Painogesic is a paracetamol brand — 500 mg tablets and a children’s syrup — for mild to moderate pain and fever. There is also Painogesic Co, which adds tramadol and is a Schedule 5 prescription medicine. The two are very different, and knowing which you have matters more than anything else on this page.
What is Painogesic?
The South African Medicine Price Registry lists three Painogesic products:
| Product | Schedule | Contains |
|---|---|---|
| Painogesic syrup | S0 | Paracetamol 120 mg/5 ml |
| Painogesic tablets | S1 | Paracetamol 500 mg |
| Painogesic Co | S5 | Paracetamol 325 mg + tramadol 37.5 mg |
Painogesic and Painogesic Co are not interchangeable. The plain product is paracetamol, available without a prescription. Painogesic Co contains tramadol, an opioid painkiller — it is prescription-only, causes drowsiness, interacts with a long list of medicines, and can cause dependence. Check which one you have before taking it, particularly if someone else handed it to you.
Paracetamol — acetaminophen internationally — acts mainly in the central nervous system to reduce the perception of pain and lower a raised temperature. Unlike anti-inflammatories, it has little effect on inflammation itself.
That distinction is practical. For a swollen joint or an inflammatory condition, an anti-inflammatory usually works better. For general pain and fever, and especially for people who cannot take NSAIDs, paracetamol is first choice — far gentler on the stomach, kidneys and heart.
Paracetamol appears under many South African names — Panado, Donapan, Napamol, Prolief, Actamol, Painogesic. Same active ingredient. Being dispensed one when you expected another is ordinary generic substitution.
The S0 syrup at 120 mg/5 ml is a paediatric strength, dosed by a child’s weight and age.
What is Painogesic commonly used for?
Painogesic (paracetamol):
- Headache, including tension headache.
- Period pain, though an anti-inflammatory is often more effective.
- Backache and muscular aches.
- Toothache, as short-term relief while waiting for dental treatment.
- Cold and flu symptoms — the aches and fever, not the infection.
- Fever, in adults with the tablets and in children with the syrup.
- Pain after minor injury or a procedure.
- Osteoarthritis pain, often as a first step.
It suits people who cannot take NSAIDs — many with stomach ulcers, kidney disease, heart failure or NSAID-triggered asthma — and it is generally the preferred painkiller in pregnancy.
Painogesic Co (paracetamol + tramadol):
For moderate to severe pain where paracetamol alone is not enough — after surgery or injury, and in some chronic pain. The two work by different mechanisms, so the combination gives better relief than either alone. It is prescribed for short courses, because tramadol causes tolerance and dependence with sustained use, and because it interacts with antidepressants, other opioids and several other medicines.
Neither treats the cause. They relieve the symptom while the underlying problem settles. Persistent pain needs a diagnosis, not indefinite relief — and regular painkiller use for headache can itself cause medication-overuse headache.
How Painogesic fits into this medicine category
| Group | Examples | What it does |
|---|---|---|
| Simple analgesics | Paracetamol (Painogesic), Panado, Donapan | Pain and fever; little anti-inflammatory effect |
| Anti-inflammatories | Ibuprofen, diclofenac | Also reduce inflammation; stomach, kidney, heart cautions |
| NSAID + paracetamol | Mypaid Forte | Two mechanisms, no opioid |
| Opioid + paracetamol | Painogesic Co, Synaleve, Mybulen, Stopayne | Stronger; dependence risk with repeated use |
| COX-2 selective | Etoricoxib | Anti-inflammatory, gentler on the stomach |
| Corticosteroids | Prednisone | Powerful anti-inflammatory, in courses |
See the pain, inflammation and musculoskeletal medicines hub.
What to check before using Painogesic
Check everything else you are taking for paracetamol. This is the check that matters most with any paracetamol product. Paracetamol is in a great many products — cold and flu sachets and tablets, sinus preparations, some cough mixtures, and compound painkillers including Painogesic Co itself. Taking two of them means taking paracetamol twice, which is the commonest route to serious accidental overdose.
Read the active ingredients on every product, and ask a pharmacist if unsure.
Speak to a pharmacist or doctor if you:
- Have liver disease, or drink alcohol heavily.
- Have kidney disease.
- Weigh under 50 kg, or are malnourished or eating very little — both genuinely reduce the safe maximum.
- Are buying for a child. Use the syrup, dosed by weight and age, not adult tablets.
- Are pregnant or breastfeeding.
- Take warfarin. Regular paracetamol use can affect anticoagulation control.
For Painogesic Co specifically, also tell them if you:
- Take antidepressants — SSRIs, SNRIs, tricyclics or MAOIs. Tramadol combined with these raises the risk of serotonin syndrome and of seizures.
- Take other opioids, benzodiazepines, sleeping tablets, or pregabalin or gabapentin. The combination can cause dangerously slowed breathing.
- Have epilepsy or a history of seizures. Tramadol lowers the seizure threshold.
- Have breathing problems, sleep apnoea, or severe liver or kidney disease.
- Have a history of substance dependence.
- Drink alcohol.
Follow the pack instructions for how much and how often. This page does not set doses, and the 24-hour maximum matters more with paracetamol than with almost any everyday medicine.
Possible cautions and when to ask a pharmacist or doctor
Paracetamol overdose is a medical emergency, and it does not feel like one at first. Someone who has taken too much may feel completely well for a day or more while serious liver damage develops. By the time symptoms appear, treatment is far less effective.
If you think you or someone else has taken too much — even if they seem fine, even if it was accidental — go to an emergency department immediately with the packaging. There is an effective antidote and it works best given early.
Plain paracetamol taken as directed is well tolerated and side effects are uncommon.
Painogesic Co commonly causes drowsiness, dizziness, nausea, constipation, dry mouth and sweating. Do not drive until you know how it affects you.
Get emergency help for:
- Any suspected overdose.
- Slow or shallow breathing, or difficulty waking someone on Painogesic Co.
- A seizure.
- Agitation with fever, sweating, shivering, muscle twitching, fast heartbeat and confusion — possible serotonin syndrome.
- Swelling of the face, lips or tongue, or difficulty breathing.
- A widespread blistering or peeling rash.
Seek advice for any rash or itching, for persistent constipation on Painogesic Co, or if you find yourself needing more than prescribed.
See a doctor if pain lasts beyond a few days, if fever persists past three days or returns, if pain is severe or worsening, if you are using painkillers most days, or if other symptoms appear — a rash, stiff neck, breathlessness or confusion. For a child, use a lower threshold.
Related medicine guides
- Browse Pain, Inflammation & Musculoskeletal Medicines guides
- Read: Prednisone used for
- Read: Donapan used for
Frequently asked questions
What are Painogesic tablets used for? Mild to moderate pain — headache, period pain, backache, toothache, body aches — and fever. They contain paracetamol 500 mg.
What is Painogesic 500 mg used for? The same. 500 mg is the standard adult paracetamol tablet strength.
What is Painogesic Co? A different, stronger medicine — paracetamol 325 mg with tramadol 37.5 mg. It is Schedule 5, prescription-only, causes drowsiness, and can cause dependence. Check which product you have.
Is Painogesic the same as Panado? Both are South African paracetamol brands with the same active ingredient. Different manufacturers.
Can I take it with ibuprofen? They are different medicines and are sometimes used together on advice. The real risk is taking paracetamol twice through a combination product.
Is the syrup for children? Yes — 120 mg per 5 ml is a paediatric strength, dosed by weight and age. Do not give adult tablets to a young child.
Is it safe in pregnancy? Paracetamol is generally regarded as the preferred painkiller in pregnancy. Painogesic Co is a different matter — ask your doctor.
What if I have taken too much? Go to an emergency department immediately with the packaging, even if you feel well. Liver damage develops without early symptoms and the antidote works best given early.