Paracetamol/Codeine Accord (Paracetamol, Codeine)

Paracetamol/Codeine Accord is a combination analgesic that acts on pain pathways and fever mechanisms.

• Dental pain: Provides relief of moderate dental discomfort and inflammation.
• Musculoskeletal pain: Reduces pain associated with strains, sprains and low‑back pain.
• Post‑operative pain: Helps manage pain following minor surgical procedures.
• Fever: Lowers elevated body temperature in adults.
• Headache: Alleviates tension‑type and mild migraine headaches.

• Paracetamol works by inhibiting central cyclooxygenase enzymes, reducing prostaglandin synthesis in the brain, which lowers pain perception and fever. Codeine, an opioid agonist, binds to μ‑opioid receptors in the central nervous system, modulating pain signaling pathways and providing additional analgesic effect.

Paracetamol/Codeine Accord may cause a range of adverse reactions.

Common Side Effects

• Nausea: Mild to moderate stomach upset.
• Drowsiness: Feeling of sleepiness or reduced alertness.
• Constipation: Difficulty passing stools.
• Dizziness: Light‑headed sensation.
• Dry mouth: Reduced salivation.
• Sweating: Increased perspiration.

Serious or Rare Side Effects

• Respiratory depression: Slow or shallow breathing, especially at higher doses.
• Allergic reaction: Rash, itching, swelling, or anaphylaxis.
• Liver toxicity: Elevated liver enzymes or hepatic injury with excessive paracetamol.
• Dependence: Potential for opioid dependence with prolonged use.
• Seizures: Rare occurrence, particularly in overdose.
• Severe hypotension: Marked drop in blood pressure.

Paracetamol/Codeine Accord should be used with caution in specific situations.

• Liver disease: Avoid or adjust dose in patients with hepatic impairment.
• Renal impairment: Use cautiously in reduced kidney function.
• Respiratory conditions: Monitor for respiratory depression in asthma or COPD.
• Alcohol use: Limit intake as alcohol can increase liver toxicity risk.
• Pregnancy and breastfeeding: Use only if clearly indicated.
• Store below 25°C: Keep in the original packaging, protect from moisture and direct light.

Paracetamol/Codeine Accord can interact with several medicines, requiring careful management.

Major Interactions (Avoid)

• MAO inhibitors: Potentially severe cardiovascular  

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