The government is doing away with Co-proxamol because of it's role in suicide. It is second only to tricyclics (anti-depressants) as the favoured prescribed drug of choice for suicide.
There is also an increased risk of accidental overdose, because one of the ingredients is dangerous in small doses, also if you take alcohol with it (as most suicide attempts do), then the drug is made more toxic.

There has been no proof that Co-Proxamol is any more effective than normal paracetamol in the relief of pain.

There are between 400-500 deaths per year due to Co-Proxamol poisoning. Approximately one fifth of these are due to accidental overdoses.

The Royal Colleges (doctors and the like) were all unanimous in asking for it's removal, while the patients who were asked, were all against it being removed.

And yet…

There are a lot of people who I know, for which Co-Proxamol is an effective painkiller.

More people kill themselves via paracetamol than any other drug (and it is often a much longer, painful death).

If people are going to kill themselves, then they will find a way to do it.

The MHRA recommendation for pain relief suggests the prescription of tricyclics for more severe pain relief – you may recognise 'tricyclics', it's the most popular prescribed drug or overdosing.

I'm guessing (for I haven't seen the report) that many of the accidental overdoses, are actually people who have taken an overdose and then changed their minds about it – or that they haven't realised quite how dangerous these drugs can be.

At the end of the day, any drug can be misused, but a lot of people now feel that the authorities are trying to 'nanny' us. I can only hope that this will mean that GP's will be better trained in pain management. Unfortunately I doubt it.

Please note IANAP (I Am Not A Pharmacist)

34 thoughts on “Co-Proxamol”

  1. i had taken co codamol 30/500 which helped a bit but what i also dont understand is codeine has more side affects and can be more addictive than propoxyphene and contains more paracetamol than co proxamol and yet doctors are replaceing co proxamol with them

  2. I'm sad to see it taken off the list. When I was an adolescent it was the only drug I found which made my period pain bearable. Without it, i couldn't actually make it through a day at school- the pain was too much to concentrate, would make you want to cry. Thankfully, those days are past, I'm now a grown up and can use the contraceptive pill to keep my periods short and light….but if it hadn't been for co-proxamol I would have had to have joined the ranks of 'feeble' women who take days off work for periods. I was lucky that, then at least, there was a solution to my problem.

  3. there are alternative compund analgesics available with less of a nasty side effect profilee.g. Co- codamol 8/500 and co-dydramol 10 /500


  4. Except that Co-dydramol can cause constipation (which I've seen kill at least one 'little old lady'), while Co-codamol can cause constipation, and affects some people like an euphoric……people like me.

    I'm a very cheap date

    I'm not convinced that it is a good idea to take the product off the market, if only because I don't think GP's will be able to change their practice for better pain management.

  5. What next, iron tablets? Aren't they supposed to be quite dangerous too if taken in large quantities (I was told it's a frequent accidental OD for toddlers as they tend to be kept in kitchens rather than medicine cabinets).We were talking today about whether the rule which limits the number of parcetamol tablets people can purchase in one go has actualy reduced the number of “impulse” suicide attempts or not.

  6. I've with you on the co-dydramiol and Co Codamol – Co codamol isn't really strong enough and co-dydramio;l sends me to tweety land. I'm not sure if it kills the pain or not, I'm too high to care.If I am hoping to function and still take a strong painkiller it needs to be co-proxamol for me, it makes me a little light headed, but I can still function. So what am I going to take if that is off the market?

  7. How long has it taken for them to take Distalgesic off the market, 30 years+?When are they going to take penicillin off the market as well, this kills people, albeit not very often.

    There are hundreds of drugs and compounds that can kill if misused, and that is the key word “misused”.

    If you take too much of any drug, it can be harmful, even fatal.

    I was on Zyban to stop me smoking, it worked a treat.

    I mentioned it to my Dr about a year after, he said they've stopped handing it out because of problems, apparently some deaths occured and Zyban was implicated.

    My answer was, “What about paracetamol, aspirin, penicillin, trycyclics, sleeping tablets, etc?”

    We could also ban kitchen knives, lets face it they are dangerous and can kill.

    To be quite honest, I think we are heading towards getting silly, if someone really wants to top themselves, they will do it, regardless of what drugs have been banned.

  8. I doubt it – if you were serious about it, you'd just go from shop to shop buying more and more. You think about all the supermarkets, chemists, general stores you could go into in one town…

  9. There must be a huge amount of painkillers that when taken in conjunction with alcohol are at least damaging or potentially fatal – paracetamol being one such drug readily available over the counter. What has always bothered me is why GP's dish out 100 tablet packs of strong painkillers when in reality people need no more than an average 4-6 a day – and unless patients have a long term problem then most go to the GP and only will take the medication for 3-5 days until what ever pain they have subsides. Do GP's precribe large quantities of tablets to curb future visits/repeat prescription requests? Similarly, I couldn't believe how many 100's of painkillers – co-proxamol and co-codamol hydrowhatsit (the really strong one that floats your brain away and turns your intestine into stone!) I was made to take in hospital (even when I wasn't in pain) and then posted home with after having a caesarean. I finally chucked out all 196 tablets the other day – I only had four once I returned home – mainly because I was so unnerved at how strong they were. I noticed that my 5 day old baby was very constipated too from ingesting the drug via my breast milk. I stuck it out and realised that nurofen was just as effective without the feeling of being out of control. You can't stop people from trying to or indeed killing themselves but I do think painkillers in certain circumstances are possibly over-prescribed.

  10. I read an article in the Journal of Psychiatry about the effect of the new sales restrictions for paracetamol on suicides. Some of the news is good, some bad.Impulse suicides attempts with paracetamol are much less common- this is thought to be because people no longer have 100 odd tablets sitting in the house to turn to when in a fit of misery or rage (with or without alcohol).

    However, as noted above, if you are really determined to kill your self, and do it with some planning, then it is entirely possible to get enough drugs to do so.

    The sad thing about the decrease in impulse suicides with painkillers is that shooting and hanging are now more common. These are more fatal actions. You can take a load paracetamol and half an hour later realise it was dumb, get on the phone to a hospital, and there's a chance with stomach pumps and the like that you will survive. Half an hour after you put a gun to your head, or after half an hour swinging from your bannister, with no one having discovered you…there's no going back.

    How do the findings of that report compare with your experiences from work Tom?

  11. Oh! why ? Oh! why? do people expect miracles. nutin' is perfect, milk kills some, bread others. I would not be messin' with this blog, if wer'n't for a Doctor recommendin' Goats milk so that [i] could put on weight [it be why, I be so stubborn and eat any thing] They should STRESS that there be so SINGLE cure all. Wot works for some, will du uthers in. A few yrs back one of my workers liked prozac, ' till one day my accent got to him and pulled a shiv on me, which got my attentuion , and promptly defanged him. upon investigation I found out 3 doctors gave this person 3 months supply in two days and this Individual liked to used said pills as chasers. I was lucky, of course , that they[bleeding pills that is] made him inept as well. But Docs and farmassists [pharmacist] must have a scheme to prevent this crass over medicating.Other than that; 20/80 rule is always in force. Dungbeetle

    P.S. May be I come from an era when Morphine, laudanum et al be for the Toffs with the money.

  12. Having had a slipped disk (moving and handling techniques? Sorry, you'll just have to pick the buggers up!) I can honestly say that co-codamol 30/500 is dreamy. Add to that diazepam and I'm a happy girl, just don't expect me to function in any way except sleep.<-- cheap date too, lets go dutch.

  13. I'm concerned about what they will perscribe my dad instead of it. He already takes a whole concotion of pain relief and medication to keep the Deep Vein Thrombosis from killing him. He takes the co-prox for the ulcers on his leg that have plagued him for almost 4 years.

  14. Another valuable exchange here worth bringing to the attention of the wonderfullyweird disrespecting Bob/Paul bloke who tangled with you on your radio interview. Good work db

  15. IANAP either, but I do get to look after people who genuinely and non-genuinely attempt suicide with various tablets. Co-Proxamol as noted by others above, contains 325mg of paracetamol and 32.5mg of dextroproxyphene. Dextroproxyphene is a weak opiod with about 1/10 the analgesic effect of morphine. With long term use, it too causes constipation, in overdose it has opiod effects (respiratory depression), and finally in conjunction with alcohol can cause cardiac arrhythmias and apnoea(total respiratory depression, i.e. no breathing). These effects are serious but reasonably treatable, albeit in an acute environment, eg:ICU.However the effect of paracetamol overdose is acute liver failure. IMHO acute liver failure is _the_ worst way to say goodbye to the world. Several weeks of agony whilst your liver falls apart and you s*** and bleed to death, is something you have to be slightly touched to consider.

    I am not really sure what I am trying to say here, as I agree with the comments about nanny states and people should be free to make _informed_ decisions about what they put in their body. However people who are attempting suicide are inherently not making informed, balanced decisions. Having seen _too_ many lethal paracetamol overdoses, I take the radical view of banning all paracetamol based drugs from over the counter sales. People will always try to commit suicide with something, limiting their choices to slightly less horrific alternatives is IMHO a good thing. The positive benefits of paracetamol such as _mild_ analgesia and control of pyrexia are nice, but only for mild problems. Anything mildly serious, and people need somethinger stronger than paracetamol. So all the people with these mild problems can suffer as far as I am concerned, if it means just one person doesn't get to enjoy the various facets of catastrophic liver failure.

    As pointed out several times, this is just my opinion, one of the many caring voices of the NHS

  16. Call me a cynic but could it be remotely possible that the reason for the withdrawal is purely financial being as so many people are prescribed this drug on the NHS. After all, when has this so called government shown any real concern for the welfare of the man in the street except to use the terminology as an excuse to save money.

  17. If the Government is so concerned about the health of the nation, why do they not have the courage of their own convictions and ban the sale of cigarettes and alcohol since they kill far more people than Co-Proxamol. Could this be for financial reasons also? What hypocrisy……………………………

  18. There is NO comparison between co-proxamol and co-codamol. They are targetted at different parts of the nervous system. I have had to take co-proxamol since the early 1980's, as a result of a major back problem. Co-codamol is of no benefit to me. I am aware of the dangers of overdosing on co-proxamol … even taking the 8 tablet maximum in 24 hours is enough to render me incapable of safe behaviour, so I stay within the limit. (My GP also warned that, as the drug was an opiate, I should be careful and watch for any side effects.)I concur with the view that the main reason is cost – it took an American MD to provide me with a bowel calming drug, for me to get my GP to prescribe the same (reluctantly, because of the cost). So, after 25 years of suffering from a form of so-called IBS, I no longer suffer.

    But I don't welcome the thought of spending the remainder of my days (no, I am NOT of retirement age yet) without access to co-proxamol. Indeed, only recently, I was treated in Hospital for lacerated fingers from an accidental dog injury, and the painkiller provided – yes, it was co-proxamol.

    Peter H, Surrey

  19. … these alternatives have their own side effects … severe constipation …. not a nice problem I can assure you. I was given Co-codamol last October instead of Co-proxamol and found it caused severe constipation, a known side effect …. any other suggestions, I was told that Co-drydramol also does the same ????

  20. I have been prescribed Co Proxamol for several years after suffereing a sponataneous pneumothorax in 1996,I found it to be pretty much useless.It makes me feel nauseous almost immediately after taking it.I am of no firm opinion as to whether it should be withdrawn really as I can manage perfectly well without it.However my sister swears by it,she has used it for a long time for severe back injury pain and is livid that it will no longer be available.I have recently been prescribed co-codamol 30/500 for chest pain after lung surgery last April and it works much better,the only side effects I have is being slightly spaced out and light headed and occasional palpitations.My pain is completely under control though so I will continue to take it until my pain resolves itself or an alternative pain killer is prescribed.

  21. I have rheumatoid arthritis. I have been taking co-proxamol for about eight years for pain relief. It has help to alleviate the moderate pain; especially at night time, when I have difficulty sleeping. It has help me to function better during the day in conjunction with other drugs for the RA.I learned a few weeks ago that the drug was about to be withdrawn. I was informed this morning; 28/2/05 that I would be taken off the drug immediately and that my co-proxamol would be substituted with paracetamol.I do not know if there will be a marked difference physically speaking, but psychologically (having been on the drug eight years daily, without a break) I feel there might be a few anxious moments, so to speak. Anyway, I'll cross that hurdle when I come to it – whatever will be, will be.

  22. I only take co proxamol occaisional for a muscle spasm like pain in my back. It relieves the spasm and the pain like a miracle.Recently I have been taking them for an aching elbow caused by repetive strain. It not only helps but I do suspect than I feel slightly euphoric afterwards and feel greeat. Is this a result of no pain or is there something in this drug that lifts the spirits. I am worried that it could be addictive. Could someone comment on this?


  23. i totaly agree with you, this is a true reason why the goverment are removing co.poroxamol. another drug company want to get in on the act and have connections in parliment well thats where all there shareholders are. co.proxamol as had a 40 year live span since 1964 when it was first put on the market. it monopolised the the drug sales for painkillers, it was being given th patiants in this country to 8 million people a year at a cost of 140 a box of 100. now there is a new product from a new company that wants the same income co.proxamol has. but this new comoany nneds to rid co.proxamol to get sales .. so what do they do, they use there shareholding connections in parliment and prince charles and andrew who have shares in the drug compny. so does mark thatcher and other famous important peple.

  24. That is ridiculous, you should NEVER be taken off Co-Proxamol so rapidly without a gradual reduction in dosage. I myself had anxiety attacks, palpitations and twitching after having them cut GRADUAL and I was only on them for 4 years. I really hope youll be ok in cutting them off completely, good luck. I recommend if you do suffer any anxiety them get straight back to your GP.

  25. co-proximol is a good effective pain killer of which I have taken for years and had no side effects. Sometimes it can make you feel drowsy, but to withdraw is not the way forward, as you can overdose on most drugs. You need to keep with the prescribed dosage and avoid alcohol.


  27. I do not believe that simple paracetomol is as effective as co-proxamol. I'm in Australia at present, where co-proxamol is still prescribed, but is called “Di-gesic” Although I've had to pay for my prescription, I've been able to buy some. When I get home to London, I'll try to obtain a private prescription, because like most other people who have commented here, it is the most effective pain killer I know. Co-drydamol and the other one make me nauseous and are constipating.Fortunately I can afford to pay, but what about those who can't ? Life is a risky business folks, I was in London in July, in Bali 24 hours before the latest bombs, I regularly cross the street and fly in aeroplanes. This is the same government which fudged smoking in public places; tobacco advertising and TV advertising of junk food to children, so I don't think this decision is about health at all. It's about saving money. I'm all for that, so why not lean on the rich drug companies and get them to reduce their prices, instead of leaving ordinary people in pain ?

  28. that is very true daisy and at the end of the day like it has been said you can overdose on anything and its a shame that me you and others also have to suffer from the withdraw

  29. Co-proxamol does not kill people .. people kill peopleor choose to kill them selfs..iorn tablets will kill you much faster than Co-proxamol .. cars kill people oh and smoking will they ban that .. nope not a chance because they make too much money.. if they made money out of Co-proxamol they would not ban it!!as for the price i was told by my doctor they cost him 1.85 a box of 100.

    other tablets do not work!! space out or just no good and now we have to suffer the come down because the doctor says there are no side affects of long term use.. then a sudden stop tell my body that!..what will be next sex because you may have a heart attack!

  30. very true mate they might as well stop alcohol too as more people seem to die from that and they stop a medicine that is more usefull to you

  31. this is the only drug that works for my 87 yr old mothers arthritic knees and only the old formulation at that. Does anyone know how I could obtain some for her

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