine above 60mg are associated with an increase in unwanted effects.
  • Method of administration Oral 4.3 Contraindications Hypersensitivity to the active substances or to any of the excipients of Zapain tablets listed in section 6.1 Children under 12 years of age.

Zapain is contraindicated in patients with moderate to severe degrees of renal or hepatic impairment. It is contraindicated in patients for whom opiate medications should not be used, such as patients with acute asthma, obstructive airway disease, respiratory depression, acute alcoholism, head injuries, raised intracranial pressure, after biliary surgery, patients suffering from diarrhoea of any cause, and patients who have taken MAOIs within 14 days.

In all paediatric patients (0-18 years of age) who undergo tonsillectomy and/or adenoidectomy for obstructive sleep apnoea syndrome due to an increased risk of developing serious and life threatening adverse reactions (see section 4.4) In women during breastfeeding (see section 4.6) In patients for whom it is known they are CYP2D6 ultra-rapid metabolisers.4.4 Special warnings and precautions for use The efficacy and safety of Zapain tablets in children below the age of 12 years has not been established, and use in such children is contraindicated.

Zapain tablets must be used with caution in patients with increases intracranial pressure, debilitated, impaired hepatic or renal function and urethral stricture. (See also “Contraindications”. Note particularly that Zapain is contraindicated in patients with severe renal or hepatic impairment.) Care should be observed in administering the product to any patient, whose condition may be exacerbated by opioids, including the elderly, who may be sensitive to their central and gastro-intestinal effects, those on concurrent CNS depressant drugs, those with prostatic hypertrophy, hypothyroidism and those with acute abdominal conditions like inflammatory or obstructive bowel disorders, Addison’s disease or myasthenia gravis.

  • Care should also be observed if prolonged therapy is contemplated.
  • Drug dependence, tolerance and potential for abuse For all patients, prolonged use of this product may lead to drug dependence (addiction), even at therapeutic doses.
  • The risks are increased in individuals with current or past history of substance misuse disorder (including alcohol misuse) or mental health disorder (e.g., major depression).

Additional support and monitoring may be necessary when prescribing for patients at risk of opioid misuse. A comprehensive patient history should be taken to document concomitant medications, including over-the-counter medicines and medicines obtained on-line, and past and present medical and psychiatric conditions.

  • Patients may find that treatment is less effective with chronic use and express a need to increase the dose to obtain the same level of pain control as initially experienced.
  • Patients may also supplement their treatment with additional pain relievers.
  • These could be signs that the patient is developing tolerance.

The risks of developing tolerance should be explained to the patient. Overuse or misuse may result in overdose and/or death. It is important that patients only use medicines that are prescribed for them at the dose they have been prescribed and do not give this medicine to anyone else.

Patients should be closely monitored for signs of misuse, abuse, or addiction. The clinical need for analgesic treatment should be reviewed regularly. Drug withdrawal syndrome Prior to starting treatment with any opioids, a discussion should be held with patients to put in place a withdrawal strategy for ending treatment with codeine.

Drug withdrawal syndrome may occur upon abrupt cessation of therapy or dose reduction. When a patient no longer requires therapy, it is advisable to taper the dose gradually to minimise symptoms of withdrawal. Tapering from a high dose may take weeks to months.

  1. The opioid drug withdrawal syndrome is characterised by some or all of the following: restlessness, lacrimation, rhinorrhoea, yawning, perspiration, chills, myalgia, mydriasis and palpitations.
  2. Other symptoms may also develop including irritability, agitation, anxiety, hyperkinesia, tremor, weakness, insomnia, anorexia, abdominal cramps, nausea, vomiting, diarrhoea, increased blood pressure, increased respiratory rate or heart rate.

If women take this drug during pregnancy, there is a risk that their newborn infants will experience neonatal withdrawal syndrome. Hyperalgesia Hyperalgesia may be diagnosed if the patient on long-term opioid therapy presents with increased pain. This might be qualitatively and anatomically distinct from pain related to disease progression or to breakthrough pain resulting from development of opioid tolerance.

Pain associated with hyperalgesia tends to be more diffuse than the pre-existing pain and less defined in quality. Symptoms of hyperalgesia may resolve with a reduction of opioid dose. Risk from concomitant use of sedative medicines such as benzodiazepines or related drugs: Concomitant use of Zapain tablets and sedative medicines such as benzodiazepines or related drugs may result in sedation, respiratory depression, coma and death.

Because of these risks, concomitant prescribing with these sedative medicines should be reserved for patients for whom alternative treatment options are not possible. If a decision is made to prescribe Zapain tablets concomitantly with sedative medicines, the lowest effective dose should be used, and the duration of treatment should be as short as possible.

The patients should be followed closely for signs and symptoms of respiratory depression and sedation. In this respect, it is strongly recommended to inform patients and their caregivers to be aware of these symptoms (see section 4.5). CYP2D6 metabolism Codeine is metabolised by the liver enzyme CYP2D6 into morphine, its active metabolite.

If a patient has a deficiency or is completely lacking this enzyme an adequate analgesic effect will not be obtained. Estimates indicate that up to 7% of the Caucasian population may have this deficiency. However, if the patient is an extensive or ultra-rapid metaboliser there is an increased risk of developing side effects of opioid toxicity even at commonly prescribed doses.

  • These patients convert codeine into morphine rapidly resulting in higher than expected serum morphine levels.
  • General symptoms of opioid toxicity include confusion, somnolence, shallow breathing, small pupils, nausea, vomiting, constipation and lack of appetite.
  • In severe cases this may include symptoms of circulatory and respiratory depression, which may be life-threatening and very rarely fatal.
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Estimates of prevalence of ultra-rapid metabolizer in different populations are summarized below:

Population Prevalence %
African Ethiopian 29%
African American 3.4% to 6.5%
Asian 1.2% to 2%
Caucasian 3.6% to 6.5%
Greek 6.0%
Hungarian 1.9%
Northern European 1%-2%

Post-operative use in children There have been reports in the published literature that codeine given post-operatively in children after tonsillectomy and/or adenoidectomy for obstructive sleep apnoea, led to rare, but life-threatening adverse events including death (see also section 4.3). All children received doses of codeine that were within the appropriate dose range; however there was evidence that these children were either ultrarapid or extensive metabolisers in their ability to metabolise codeine to morphine. Children with compromised respiratory function Codeine is not recommended for use in children in whom respiratory function might be compromised including neuromuscular disorders, severe cardiac or respiratory conditions, upper respiratory or lung infections, multiple trauma or extensive surgical procedures. These factors may worsen symptoms of morphine toxicity.” Overdosage in patients with non-cirrhotic alcoholic liver disease can be hazardous. The hazard of paracetamol overdose is greater in those with alcoholic liver disease. Codeine at high doses has the same disadvantages as morphine, including respiratory depression. Drug dependence of the morphine type can be produced by the Codeine, and the potential for drug abuse with codeine must be considered. Codeine may impair mental or physical abilities required in the performance of potentially hazardous tasks. Patients must be advised not to exceed the recommended doses. Patients must be advised not to take other products containing paracetamol or opiate derivatives when taking Zapain, and to consult their doctor if symptoms persist. The cough suppressant effect of codeine may be undesirable in patients with some respiratory conditions. The leaflet will state in a prominent position in the ‘before taking’ section: • Do not take for longer than directed by your prescriber • Taking codeine/dihydrocodeine (DHC) regularly for a long time can lead to addiction, which might cause you to feel restless and irritable when you stop taking the tablets. • Taking a painkiller for headaches too often or for too long can make them worse. The label will state (To be displayed prominently on outer pack- not boxed): • Do not take for longer than directed by you prescriber as taking codeine/DHC regularly for a long time can lead to addiction.4.5 Interaction with other medicinal products and other forms of interaction The hypotensive effects of antihypertensive agents, including diuretics, may be potentiated by codeine. Quinine or quinidine may inhibit the analgesic actions of codeine. The CNS depressant action of Zapain may be enhanced by coadministration with any other drug which has a CNS depressant effect (e.g. anxiolytics, hypnotics, antidepressants, antipsychotics and alcohol). Concomitant use of any drug with a CNS depressant action should be avoided. If combined therapy is necessary, the dose of one or both agents should be reduced. Concomitant administration of Zapain and MAOIs or tricyclic antidepressants may increase the effect of either the antidepressant or codeine. Concomitant administration of codeine and anticholinergics may cause paralytic ileus. Concomitant administration of codeine with an anti-diarrhoeal agent increases the risk of severe constipation, and coadministration with an antimuscarine drug may cause urinary retention. The absorption of paracetamol is speeded by metaclopramide or domperidone, and absorption is reduced by cholestyramine. Codeine may delay the absorption of mexilitine, and cimetidine may inhibit codeine metabolism. Opioids may interfere with the results of plasma amylase, lipase, bilirubin, ALP, LDH, AST, and ALT tests. The effects of codeine on the gut may interfere with diagnostic tests of gastro-intestinal functions. The anticoagulant effect of warfarin and other coumarins may be increased by long term regular daily use of paracetamol, with increased risk of bleeding. Occasional doses of paracetamol do not have a significant effect on these anticoagulants. Sedative medicines such as benzodiazepines or related drugs: The concomitant use of opioids with sedative medicines such as benzodiazepines or related drugs increases the risk of sedation, respiratory depression, coma and death because of additive CNS depressant effect. The dose and duration of concomitant use should be limited (see section 4.4).4.6 Fertility, pregnancy and lactation Pregnancy : Regular use during pregnancy may cause drug dependence in the foetus, leading to withdrawal symptoms in the neonate. If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available. Administration during labour may depress respiration in the neonate and an antidote for the child should be readily available. Breast-feeding : Administration to nursing women is not recommended as codeine may be secreted in breast milk and may cause respiratory depression in the infant. If the patient is an ultra rapid metaboliser of CYP2D6, higher levels of the active metabolite, morphine, may be present in breast milk and on very rare occasions may result in symptoms of opioid toxicity in the infant, which may be fatal. Fertility: No data available 4.7 Effects on ability to drive and use machines Patients should be advised not to drive or operate machinery if Zapain causes dizziness or sedation. Codeine may cause visual disturbances. This medicine can impair cognitive function and can affect a patient’s ability to drive safely. This class of medicine is in the list of drugs included in regulations under 5a of the Road Traffic Act 1988. When prescribing this medicine, patients should be told: • The medicine is likely to affect your ability to drive • Do not drive until you know how the medicine affects you • It is an offence to drive while under the influence of this medicine • However, you would not be committing an offence (called ‘statutory defence’) if: o The medicine has been prescribed to treat a medical or dental problem and o You have taken it according to the instructions given by the prescriber and in the information provided with the medicine and o It was not affecting your ability to drive safely 4.8 Undesirable effects The information below lists reported adverse reactions, ranked using the following frequency classification: common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100) and not known (cannot be estimated from the available data).

System organ class Frequency Adverse effects
Blood and lymphatic system disorders Not known Thrombocytopenia, Agranulocytosis*
Immune system disorder Not known Hypersensitivity (including skin rash)
Psychiatric disorders Not known Dysphoria Euphoria Drug dependence (see section 4.4),
Nervous system disorders Common Not known Dizziness c Light-headedness c Sedation c Headache
Eye Disorder Not known Miosis visual disturbances
Cardiac disorders Not known bradycardia
Ear and labyrinth disorders Not known Hearing loss
Respiratory, thoracic and mediastinal disorders Common Not known Shortness of breath c Respiratory depression a
Gastrointestinal disorders Common Not known Nausea c vomiting c Constipation c, Abdominal pain,
Hepatobiliary disorders Not known Liver damage b
Skin and subcutaneous tissue disorders Not known Pruritus
Renal and urinary disorders Not known Difficult micturition Urinary retention
General disorders and administration site conditions Uncommon Drug withdrawal syndrome

a Codeine can cause respiratory depression particularly in overdosage and in patients with compromised respiratory function. b Liver damage in association with therapeutic use of paracetamol has been documented; most cases have occurred in conjunction with chronic alcohol abuse.

C Some of these side effects appear more common in ambulatory: rather than non-ambulatory patients. Lying down may alleviate these effects they occur. *There have been some reports of blood dyscrasias- Thrombocytopenia and argranulocytosis, with the use of paracetamol- containing products, but the causal relationship has not been established.

Prolonged use of a pain killer for headaches can make them worse. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.

  1. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme website www.mhra.gov.uk/yellowcard.
  2. Or search for MHRA Yellow Card in the Google Play or Apple App Store.4.9 Overdose Patients should be informed of the signs and symptoms of overdose and to ensure that family and friends are also aware of these signs and to seek immediate medical help if they occur.
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Paracetamol Symptoms of overdosage with paracetamol in the first 24 hours are pallor, nausea, vomiting, anorexia, and abdominal pain. In 12 to 48 hours liver damage may become apparent, together with abnormalities of glucose metabolism, and metabolic acidosis.

  1. Liver damage has occurred in adults taking 10g or more of paracetamol.
  2. Excess quantities of a toxic metabolite become irreversibly bound to liver tissue, and immediate treatment is essential.
  3. Patients ingesting 7.5g or more of paracetamol in 4 hours should be referred to hospital urgently.
  4. Overdose with paracetamol can commonly cause acute hepatic necrosis with severe liver damage and may lead to fulminant hepatic failure, which is usually fatal.

In severe overdose hepatic failure may progress to encephalopathy, coma and death. Even in the absence of severe liver damage, acute renal failure due to acute tubular necrosis may develop without hepatic failure. There are no specific early signs of severe poisoning with paracetamol.

  1. Consciousness is not usually impaired, and maximum abnormality of liver function tests is delayed for at least three days.
  2. Liver damage is caused by conversion of paracetamol to a highly reactive metabolite.
  3. Necrosis does not occur unless hepatic glutathione is depleted.
  4. Early treatment of paracetamol overdose with agents which facilitate glutathione synthesis, for example N-acetylcysteine and methionine, can prevent liver damage, renal failure, and death.

Treatment must be started within 8 to 10 hours, and is not effective if delayed beyond 15 hours. Cardiac arrhythmias and pancreatitis have been reported. Codeine The effects in overdosage will be potentiated by simultaneous ingestion of alcohol and psychotropic drugs.

Symptoms Central nervous system depression, including respiratory depression, may develop but is unlikely to be severe unless other sedative agents have been co-ingested, including alcohol, or the overdose is very large. The pupils may be pin-point in size; nausea and vomiting are common. Hypotension and tachycardia are possible but unlikely.

Management This should include general symptomatic and supportive measures including a clear airway and monitoring of vital signs until stable. Consider activated charcoal if an adult presents within one hour of ingestion of more than 350mg or a child more than 5mg/kg.

Give naloxone if coma or respiratory depression is present. Naloxone is a competitive antagonist and has a short half-life so large and repeated doses may be required in a seriously poisoned patient. Observe for at least four hours after ingestion or eight hours if a sustained release preparation has been taken.5.

Pharmacological properties 5.1 Pharmacodynamic properties Pharmacotherapeutic group: Opioids in combination with non-opioid analgesics, ATC code: N02AJ06 Paracetamol (N02B E51) has analgesic and antipyretic actions. It is a weak inhibitor of prostaglandin biosynthesis.

Single or repeated therapeutic doses of paracetamol do not affect the cardiovascular or respiratory systems. Gastric irritation, erosion, or bleeding is not produced by paracetamol. There is minimal effect on platelets, no effect on bleeding time or excretion of uric acid. Codeine (N02A A59) is a centrally acting weak analgesic.

Codeine exerts its effect through μ opioid receptors, although codeine has low affinity for these receptors, and its analgesic effect is due to its conversion to morphine. Codeine, particularly in combination with other analgesics such as paracetamol, has been shown to be effective in acute nociceptive pain.

Codeine affects the CNS and the gut, including analgesia, drowsiness, mood changes, respiratory depression, reduced gastrointestinal motility, nausea or vomiting, changes in the endocrine and autonomic nervous system. Codeine’s effect on pain relief is selective, and it does not affect other sensations such as touch, vibration, vision, or hearing.5.2 Pharmacokinetic properties Paracetamol is readily absorbed from the gastrointestinal tract with peak plasma concentrations occurring about 30 minutes to 2 hours after ingestion.

Paracetamol is metabolised in the liver and excreted in the urine mainly as the glucuronide and sulphate conjugates, with about 10% as glutathione conjugates. Less than 5% is excreted as unchanged paracetamol. The elimination half life varies from about 1-4 hours.

Plasma protein binding is negligible at usual therapeutic concentrations, although this is dose dependent. A minor hydrolated metabolite which is usually produced in very small amounts by mixed function oxidases in the liver and which is usually detoxified by conjugation with liver glutathione may accumulate following paracetamol overdosage and cause liver damage.

Codeine and its salts are absorbed from the gastro-intestinal tract and peak plasma concentrations are produced in about 1 hour. It is metabolised in the liver to morphine and norcodeines. Codeine and its metabolites are excreted almost entirely by the kidney, mainly as conjugates with glucuronic acid.

  1. The plasma half life is between 3 and 4 hours.5.3 Preclinical safety data Conventional studies using the currently accepted standards for the evaluation of toxicity to reproduction and development are not available.6.
  2. Pharmaceutical particulars 6.1 List of excipients Maize Starch Methylcellulose Talc Calcium Stearate Povidone Purified Water Hypromellose Macrogol 3350 6.2 Incompatibilities Not applicable 6.3 Shelf life 36 months 6.4 Special precautions for storage Do not store above 25°C 6.5 Nature and contents of container Polyethylene container with low density polyethylene child resistant closure OR Aluminium-Polyethylene Terephthalate (PET) foil over PVC/PVDC film blisters In pack sizes of 50, 56, 100 or 112 tablets.6.6 Special precautions for disposal and other handling No special requirements for disposal Any unused medical or waste material should be disposed of in accordance with local requirements 7.

Marketing authorisation holder Mercury Pharmaceuticals Ltd., Capital House, 85 King William Street, London EC4N 7BL, UK 8. Marketing authorisation number(s) PL 12762/0034 9. Date of first authorisation/renewal of the authorisation Date of first authorisation: 22 November 1999 Date of latest renewal: 03 March 2009 10.

Can you take paracetamol and ibuprofen together?

Taking ibuprofen with other painkillers – It’s safe to take ibuprofen with paracetamol or codeine, But do not take ibuprofen with similar painkillers like aspirin or naproxen without talking to a pharmacist or doctor. Ibuprofen, aspirin and naproxen belong to the same group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs),

Can you buy codeine over counter UK?

Over-the-counter (OTC) painkillers are painkillers that you can buy without a prescription from a doctor. You may be able to buy them from a pharmacy or a shop. OTC painkillers include paracetamol, ibuprofen, low-dose codeine, dihydrocodeine and aspirin. Review your cookie settings to access all features.

What pain is Zapain good for?

What Is Zapain Used For? – Zapain is used for pain relief whereas weaker pain relief drugs are not helping. Codeine is an opioid drug mixed with paracetamol to form co-codamol it is commonly used to treat muscular pain like backache, headaches, and migraines along with toothache. It can be a very effective pain relief option.

What is the strongest pain relief?

Opiates are the strongest pain killers we are able to prescribe and can be very effective at treating acute, severe pain caused by injury, surgery or cancer pain, However the role of opiates in chronic pain (pain lasting a long period of time) is less clear.

For most people opiates are NOT effective for chronic pain, Opiates include such medicines as codeine, dihydrocodeine, morphine, oxycodone, buprenorphine and fentanyl. Opiates are to be considered for pain management only when all other medication and non- medication options have been explored. https://livewellwithpain.co.uk/ Opiates can be helpful initially in reducing the feeling of pain in acute situations such as after an injury where you may have broken a bone.

They may be used in hospital after major surgery Yet we would expect the pain to improve relatively quickly as the broken bone or injury repairs. Acute prescriptions for opiates will not exceed 7 day’s supply, which is the expected duration of pain severe enough to require opioids.

In those instances where opiates are the most suitable option of analgesia for a patient, (for example in the elderly, where other analgesia is not suitable,) then a clinical decision will be made and the prescriber will prescribe the minimum effective dose for a specified period of time, with planned follow up, before any further prescriptions can be issued.

For chronic pain the benefits of opiates are limited. Recent clinical evidence shows that the use of opiates for the management of chronic pain is ineffective and has the potential to be harmful (1). We understand chronic pain can have a severe impact on your quality of life and many people who suffer from chronic pain long for a quick solution to eradicate pain completely.

TOLERANCE AND INCREASED PAIN

When opiates are only prescribed for a short period of time, the body doesn’t have time to adapt and therefore you experience pain relief from the opiates. This initial feeling of relief is often experienced when the dose or strength of the opiate is increased.

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ADDICTION

Opiate medication is addictive. It is unusual for someone with acute, short term pain to become addicted to opiates if they follow the prescribing advice of the clinician and take the minimum effective dose for the shortest period of time. However, longer term use of opiates can lead to addiction.

If you believe you are addicted to opiate medication then please arrange an appointment with the GP or pharmacist at the surgery. We can help support you with a reduction plan which is safe. We would not advice stopping your opiate medication abruptly. Further information can also be found at FORWARD LEEDS Forward Leeds self referral form Chronic pain is complex and there are often other factors which contribute to the cause of pain.

Some of these may be physical; others may be emotional and social. If you believe there are other factors which may be contributing to your pain please arrange for an appointment with a GP or pharmacist.

MISUSE OF MEDICATION

Opiates have the potential for misuse. They may cause physical dependence, where any of the risk factors are identified for a patient an appointment with a GP or pharmacist will be made before any further medication is prescribed. SIDE EFFECTS When you first start taking opiate based medication some people get side effects such as:

Dizziness Drowsiness Nausea and/ or vomiting confusion

These symptoms normally settle after a few days. Other ongoing side effects of opiates include:

Constipation that can require laxatives Reduced libido (sex drive), erectile dysfunction and irregular periods Itchy skin Weight gain reduced fertility, Increased levels of pain Mood changes, agitation Loss of interest and concentration Difficulty breathing especially at night.

There is also an increasing awareness that people can die from opiate use. This is not really a problem with weak opiates such as codeine on its own. Yet this can be an issue when more than one opiate is prescribed or when prescribed in higher doses or with other drugs that affect breathing like benzodiazepines or gabapentin or pregabalin the risk is increased.

DRIVING

Please see the DVLA website for information on driving when taking prescription medicines such as opioids. DVLA advice drug- driving

ALCOHOL

If you are taking an opiate do not drink alcohol. LOST PRESCRIPTIONS WILL NOT BE REPLACED. PRESCRIPTIONS REQUESTED EARLY FOR TRAVEL; WILL REQUIRE PROOF OF TRAVEL If you take higher doses than prescribed and run out of medication before the next prescription is due, you will NOT be prescribed extra tablets.

These medicines are controlled drugs and will not be prescribed early. PRESCRIPTION WAITING TIME REMINDER. The practice endeavors to fulfil the following. PRESCRIPTION REQUESTS; Prescription requests take up to two full working day’s to action. Please be aware this will only lead to a prescription if it is appropriate to prescribe.

Please refrain from waiting in the reception area for the prescription process to take place. It will not result in prescriptions being fulfilled any quicker. Thank you for your co-operation. Want to reduce your opiate medication or other pain meds? If you are taking regular opiates or other pain killers and you want to stop them then please contact the surgery to arrange an appointment with a GP or pharmacist.

NICE, Medicines optimisation in chronic pain, online, updated 1/9/2019. Accessed 18/1/21. https://www.nice.org.uk/advice/KTT21/chapter/Evidence-context

What are the side effects of the drug Codipar?

Possible side effects are feeling sick (nausea) and being sick (vomiting) light headedness, dizziness, sleepiness shortness of breath stomach pains, constipation.

How long can you stay on Zapain?

The recommended dose is one or two capsules every four to six hours as required up to a maximum of 8 capsules in any 24 hour period. If you feel the effect of Zapain Capsules is too strong or too weak or your symptoms persist, speak to your doctor or pharmacist. This medicine should not be taken for more than 3 days.

Can I take 2 500mg pain relief?

Zapain 30Mg 500Mg Tabletės What For You should only take 1-2 pills of 500-mg Tylenol at a time and no more than 6 pills in a 24-hour period. Long-term Tylenol use can cause liver damage You should only take 1-2 pills of 500-mg Tylenol or acetaminophen at a time and no more than 6 pills in a 24-hour period.

  1. The maximum daily dose of Tylenol for a healthy adult who weighs at least 150 pounds is 4,000 mg.
  2. However, since some people may develop serious health issues such as liver damage even with 4,000 mg in a day, most experts recommend not exceeding 3,000 mg of a day.
  3. Taking Tylenol for long durations can cause dangerous side effects.

If you need to take more for chronic pain, talk to your doctor.

Can you have 2 paracetamol and 2 ibuprofen together?

Can I take paracetamol and ibuprofen together? – Ibuprofen and paracetamol can be safely taken together, though this combination is not recommended for long-term use in chronic pain. This particular combination is sometimes used as an alternative to opioid-based painkillers, such as codeine, for the management of short-term moderate pain.

So far, short-term use studies have not identified any specific safety concerns with this combination, other than the ones already known to be associated with the individual drugs themselves. Longer-term use studies reported an increased incidence of bleeding and gastrointestinal events, higher than the risks of the individual drugs.

Special caution should therefore be used if considering this combination for long-term use.

Is it bad to take 2 paracetamol and 2 ibuprofen?

Taking paracetamol with other painkillers – It’s safe to take paracetamol with other types of painkiller that do not contain paracetamol, such as, or, Do not take paracetamol alongside other medicines that contain paracetamol. If you take 2 different medicines that contain paracetamol, there’s a risk of overdose.

Can I take 4 paracetamol at once?

If you take too much – Taking 1 or 2 extra tablets is unlikely to harm you. Do not take more than 8 tablets in 24 hours. Taking too much paracetamol can be dangerous and you may need treatment. Too much paracetamol can cause liver damage.

Which is the best body pain killer tablet?

Ibuprofen (Advil, Motrin) is a nonsteroidal anti-inflammatory drug (NSAID) that treats pain, fever, and swelling. Many people consider this to be one of the best pain relief medications.

What drug is closest to codeine?

Codeine is an opioid drug closely related to morphine and, like morphine, is derived from opium poppies. Codeine can cause opioid tolerance, dependence, addiction, poisoning and in high doses, death.

Which tablet is best for muscle pain?

What to Take for Muscle Pain, Joint Pain and Sports Injuries – Content Ibuprofen (trade names are Advil, Motrin, Midol) “targets inflammation, so it is particularly helpful for muscle pain, joint pain and sports injuries, For the winter, ibuprofen really comes in handy for sore throats.” Precautions – Ibuprofen can increase your risk of heart attack or stroke, especially if you use it long term, take high doses, or have heart disease,

“Naproxen and ibuprofen are better for inflammation and muscle strains. A bonus of Naproxen is you can take it twice a day versus every 4 to 6 hours like with acetaminophen. This can be more convenient for many people.” Precautions – May increase your risk of heart attack or stroke, especially if you use it long term or have heart disease.

If you have had a stomach ulcer or gastritis, talk to your doctor before taking naproxen.

What is codeine used for?

Codeine is a painkiller that is part of a group of medicines called opiates. It’s used to treat pain, for example, after an operation or an injury. It’s also used for ongoing pain when painkillers such as paracetamol, ibuprofen and aspirin have not worked.

Codeine is also used to treat diarrhoea, It works in the central nervous system and the brain to block pain signals to the rest of the body. It also reduces the anxiety and stress caused by pain. Codeine is available on prescription and comes as tablets, a liquid you swallow and as an injection. Codeine injections are usually only given in hospital.

You can also buy lower-strength codeine from a pharmacy. It comes mixed with paracetamol ( co-codamol ) or with aspirin ( co-codaprin ) or with ibuprofen ( Nurofen Plus ). Pharmacies also sell codeine as a syrup (linctus) to treat dry coughs.

How does codeine work?

How does codeine work? – Codeine works directly on the central nervous system and reduces feelings of pain by interrupting the way nerves signal pain between the brain and the body. It also suppresses the activity in the brain that controls coughing.