Paracetamol + Codeine (Codelmicst)

Pharmacological group: analgesics; analgesics opioids; Non-narcotic analgesics

Pharmacological action: combined drug whose action is due to the effects of its constituent components. Paracetamol has analgesic and antipyretic activity. Codeine has a central antitussive effect (excitability by inhibiting cough center), and the analgesic effect due to the excitation of opioid receptors in various parts of the CNS and peripheral tissues, resulting in stimulation of antinociceptive system and change the emotional perception of a pain. To a lesser extent than morphine respiratory depression, less likely to cause miosis, nausea, vomiting and constipation (opioid receptor activation in the intestine causes relaxation of smooth muscle, reduction of motility and sphincter spasm). Duration of Analgesic Effect - 4 hours, antitussive - 4.6 hours.
The impact on the receptors: the opiate receptors
Legal status: available only on prescription; List III (US)
Application: oral

Codelmicst analgesic is composed of a combination of codeine phosphate and paracetamol (acetaminophen). Codelmicst tablets used to relieve mild to moderate pain, or when paracetamol NSAIDs (nonsteroidal antiinflammatory drugs) such as ibuprofen, naproxen or aspirin, do not themselves cause sufficient relief of symptoms. Codelmicst is sold under various brand names.

The compositions of Codelmicst
There are seven variants of dosing:

8 mg codeine phosphate tablet (e.g., Tylenol 1 in USA / Canada)
Codeine phosphate 10 mg per tablet
Codeine phosphate 12.8 mg per tablet
15 mg of codeine phosphate per tablet (for example, 2 brands of Tylenol in the US / Canada, Norway, Australia (several brands), Great Britain)
20 mg of codeine phosphate per tablet (Prontalgine in France, Empacod, South Africa and Zimbabwe)
30 mg codeine phosphate tablet (e.g., Tylenol 3 in USA / Canada - Emtec-30 or "Emtec" in Canada is available in capsules such as Tylex or in the form of tablets / capsules Solpadol, for example, Kapake, Panacod and Zapain).
Codeine phosphate 60 mg per tablet (e.g., Tylenol 4 in USA / Canada, usually contain from 300 to 1000 mg (1 g) [[paracetamol | paracetamol]] per tablet. You can also like Ladasten.

In the United Kingdom a prescription dispensed tablets 15/500 and 30/500, but without the prescription form available at 8/500 and 12.8 / 500. In Australia, only prescription tablets dispensed 30/500 and 10/500. Tablets 15/500 included in List 3 (that is, these drugs for pharmacists only). The instructions from the manufacturer recommended not to exceed the recommended doses - two tablets every four hours and a maximum of eight tablets (8h500 mg) in a 24-hour period and no more than two (2x500 mg) for one time. Unless otherwise prescribed by your doctor or pharmacist to avoid other drugs containing acetaminophen. Excessive amounts of acetaminophen can cause serious liver damage. Kodelmikst sold in Canada and the United States are also under the title «Atasol Codeine». In the UK, it is marketed under the brand name «Solpadeine Plus» and «Solpadeine Max», and «Solpadol». In Australia - as the «Panadeine», «Panadeine Extra» and «Panadeine Forte». Kodelmikst sold under the trademarks «Paralgin Minor» (15/200), «Paralgin Forte» (30/400), «Paralgin Major» (60/800), «Pinex Forte» (30/500) and «Pinex Major» ( 60/1000) in Norway.

Side effects
Side effects may include constipation, skin rash, dizziness, sedation, shortness of breath, hypersensitivity reactions, syncope (fainting or presyncopal state), nausea and / or vomiting, confusion, short term memory loss, drowsiness, changes in the blood, allergic reactions, euphoria , dysphoria, abdominal pain, itching, easy bruising, bleeding gums, dry mouth, and addictive. Genetic differences between individuals lead to a different rate of metabolism of codeine to morphine. Approximately 5% of people have this metabolism may be particularly fast, which leads to higher levels of morphine transmitted through breast milk in quantities that could potentially lead to fatal respiratory oppression child through breastfeeding.

Availability:
From 1 June 2012 Russia imposed a ban on the sale of drugs codeine without a prescription. Codelmicst is a combination of paracetamol and codeine, and is released from pharmacies only by prescription.