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Back to Medicines A to Z. Co-codamol is a mixture of 2 different painkillers — paracetamol and codeine.


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We report the case of an elderly patient with diastolic heart failure and renal insufficiency admitted to hospital as he complained of having a history of hypogastric pain and dysuria without fever due to renal lithiasis and urinary infection.

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After about 1 hour of the administration, he suddenly complained of the onset of a lancinating epigastric pain radiating to the whole abdomen and retrosternum accompanied by nausea. The electrocardiogram EKG was negative for myocardial infarction and computed tomography excluded aortic dissection and other causes of acute abdomen.

Laboratory tests showed instead liver and pancreatic damage. The symptomatology was relieved 3 hours later of the onset after antispastic treatment with anticholinergics floroglucine. The likely underlying pathophysiological mechanism is the codein-induced spasm of the sphincter of Oddi combined with dysfunction of the same sphincter and reduced bile storage capacity related to a cholecystectomy.

Sudden severe abdominal pain after a single low dose of paracetamol/codein in a cholecystectomized patient: learning from a case report

When a similar event does not regress, it may lead to more severe conditions such as acute pancreatitis. Since codein is a widely used drug, this report may suggest cholecystectomy as a contraindication during administration for the risk of occurrence of these complications. Please enable it to take advantage of the complete set of features!

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Codeine for pain relief

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Abstract We report the case of an elderly patient with diastolic heart failure and renal insufficiency admitted to hospital as he complained of having a history of hypogastric pain and dysuria without fever due to renal lithiasis and urinary infection. Zahoor A, et al. Eur J Anaesthesiol. PMID: No abstract available. A new source of drug-induced acute pancreatitis: codeine. Hastier P, et al. Am J Gastroenterol. PMID: Aten Primaria. PMID: Spanish. No abstract available. Helland A, et al. Tidsskr Nor Laegeforen.

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PMID: Review. Combination analgesia in - a rational approach: focus on paracetamol-tramadol. Schug SA. Clin Rheumatol. Epub Jun 2.

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See all similar articles. Cited by 4 articles Evolving paradigms in the treatment of opioid-induced bowel dysfunction. Poulsen JL, et al. Therap Adv Gastroenterol. Prior cholecystectomy predisposes to acute pancreatitis in codeine-prescribed patients. Turkmen S, et al.

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Clinical potential of naloxegol in the management of opioid-induced bowel dysfunction. Clin Exp Gastroenterol. Opioid-induced bowel dysfunction: pathophysiology and management. Brock C, et al. Publication types Case Reports Actions.

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A case of codeine induced anaphylaxis via oral route

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