Salterpyn is a South African compound painkiller. The syrup contains paracetamol, codeine and promethazine; Adco-Salterpyn tablets contain paracetamol, codeine, meprobamate and caffeine. Both are used for pain, but they contain very different additional ingredients — check which one you have, as the cautions differ substantially.
What is Salterpyn?
Two quite different products carry this name:
| Product | Contains | Schedule |
|---|---|---|
| Salterpyn syrup | Paracetamol 120 mg/5 ml + codeine phosphate 5 mg/5 ml + promethazine | S2 |
| Adco-Salterpyn tablets | Paracetamol 320 mg + codeine phosphate 8 mg + meprobamate 150 mg + caffeine 32 mg | S5 |
This is not a minor distinction. The tablet is Schedule 5 — a tighter control than the syrup — because it contains meprobamate, and that ingredient carries risks the syrup does not.
What each ingredient does:
- Paracetamol relieves pain and fever. It is the base of the product.
- Codeine is a weak opioid, converted in the body to morphine. It adds pain relief and causes constipation and drowsiness.
- Promethazine (syrup) is a sedating antihistamine, adding drowsiness and reducing nausea.
- Meprobamate (tablets) is an older anti-anxiety and muscle-relaxant medicine. It causes dependence, has serious withdrawal effects including seizures, and is dangerous in overdose. It has been withdrawn or heavily restricted in many countries for exactly these reasons.
- Caffeine is included as a mild stimulant, said to enhance pain relief.
Compound analgesics like this are meant for short-term use. Every additional ingredient adds its own risk, and two here — codeine and meprobamate — carry dependence potential.
What is Salterpyn commonly used for?
- Moderate pain not relieved by paracetamol alone.
- Headache and tension headache.
- Muscular and back pain, where the muscle-relaxant and sedative components are intended to help.
- Period pain.
- Dental pain, short-term.
- Pain with associated tension or difficulty sleeping, where the sedating ingredients are part of the intent.
- Cold and flu symptoms, in the syrup form.
It relieves symptoms and does not treat causes. Ongoing pain needs a diagnosis.
Compound painkillers of this type are a recognised cause of medication-overuse headache. Taking painkillers for headache on most days can itself perpetuate the headache, producing a cycle where the treatment sustains the problem. If you take painkillers on more than about 10 days a month, mention it to a doctor — this is common, under-recognised, and treatable.
How Salterpyn fits into this medicine category
| Group | Examples | Notes |
|---|---|---|
| Simple analgesics | Paracetamol (Donapan) | Pain and fever; no dependence risk |
| NSAIDs | Ibuprofen, diclofenac | Pain and inflammation |
| Compound analgesics | Salterpyn, Stilpane, Mybulen | Paracetamol plus codeine and others |
| Weak opioids | Codeine, tramadol | Moderate pain; dependence potential |
| Sedatives / anxiolytics | Meprobamate, diazepam | Dependence; withdrawal risk |
| Sedating antihistamines | Promethazine | Drowsiness, nausea, allergy |
See the mental health, nerve and neurological medicines hub.
What to check before using Salterpyn
Check everything else you take for paracetamol. This product already contains it, and paracetamol appears in a great many cold and flu remedies, sinus products and other painkillers. Doubling up is the most common route to serious accidental overdose.
Do not drink alcohol with it. Alcohol compounds the sedation from codeine, promethazine and meprobamate, and adds to the risk of liver harm from paracetamol.
Never give the syrup to a child under two years old, because of the promethazine. Codeine is also not recommended in children, and is specifically contraindicated under 12 and after certain surgery.
Speak to a pharmacist or doctor first if you:
- Have liver disease, or drink heavily.
- Have kidney disease.
- Have breathing problems — asthma, COPD or sleep apnoea. Codeine and promethazine both suppress respiration.
- Have a history of substance or alcohol dependence.
- Have glaucoma, prostate enlargement or difficulty passing urine.
- Have epilepsy.
- Have depression or another mental health condition.
- Are elderly, where sedation, confusion and falls are more likely.
- Are pregnant or breastfeeding. Codeine passes into breast milk, and some mothers convert it rapidly to morphine, which has caused harm to babies.
- Take any other sedating medicine, or an MAOI antidepressant.
- Weigh under 50 kg.
Do not drive or operate machinery. The combined sedation is substantial and can persist into the next day.
Possible cautions and when to ask a pharmacist or doctor
Common effects are drowsiness, dizziness, constipation, dry mouth, nausea and blurred vision. Constipation from codeine does not settle on its own — increase fluid and fibre, and ask a pharmacist if it persists.
Seek medical attention urgently if you notice:
- Slow, shallow or difficult breathing, or unusual difficulty waking someone. This is an emergency, particularly in a child or where alcohol or another sedative is involved.
- Marked confusion, or hallucinations.
- A seizure.
- Swelling of the face, lips or tongue, or difficulty breathing.
- A severe rash or blistering skin.
- Yellowing of the eyes or skin.
- Inability to pass urine.
Paracetamol overdose is a medical emergency and does not feel like one at first. Someone who has taken too much may feel entirely well for a day or more while liver damage develops silently. Go to an emergency department immediately with the packaging if too much has been taken — even accidentally, even if the person seems fine. The antidote works best given early.
Do not stop the tablets abruptly after regular use. Meprobamate withdrawal can cause anxiety, tremor, insomnia, hallucinations and seizures, and codeine withdrawal causes its own symptoms. If you have been taking them regularly, ask a doctor to help you reduce gradually rather than stopping on your own.
Dependence on compound painkillers is common and easy to slide into, precisely because they are effective and readily available. Needing them more often, needing more for the same effect, taking them for tension or sleep rather than pain, or feeling unable to manage without them are all reasons to speak to a doctor. This is a treatable situation, not a failing, and raising it early makes it far easier to resolve.
See a doctor if pain lasts more than a few days, worsens, or if you are using painkillers on most days.
Related medicine guides
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Frequently asked questions
What are Salterpyn tablets used for? Moderate pain — headache, muscular and back pain, period and dental pain. Adco-Salterpyn tablets contain paracetamol, codeine, meprobamate and caffeine, and are Schedule 5.
What is Salterpyn syrup used for? Pain and cold and flu symptoms. The syrup contains paracetamol, codeine and promethazine, and must never be given to a child under two.
What is meprobamate? An older anti-anxiety and muscle-relaxant medicine in the tablets. It causes dependence, has serious withdrawal effects including seizures, and is restricted in many countries.
Is Salterpyn addictive? It contains codeine, and the tablets also contain meprobamate — both carry dependence potential. It is intended for short-term use.
Can I take it with paracetamol? No. It already contains paracetamol, and adding more risks overdose. Check cold and flu remedies too.
Can I drink alcohol with it? No. Alcohol compounds the sedation and increases the risk of liver harm.
Can I give it to my child? The syrup must never be given under two years old, and codeine is not recommended in children generally. Ask a pharmacist.
Can I stop taking it suddenly? Not after regular use. Meprobamate withdrawal can cause seizures. Ask a doctor about reducing gradually.