Klipal (Paracetamol, Codeine Phosphate Hemihydrate)

Klipal combines paracetamol and codeine to address pain and related symptoms in the central nervous system.

• Mild to moderate pain: provides effective analgesia for conditions such as headache, musculoskeletal pain, and postoperative discomfort.
• Fever: reduces elevated body temperature associated with infections or inflammatory states.
• Cough: suppresses non‑productive cough by acting on the cough centre in the brain.

• Paracetamol acts centrally to inhibit cyclooxygenase enzymes, decreasing prostaglandin synthesis and producing analgesic and antipyretic effects. Codeine phosphate hemihydrate is an opioid agonist that binds to μ‑opioid receptors in the central nervous system, leading to analgesia and cough suppression through reduced neuronal excitability.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Drowsiness: increased sleepiness or reduced alertness.
• Constipation: reduced bowel movements.
• Dizziness: sensation of light‑headedness.
• Dry mouth: reduced salivation.
• Vomiting: occasional emesis.

Serious or Rare Side Effects

• Respiratory depression: slowed breathing, especially with high doses.
• Allergic reactions: rash, itching, or swelling.
• Seizures: rare occurrence in susceptible individuals.
• Severe hypotension: marked drop in blood pressure.
• Liver toxicity: risk with excessive paracetamol intake.
• Dependence or addiction: potential with prolonged codeine use.

When using Klipal, consider the following safety measures.

• Assess liver function: avoid use in patients with severe hepatic impairment.
• Monitor respiratory status: watch for signs of slowed breathing, especially in opioid‑naïve individuals.
• Avoid concurrent CNS depressants: limit use with benzodiazepines or alcohol.
• Use caution in the elderly: increased sensitivity to sedation and constipation.
• Do not exceed recommended total paracetamol dose: adhere to prescriber guidance.
• Store at room temperature: keep in the original pack, protect from moisture.

Klipal may interact with other medicines; review the following categories.

Major Interactions (Avoid)

• Other opioids: additive respiratory depression.
• Benzodiazepines or sedatives: enhanced CNS depression.
• MAO inhibitors: risk of severe hypotension.
• Alcohol: increased risk of liver toxicity and sedation.
• CYP2D6 inhibitors (e.g., fluoxetine): may alter codeine metabolism.

Moderate Interactions (Monitor Closely)

• Antidepressants (SSRIs/SNRIs): potential for serotonin syndrome.
• Antihistamines: may increase drowsiness.
• Anticholinergics: can worsen constipation.
• Diuretics: may affect fluid balance.
• CYP3A4 inducers (e.g., rifampicin): may reduce analgesic effect.