Ibuprofen And Codeine The Boots Company (Ibuprofen, Codeine Phosphate Hemihydrate)

Ibuprofen and codeine phosphate hemihydrate is used to manage pain and fever by targeting inflammatory and opioid pathways.

• Mild to moderate pain: provides analgesia through anti‑inflammatory action of ibuprofen and mu‑opioid receptor activation by codeine.
• Fever: reduces elevated body temperature via ibuprofen’s antipyretic effect.
• Headache: alleviates tension or vascular headache by combined anti‑inflammatory and opioid mechanisms.
• Dental pain: controls post‑extraction or procedural discomfort with synergistic analgesic action.

• Ibuprofen inhibits cyclooxygenase‑1 and cyclooxygenase‑2 enzymes, decreasing prostaglandin synthesis and thereby reducing inflammation, pain, and fever. Codeine phosphate hemihydrate is metabolised to morphine, which binds to mu‑opioid receptors in the central nervous system, producing analgesia and cough suppression. The combination yields additive pain relief by addressing both peripheral inflammatory mediators and central opioid pathways.

Adverse reactions may occur with any medication. The following lists have been observed with the ibuprofen‑codeine combination.

Common Side Effects

• Nausea or vomiting
• Constipation or diarrhoea
• Dizziness or light‑headedness
• Drowsiness or fatigue
• Stomach discomfort or dyspepsia
• Headache

Serious or Rare Side Effects

• Respiratory depression or shallow breathing
• Severe allergic reactions (anaphylaxis, skin rash)
• Gastrointestinal bleeding or ulceration
• Liver enzyme elevation or hepatitis
• Seizures or convulsions
• Low blood pressure or syncope

Before prescribing or dispensing, consider the following safety measures.

• Assess renal function: avoid or adjust dose in severe renal impairment.
• Screen for opioid dependence: use with caution in patients with a history of substance abuse.
• Avoid concurrent NSAIDs: increased risk of gastrointestinal bleeding.
• Use caution in the elderly: higher susceptibility to sedation, falls, and renal effects.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Drug‑drug interactions can modify efficacy or safety.

Major Interactions (Avoid)

• Other opioid analgesics: additive risk of respiratory depression.
• Strong CYP2D6 inhibitors (e.g., quinidine, fluoxetine): may increase codeine plasma levels and toxicity.
• Anticoagulants (e.g., warfarin): heightened risk of gastrointestinal bleeding.

Moderate Interactions (Monitor Closely)

• Diuretics: may reduce renal clearance of ibuprofen, affecting renal function.
• ACE inhibitors: combined use can impair renal perfusion, especially in volume‑depleted patients.