To wonder if you can overdose on cocodamol like this?

[PoesyCherish]

I take cocodamol for joint pain - 2 of the 30/500 mg tablets. Sometimes I forget when I took my last dose. If I take one at say 7 am and then I take another at 10 am, am I at risk of overdosing? I know you have to be really careful with paracetamol but some days I'm just in so much pain either 4 hours seems too long to go or I just completely forget what time I've taken it.

On an average day I'll either take none or I take 2 tablets at bedtime. But when the pain gets bad I do end up taking the full 8 in 24 hours.

Try taking half the dose more often to keep on top of it, easier than pain building up and waiting for it to kick in again. Speak to your pharmacist.
Don't overdose on paracetamol, it is dangerous. If you take meds regularly try to have regular times, near meals for example.
See your doctor, they can give stronger dose or refer to pain clinic

If you have to take them every x hours set a timer on your phone that counts down. Everytime alarm goes off, take tablets and restart timer.

I always write down when I take cocodamol. I now have separate codeine phosphate so can take extra in between if need to

ggybear16

500mg paracetamol is the maximum 4 hourly dose. No, it's 2x500mg every 4 hours. My cocodamol 30/500 instructions reads 1-2 tablets every 4-6 hours.

They are careful about codeine because it's addictive (ironically pain may be a withdrawal symptom). Opiates may also suppress breathing so overdose is a different problem (paracetamol od can damage your liver) have a way of recording when you took it, a chart perhaps.

Huggybear, apologies - wasn't dircting that to you!

Yes, as said you must be very careful. Esp with paracetamol. It can do you real harm even at small overdose.

I agree that having codeine prescribed separately is much better to tailor the dose and spread it out if needs be.

Can recommend the ibuprofen gels. Very effective and should not cause stomach problems, (though ibuprofen has other issues so not sure of gel is completely problem free). Supermarkets have a cheaper generic ibuprofen gels that are good.

The root cause is you need to create a habit that means you consistently take your medication. Worrying about overdosing is the wrong focus.

Opiod based pain killers eg cocodamol are not recommended for the long term management of non cancer based pain. The reason for this is because your body builds a tolerance to morphine - which is what codeine metabolises into in the body - extremely quickly, so higher and higher doses are needed to maintain the same efficacy.

Taking too much paracetamol is dangerous - even by overlapping doses by 1 hour you can cause irreparable kidney damage.

Taking too much codeine is dangerous - it can suppress your breathing, especially if mixed with alcohol or other drugs.

I think you need pain management. Go back to your doctor and talk options.
Looks like you aren't coping with your dosis and there may be options.
Maybe steroid injections etc.

OP I've been in those shoes many times.

There are lots of apps specially designed for this - fast and easy to keep on top of what you took, when you took it, and when you can take the next one etc.

www.dr-hempel-network.com/digital-health-technolgy/top-10-mobile-apps-in-medication-management/

I highly recommend. Like you, I'm fine with not going over the max, but when it gets bad I struggle to remember what time anything happened or whether it happened a time all.

App with a four hour timer, tap in when you take a dose and it logs that, and shows a badge or bleeps at you to alert when it's ok to take the next dose, job done.

You should alternate between taking the codeine with paracatemol and ibuprofen. I would be careful though codeine is addictive and has various side effects and it sounds like you're taking alot.

Apologies @PoesyCherish, as others have said the maximum dosage for paracetamol is 500mg x 2 so 1000mg up to 4 x a day.

It's not the codeine, in those amounts the codeine isn't the issue, it's the paracetamol. People don't tend to think of it as a drug iyswim but it can really fuck your liver in overdose, especially if it's lots of small overdoses over time. If you're doing this regularly then I think you need to speak to your GP and maybe have a blood test or something to check your liver and kidney function. You need some other way of relieving pain if co codamol isn't cutting it. Paracetamol overdose is a fucking horrible way to die.

I take a lot of meds including MST and co codamol. I also have "chemo brain" and need a lot of help remembering when I take them. So I use the note function on my phone to remind me. If I didn't I'm sure I'd be overdosing constantly! Of course you can use a notebook instead of a phone if that's easier? Good luck!

Thanks all for the advice.

I am really conscious of the effects of taking too much codeine. As a neuroscience student I've studied this a lot and know about pain as a result of withdrawal and your body becoming accustomed to the doses etc which is why I'm really careful to only take it when the pain is bad. Some days I don't take it at all but then other days I take it 4 x a day, though this is rare and pain has to be really bad for me to do that. It's on those odd occasions that I get worried about taking doses too close together and having the issues with the paracetamol. There have been some really good suggestions on how to manage this so thank you.

Unfortunately my GP doesn't really get it and thinks physio alone should help - it doesn't. Over the years I've tried physio, topical gels, heat packs, TENS machine, NSAIDs and now of course I'm on the cocodamol which is by far the most helpful. I'm worried if I go back to my GP they'll just say the cocodamol obviously isn't working so we'll no longer prescribe it - which is what they've done in the past.

If my son is poorly I’m really paranoid that I’ll forget what time I’ve given him a dose of paracetamol. Particularly if it’s at night time. I just start my stopwatch on my phone when I give it to him. If he needs another dose I just check that it’s gone over 4 hours on the stopwatch.

I’m on 30/500 for back pain along with a load of other meds. Broke my foot a few weeks ago and was in a lot of pain. Realised that for two days I’d taken an extra 2 tablets each day. Seen the GP who sent me straight to hospital to have bloods done and was told to take an over night bag and be prepared to stay in as they monitored me and if necessary help reduce the paracetamol in my body. Luckily my bloods were fine. But it certainly gave me a wake up call after taking these daily (prescribed) for 8 years!

I suggest either using an app... or only take at specific times, so 7 and the 12 etc.

As a neurology student I am surprised you needed to ask, do you not study drug reactions and half lives?

Some people can overdose on just one extra paracetamol. Of course it's not the same for everyone but no one knows if they will be that one. So don't risk it. Also you can only take a maximum of 4 doses (8 tablets) in 24 hours, so it's concerning if you not managing to go 3 hours between doses.

I would definitely speak to your GP.

Joint pain can be horrendous, sorry your going through this. I do think you need a better plan though, get an appointment with your GP, he can maybe send you to a pain clinic who can better advise. There are always of balancing meds to get more from them. So apparently (a friend after pain clinic discovered) missing tramadol and paracetamol can have a much greater effect than alone for example.

Having just had this almost exact issue with an elderly relative with dementia, this is what we were told. As a one off it is not a concern. If you take the entire daily dose of paracetamol in 24 hours it is considered a toxic amount and you would need to be in hospital for monitoring but if you are taking tablets too soon on a frequent basis, you’ll need blood tests to check for liver damage (this can cause more damage quicker if you don’t weigh much).

Keeping a note on your phone/diary/calendar about when you take them is a great idea.

I take up to 6 co-codamol tablets a day, but never, ever take a dose without writing down the time to avoid the risk of overdosing.

I'm prescribed codeine without paracetomol so I can take them separately- staggered doses

Is there a reason you are being prescribed cocodomol not separately?

Of course it's an over dose, and you could have side effects. But if it isn't working go back to the Drs- they could prescribe something different like dihydracodeine or tramadol?

Codeine stops working if you take it daily for long periods of time, so you may need to have "off days" or you may need an alternative so that your body goes back to normal tolerance wise.

When I took cocodamol for severe pain, I had the same problem - I tried a pill dispenser but it didn't really work for me, so instead I just took it at the same time regardless of when I got up. So 7am, 10am, 2pm, 6pm and so on; even if I was up at 5am.