Codoxol is a four-ingredient tablet containing paracetamol, codeine, caffeine and doxylamine. It is taken for tension headache, body aches and the pain and discomfort of colds and flu. It contains codeine, which is habit-forming, so it is meant for short-term use only.
What is Codoxol?
The South African Medicine Price Registry lists Codoxol as a Schedule 2 tablet — available from a pharmacy without a prescription, with the pharmacist’s involvement:
| Ingredient | Amount | What it does |
|---|---|---|
| Paracetamol | 450 mg | Pain relief and fever reduction |
| Codeine phosphate | 10 mg | Opioid pain relief; also suppresses cough |
| Caffeine | 30 mg | Mild stimulant; enhances the painkillers |
| Doxylamine succinate | 5 mg | Sedating antihistamine; muscle relaxation and drying |
This is a compound analgesic of a type common in South Africa — Mybulen, Synaleve, Stopayne and Myprodol are relatives, with varying combinations.
Each ingredient does something, and each brings its own cautions:
Paracetamol is the backbone, acting centrally to reduce pain and fever.
Codeine is a weak opioid. In the body it is converted by the liver into morphine, which is what actually provides the pain relief. How efficiently people do that conversion varies enormously by genetics — some barely convert it at all and get little benefit, while a small number convert it very rapidly and can experience opioid effects at ordinary doses.
Caffeine is not filler. It modestly enhances the effect of the painkillers and helps with the drowsiness the other ingredients cause.
Doxylamine is a sedating antihistamine. In a headache preparation it contributes muscle relaxation, dries a runny nose, and adds sedation — which is useful at night and a problem during the day.
What is Codoxol commonly used for?
- Tension headache — the most common reason people buy it.
- Migraine, for symptom relief.
- Body aches and muscular pain, including muscle spasm and backache.
- Cold and flu symptoms — the aches, headache, fever and runny nose.
- Period pain.
- Toothache, as short-term relief while waiting for dental treatment.
- Pain after minor injury.
- Sinus pain and pressure.
It is designed for pain with a tension or muscular component, which is where the combination earns its place over plain paracetamol.
The important limit is time. Codoxol is for occasional, short-term use — a few days at most. Two problems follow from regular use:
Dependence. Codeine is an opioid, and taking codeine-containing painkillers daily leads to physical dependence within weeks. This is common, it happens to ordinary people managing ordinary pain, and it is one of the most frequent medicine problems South African pharmacists see.
Medication-overuse headache. Taking painkillers for headache more than about two or three days a week can itself cause headaches — a cycle where the treatment sustains the problem. Codeine-containing products are particularly prone to this. If you have a daily headache and take something for it daily, that pattern is worth showing a doctor.
How Codoxol fits into this medicine category
| Group | Examples | Notes |
|---|---|---|
| Compound analgesics | Codoxol, Mybulen, Synaleve, Stopayne | Several ingredients; codeine cautions apply |
| Simple analgesics | Paracetamol | No dependence risk; first choice for regular use |
| Anti-inflammatories | Ibuprofen, diclofenac | Better for inflammatory pain; stomach cautions |
| Antihistamines | Cetirizine (Austell Cetirizine), chlorphenamine (Rhineton) | Allergy specifically |
| Decongestants | Pseudoephedrine | Blocked nose; blood pressure cautions |
If your pain is occasional and mild, plain paracetamol carries none of the codeine problems. See the allergy, cold and flu medicines hub.
What to check before using Codoxol
Check everything else you take for paracetamol. It appears in a great many cold and flu remedies, sinus products and other painkillers. Taking Codoxol alongside one of them means taking paracetamol twice, which is the most common route to serious accidental overdose.
Check for codeine too. Doubling up on codeine-containing products is equally easy and adds sedation and dependence risk.
Speak to a pharmacist or doctor if you:
- Have liver disease, or drink alcohol heavily.
- Have kidney disease, or weigh under 50 kg.
- Have breathing problems — asthma, COPD, sleep apnoea. Codeine suppresses breathing.
- Take sedating medicines — benzodiazepines, sleeping tablets, other opioids, gabapentin or pregabalin. These combinations meaningfully increase the risk of dangerously slowed breathing.
- Take MAOI antidepressants, or have taken one in the past fortnight.
- Have glaucoma, an enlarged prostate or difficulty passing urine — relevant to doxylamine.
- Have a history of dependence on opioids, alcohol or other substances.
- Have constipation or a bowel condition.
- Are pregnant or breastfeeding. Codeine is generally avoided in breastfeeding, because a mother who converts codeine rapidly can pass unsafe amounts of morphine into her milk.
- Are elderly, where sedation and falls are a greater risk.
Do not give it to children. Codeine is not recommended in children, and should never be given after tonsil or adenoid surgery.
Do not drink alcohol with it, and do not drive until you know how it affects you.
Possible cautions and when to ask a pharmacist or doctor
Common effects are drowsiness, dizziness, dry mouth, constipation, nausea and difficulty concentrating. Constipation is very common with codeine and does not improve on its own.
Get emergency help for:
- Very slow, shallow or difficult breathing, extreme drowsiness or unresponsiveness.
- Suspected paracetamol overdose. This is the most dangerous scenario and the least obvious — someone who has taken too much may feel entirely well for a day or more while serious liver damage develops. Go to an emergency department immediately with the packaging, even if the person seems fine and even if it was accidental. There is an effective antidote and it works best given early.
- Swelling of the face, lips or tongue, difficulty breathing, or a widespread blistering rash.
Contact a doctor if:
- You are using it more than two or three days a week, or for more than a few days at a time.
- You feel you cannot manage without it, or find yourself taking more than the pack allows. This is common, it is treatable, and pharmacists and doctors deal with it regularly without judgement.
- Headaches are becoming more frequent — that may be medication-overuse headache, which improves once the medicine is withdrawn under guidance.
- Pain persists beyond a few days, fever beyond three, or symptoms worsen after improving.
- You develop a sudden severe headache, headache with fever and a stiff neck, weakness, confusion, visual changes or headache after a head injury. Those need urgent assessment.
Related medicine guides
- Browse Allergy, Cold & Flu Medicines guides
- Read: Austell Cetirizine used for
- Read: Rhineton used for
Frequently asked questions
What are Codoxol tablets used for? Tension headache, migraine, body and muscular aches, period pain, toothache, and the pain and discomfort of colds and flu.
Are Codoxol tablets used for headache? Yes — tension headache is the most common reason people take them. But using them more than two or three days a week can cause medication-overuse headache.
What is in Codoxol? Paracetamol 450 mg, codeine phosphate 10 mg, caffeine 30 mg and doxylamine 5 mg.
Do I need a prescription? No. It is Schedule 2 — available from a pharmacy without one, with the pharmacist’s involvement.
Is it addictive? It contains codeine, an opioid, and regular use leads to dependence. It is intended for short-term use only.
Why does it make me drowsy? Both the codeine and the doxylamine are sedating. Do not drive until you know how it affects you, and avoid alcohol.
Can I take it with another painkiller? Check the ingredients first. Many contain paracetamol or codeine already, and doubling up on either is dangerous.
Can I give it to my child? No. Codeine is not recommended for children.