ZAPAIN CAPLETS 500MG/30MG
Codeine and Paracetamol
ZAPAIN CAPLETS 500MG/30MG
Codeine and paracetamol
USES:moderate to severe pain
For the relief of severe pain
Posology and method of administration
Method of administration: Oral.
Adults The usual dose is one or two caplets every four hours as required. The total daily dose should not exceed 240 mg codeine phosphate (8 caplets in a day).
Elderly A reduced dosage may be necessary.
Children Not recommended in children below the age of 12 years.
Dosage needs to be adjusted according to the severity of pain and the response of the patient.
Tolerance to Codeine can develop with continued use. The incidence of unwanted effects is dose related. Doses of Codeine above 60 mg are associated with an increase in unwanted effects.
Hypersensitivity to either paracetamol or codeine, or any of the excipients of Zapain caplets.
Children under 12 years of age.
Zapain is contraindicated in patients with moderate to severe degrees of renal or hepatic impairment.
It is contraindicated in patients for whom opiate medications should not be used, such as patients with acute asthma, obstructive airway disease, respiratory depression, acute alcoholism, head injuries, raised intracranial pressure, after biliary surgery, patients suffering from diarrhoea of any cause, and patients who have taken MAOI's within 14 days.
Special warnings and precautions for use
The efficacy and safety of Zapain caplets in children below the age of 12 years has not been established, and use in such children is contraindicated.
Zapain caplets must be used with caution in patients with increases intracranial pressure, acute abdominal conditions, the elderly, the debilitated, impaired hepatic or renal function, hypothyroidism, Addison's disease, prostatic hypertrophy, and urethral stricture. (See also 'Contraindications'. Note particularly that Zapain is contraindicated in patients with severe renal or hepatic impairment.)
Overdosage in patients with non-cirrhotic alcoholic liver disease can be hazardous. The hazard of paracetamol overdose is greater in those with alcoholic liver disease.
Codeine at high doses has the same disadvantages as morphine, including respiratory depression. Drug dependence of the morphine type can be produced by the Codeine, and the potential for drug abuse with codeine must be considered. Codeine may impair mental or physical abilities required in the performance of potentially hazardous tasks.
Patients must be advised not to exceed the recommended doses.
Patients must be advised not to take other products containing paracetamol or opiate derivatives when taking Zapain, and to consult their doctor if symptoms persist.
The cough suppressant effect of codeine may be undesirable in patients with some respiratory conditions.
The risk-benefit of continued use should be assessed regularly by the prescriber.
The leaflet will state in a prominent position in the 'before taking' section
' Do not take for longer than directed by your prescriber
' Taking codeine/dihydrocodeine (DHC) regularly for a long time can lead to addiction, which might cause you to feel restless and irritable when you stop taking the tablets.
' Taking a painkiller for headaches too often or for too long can make them worse.
The label will state (To be displayed prominently on outer pack- not boxed):
' Do not take for longer than directed by you prescriber as taking codeine/DHC regularly for a long time can lead to addiction.
Interaction with other medicinal products and other forms of interaction
The hypotensive effects of antihypertensive agents, including diuretics, may be potentiated by codeine.
Quinine or quinidine may inhibit the analgesic actions of codeine.
The CNS depressant action of Zapain may be enhanced by coadministration with any other drug which has a CNS depressant effect (e.g. anxiolytics, hypnotics, antidepressants, antipsychotics and alcohol). Concomitant use of any drug with a CNS depressant action should be avoided. If combined therapy is necessary, the dose of one or both agents should be reduced.
Concomitant administration of Zapain and MAOI's or tricyclic antidepressants may increase the effect of either the antidepressant or codeine.
Concomitant administration of codeine and anticholinergics may cause paralytic ileus.
Concomitant administration of codeine with an anti-diarrhoeal agent increases the risk of severe constipation, and coadministration with an antimuscarinic drug may cause urinary retention.
The absorption of paracetamol is speeded by metaclopramide or domperidone, and absorption is reduced by cholestyramine.
Codeine may delay the absorption of mexilitine, and cimetidine may inhibit codeine metabolism.
Opioids may interfere with the results of plasma amylase, lipase, bilirubin, ALP, LDH, AST, and ALT tests.
The effects of codeine on the gut may interfere with diagnostic tests of gastro-intestinal functions.
The anticoagulant effect of warfarin and other coumarins may be increased by long term regular daily use of paracetamol, with increased risk of bleeding. Occasional doses of paracetamol do not have a significant effect on these anticoagulants.
Pregnancy and lactation
Zapain is not recommended during pregnancy or lactation.
Codeine crosses the placenta and is found in breast milk.
Use during pregnancy may lead to withdrawal syndromes in neonates, and use during labour may cause neonatal respiratory depression.
Effects on ability to drive and use machines
Patients should be advised not to drive or operate machinery if Zapain causes dizziness or sedation. Codeine may cause visual disturbances.
The commonest side effects of codeine are nausea, vomiting, light headedness, dizziness, sedation, shortness of breath and constipation. Some of these side effects appear more commonly in ambulatory rather than non-ambulatory patients. Lying down may alleviate these effects if they occur. In addition, miosis, visual disturbances, headache, bradycardia, respiratory depression, difficult micturition and urinary retention, and allergic reaction (including skin rash) can occur.
Codeine can cause respiratory depression particularly in overdosage and in patients with compromised respiratory function.
Euphoria, dysphoria, constipation, abdominal pain, and pruritis can occur as reactions to Zapain.
Liver damage in association with therapeutic use of paracetamol has been documented; most cases have occurred in conjunction with chronic alcohol abuse.
There have been some reports of blood dyscrasias- Thrombocytopenia and argranulocytosis, with the use of paracetamol- containing products, but the causal relationship has not been established.
Regular prolonged use of codeine/DHC is known to lead to addiction and symptoms of restlessness and irritability may result when treatment is then stopped.
Prolonged use of a pain killer for headaches can make them worse.
Asset Chemist is a registered pharmacy in the UK and is now the country\'s best value dedicated internet pharmacy. All of our content on this website is for information purposes only, and we recommend you use it as a support to the advice given to you by your healthcare providers. Please ensure you read all product packaging and labels prior to use. Please consult your doctor before using any new product. For more information view our Terms [&] Conditions.
We also provide a prescription service for you or your pet and delivery the medication direct to your door.
As an Online Pharmacy we strictly observe legal requirements in both our and your country. However, we recommend you check the importation regulations of your country to verify the laws of ordering online pharmaceuticals and over the counter medication from abroad. The buyer is responsible for determining and abiding by his/her country\'s importation regulations.
Please visit www.postoffice.co.uk/letters-parcels/mailing-guide/restricted-and-prohibited-goods