Medication · opioid combination

Supplements and Co-codamol.

Not yet catalogued in the Distil interactions database. We surface that distinction explicitly.

Co-codamol, sold under the brand names Solpadol, Tylex, Kapake, Zapain, is a combination opioid analgesic.

Co-codamol is a combination opioid analgesic. In UK prescribing that mostly means codeine combined with paracetamol, or dihydrocodeine combined with paracetamol. The combination places a weak opioid alongside paracetamol, allowing lower doses of each component for additive analgesia. The supplement surface combines the opioid concerns with the paracetamol concerns. Opioid side. Additive CNS depression with alcohol, benzodiazepines, kava, valerian at higher doses, magnesium glycinate at high doses at bedtime; serotonergic concerns for combinations containing tramadol. Paracetamol side. Additive hepatotoxicity at chronic high doses, particularly alongside alcohol or supplements with hepatic load. Codeine is a CYP2D6 prodrug requiring conversion to morphine for analgesic effect. CYP2D6 inhibitors (some SSRIs, certain supplements at high doses) reduce that conversion and the analgesic effect. The CYP2D6 ultra metaboliser genotype carries the opposite concern, with excessive morphine production.

We have not yet completed an explicit assessment of supplement interactions with Co-codamol in the Distil database. That is different from saying nothing exists. We surface this distinction deliberately: the Distil checker tells you when we have explicitly assessed a pair and when we have not, because both are useful information. If you take Co-codamol alongside a supplement, the checker below will surface anything already in our database, and the missing-item form at the bottom of the page routes uncatalogued pairs into our next curation pass.

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

Your supplements

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Your medications

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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

Read the full methodology

Your whole stack

Want this checked across everything you take?

This page checks the pairs you enter. The personalised Distil report goes further:

the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
where your current routine may be leaving you short of your goals
the evidence-backed compounds worth adding, and the ones worth dropping

It's a paid report: £79, or £49 for the first 25 customers. The interactions check is one section of it, and you can read a real one in full before you buy.

See a real sample report

Something missing?

If a supplement or medication you take isn't in our autocomplete, tell us. We go through what people flag every week and add what's missing.

Thanks, that's logged. We go through flagged items every week.

Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.