Zapain is a prescription painkiller that combines codeine and paracetamol. It’s used to manage moderate to severe pain, but like other opioid medications, it carries risks. Many people search for answers about Zapain side effects, withdrawal symptoms and whether you can get addicted to Zapain.
Common side effects include constipation, nausea, dizziness and drowsiness, while more serious reactions such as breathing difficulties or allergic responses require urgent medical attention. Because Zapain contains codeine, prolonged use can cause dependence and addiction, making it important to understand the risks of coming off Zapain safely.
If you or someone you care about is struggling with Zapain misuse, Castle Craig can help. Call us confidentially on 01721 546 263 for advice on codeine withdrawal treatment and recovery support tailored to prescription painkiller addiction.
What is Zapain and What is it Used For?
Zapain is used for pain relief where weaker pain relief drugs are not helping. Codeine is an opioid drug mixed with paracetamol to form co-codamol. It is commonly used to treat muscular pain, such as backache, headaches and migraines, as well as toothache. It can be a very effective pain relief option.
Unlike weaker co-codamol tablets available over the counter, Zapain is prescription-only and represents the strongest strength, making it suitable for treating moderate to severe pain when standard painkillers like paracetamol or ibuprofen are not effective.
Because Zapain contains codeine, an opioid analgesic, it carries a risk of dependence and addiction if used long-term or without medical supervision. Patients are advised to discuss a clear treatment plan, including how to stop safely, to reduce the likelihood of developing codeine withdrawal symptoms or addiction.
How Strong Is Zapain and What Are the Normal Doses?
Zapain is the branded version of co-codamol, a painkiller combining 500mg of paracetamol with 8mg, 15mg, or 30mg of codeine. The strength is written on the pack as two numbers, such as 30/500 for 30mg of codeine and 500mg of paracetamol. Zapain usually refers to the highest strength, containing 30mg of codeine.
Adults and young people over 16 can take one to two tablets up to four times in 24 hours, leaving at least four hours between doses. The maximum recommended daily intake is eight tablets in 24 hours, regardless of strength.
It is essential not to exceed the dosage, as too much paracetamol can cause serious liver damage. Zapain should not be taken for longer than three consecutive days unless advised by your GP. If your pain persists, seek medical guidance rather than increasing your dose.
Start Your Recovery at a Residential Rehab Today
Common Co-Codamol Side Effects
Like all medications, Zapain can cause side effects, ranging from mild and short-term issues to more serious complications with long-term use. Understanding what these effects look like and how to manage them can help you use the medication safely and recognise when to seek medical advice.
-
Common Side Effects of Zapain Use
Many of Zapain’s side effects can be managed with simple lifestyle adjustments. For instance, constipation may ease with extra fluids and daily movement, while nausea often improves when the medication is taken with food and plenty of water.
If drowsiness occurs, avoid driving or drinking alcohol until you know how Zapain affects you. Headaches can sometimes appear but usually ease with hydration, though persistent symptoms should be checked with your doctor. Common side effects of using co-codamol include:
- Constipation
- Nausea
- Vomiting
- Sleepy
- Headaches
-
Serious Side Effects of Taking Zapain
While many side effects are mild, some reactions to Zapain can be serious and require immediate medical attention. These include allergic reactions, vision problems, severe drowsiness, or breathing difficulties.
If you experience any of these symptoms, seek urgent medical help without delay.
- Rash
- Issues urinating
- Eyesight changes
- Dizziness
- Allergic reactions
- Hearing loss
- Feel very happy or very low
- Changes in blood cells
-
Long-term Side Effects of Being on Zapain
Using Zapain for longer than recommended can cause lasting problems due to its codeine content. Prolonged use increases the risk of tolerance, dependence, and addiction.
It may also lead to chronic constipation, liver damage from excess paracetamol, mood changes, and reduced hormone levels. Long-term monitoring by a doctor is essential.
- Addiction
- Low blood pressure
- Abnormal breathing
- Respiratory arrest
- Kidney failure
- Liver failure
- Bleeding from the stomach
- Seizures
- Overdose (can be fatal)
Who Should Avoid Taking Zapain?
While Zapain can be helpful in managing moderate to severe pain, it isn’t appropriate across all populations. Do not use Zapain if you:
- Are under the age of 12
- Are allergic to paracetamol or codeine
- Have severe kidney disease
- Have severe liver disease
- Metabolise codeine into morphine rapidly
- Are breastfeeding
- Are pregnant
- Have asthma or other breathing issues like chronic bronchitis
- Have suffered a head injury or have increased pressure on the brain
- Drink a lot of alcohol or have an alcohol addiction
- Have recently had a gallbladder operation
- Have diarrhoea
- Are currently taking monoamine oxidase inhibitors or have been taking them in the last two weeks?
It should not be given to children post-operation for tonsillectomy and/or adenoidectomy for obstructive sleep apnoea, as it has led to rare but serious side effects including death.
You should exercise caution and discuss the cost-benefit analysis with your doctor or pharmacist if you:
- Are noticeably weak
- Are elderly
- Have stomach pain
- Have an underactive thyroid gland
- Have liver problems
- Have kidney problems
- Have myasthenia gravis
- Have a disease of the biliary tract
- Have Addison’s disease
- Are male and have an enlarged prostate gland
- Are female and have a narrowing of your urethra
Codeine is metabolised by the liver where it is turned into morphine. This is achieved through the liver enzyme CYP2D6, which some people do not have or have a deficiency of. If you are in this population. the pain-relieving effect will not be achieved. It’s estimated that up to 7% of Caucasians, 6.5% of African Americans, 2% of Asians, and 29% of African Ethiopians could have this deficiency.
-
Can You Take Zapain While Pregnant?
No, you should avoid taking Zapain during pregnancy. While it is safe to take paracetamol during pregnancy, codeine can have negative impacts on your baby and this is particularly noticeable in your third trimester.
Taking Zapain during pregnancy can cause your baby to experience withdrawal symptoms after they are born. It also puts them at a higher risk of experiencing breathing problems which will require additional monitoring.
Because of these risks to the baby, it is not advisable that you take co-codamol during pregnancy. If paracetamol isn’t helping manage your pain, your best option is to speak with your doctor or healthcare provider to explore the options available to you.
-
Can I Take Zapain While Breastfeeding?
Codeine from the co-codamol will be present in breast milk and can cause breathing issues in babies. For that reason, it is advised to avoid co-codamol while breastfeeding.
You can take paracetamol on its own. If that doesn’t manage your pain levels, again, your best option will be to speak with your healthcare provider to see what pain relief options are available.
It’s also worth noting that while some people lack the correct liver enzyme to break down Zapain into morphine, some are considered ‘ultra-rapid metabolisers’. If a breastfeeding woman, higher levels of the active metabolite, morphine, could be present in their milk which on very rare occasions could lead to opioid toxicity in the baby, which can be fatal.
-
Can You Drink Alcohol While Taking Zapain?
You should avoid alcohol while taking Zapain. It is especially important you avoid alcohol for the first few days of taking Zapain, until you can assess how the drug affects you.
If it makes you feel sleepy or lethargic, it would be best to avoid alcohol as that can exacerbate this symptom. Mixing the two can also increase the risk of experiencing serious side effects.
If you are currently dealing with an addiction to alcohol and stopping would pose a danger to your health, speak with your doctor or pharmacist who will be able to advise. You may require a different form of pain relief.
How Long Does Codeine Stay In Your System?
How long codeine stays in your system will depend on your weight, metabolism, urine pH levels, fluid intake, kidney function, liver function, dose and duration of use. However, in general, you can expect the following timeframes:
- Urine: In most people, codeine can be detected in urine for up to 48 hours after they last took it. This could increase to a week for long-term users.
- Saliva: 21 hours after last taking it.
- Hair follicles: Over two months since last use.
Can You Get Addicted to Zapain?
Yes – while codeine is what makes Zapain so effective as pain relief, unfortunately, it can lead to physical dependence and opioid addiction. This is why you shouldn’t take it for more than three days. Unfortunately, there is increasing evidence of prescription opioid addiction in the UK.
Signs of Zapain Addiction
- Taking higher doses than what has been prescribed
- Taking it more frequently
- Continued use after pain has stopped
- Hiding use from other people
- Using multiple pharmacies to buy co-codamol
- Getting co-codamol from sources other than your pharmacy
- Feeling confused
- Experiencing hallucinations
- Vision changes
- Seizures
Free Opioid Addiction Assessment
Taking the first step and asking for help can feel daunting, but our team is here to assist you.
Can You Get Withdrawal Symptoms From Branded Co-Codamol?
Yes. Because Zapain contains codeine, a type of opioid, it can cause physical dependence if taken for more than a few days. When you stop suddenly, your body may react with withdrawal symptoms as it adjusts to the absence of the drug.
Withdrawal symptoms of Zapain can include restlessness, sweating, irritability, insomnia, stomach cramps, diarrhoea, nausea and flu-like aches. These can feel uncomfortable but are usually not life-threatening. To minimise risks, it’s best to come off Zapain gradually under medical supervision rather than stopping abruptly.
-
Common Withdrawal Symptoms of Codeine-based Painkillers
These are uncomfortable but usually not life-threatening. They can make stopping Zapain feel very challenging without support:
- AnxietyAgitationRestlessnessTrouble sleeping (insomnia)ShakingPins and needles
Ringing in your ears
Sweating
Chills
Palpitations
Abdominal cramps
Nausea and vomiting
Diarrhoea
- AnxietyAgitationRestlessnessTrouble sleeping (insomnia)ShakingPins and needles
-
Severe Withdrawal Side Effects of Stopping Zapain
These symptoms can be dangerous and may require immediate medical supervision, especially if you stop Zapain suddenly after long-term use:
- Intense tremors
- Increased blood pressure
- Rapid respiratory rate
- Severe dehydration from persistent vomiting/diarrhoea
- Hallucinations or confusion
- Seizures (rare but possible in high-dose dependence)
- Suicidal thoughts or extreme mood swings
Zapain Withdrawal Timeline
When you stop taking Zapain, withdrawal symptoms follow a fairly predictable timeline. The exact duration will depend on factors such as how long you’ve been using the medication, your dosage, and your overall health.
- First 12–24 hours: Early symptoms like anxiety, restlessness, sweating, and insomnia can appear.
- Days 2–3: Withdrawal usually peaks, with stronger physical effects such as nausea, diarrhoea, cramps, and shaking.
- Days 4–7: Symptoms begin to ease, though psychological withdrawal (low mood, cravings, irritability) often lingers.
- Week 2 and beyond: Some people experience prolonged symptoms such as fatigue, disturbed sleep, or anxiety. This is known as Post-Acute Withdrawal Syndrome (PAWS).
Getting Professional Help for Prescription Painkiller Withdrawal
Coming off Zapain can be challenging, especially if you’ve been taking it for a long time. Many people underestimate just how strong the physical and psychological symptoms can be, which makes professional support essential.
Safe codeine withdrawal requires more than willpower. With the right medical care and therapeutic support, it is possible to reduce symptoms, lower relapse risk and rebuild life without relying on codeine-based painkillers.
-
Medically Managed Detox
A medically managed detox is often the first step in treating Zapain withdrawal. In a supervised setting, doctors gradually taper your dose or prescribe substitute medications to ease symptoms such as sweating, nausea, and agitation.
The goal is to stabilise your body while keeping you safe and comfortable. Medical teams also monitor for complications like dehydration, seizures, or dangerous blood pressure changes, which can occur during unsupervised detox.
-
Rehab Treatment for Zapain Withdrawal
Residential rehab provides 24-hour support during withdrawal and recovery. This structured environment allows you to focus on healing without outside pressures or access to painkillers.
Alongside detox, prescription drug rehab programmes include counselling, group therapy and relapse prevention planning. Many centres also provide holistic treatments such as yoga, meditation and nutrition therapy to support both mind and body during recovery.
-
Therapy and Counselling for Codeine Detox
Psychological support plays a huge role in overcoming Zapain dependence. Addiction therapy helps address the reasons why codeine became part of your life, whether that’s chronic pain, stress or emotional struggles.
Options may include cognitive behavioural therapy (CBT), trauma-informed therapy and one-to-one counselling. Theraeutic approaches for Zapain withdrawal not only help manage cravings but also build healthier coping mechanisms to prevent relapse.
-
Ongoing Support for Stopping Opioid Painkillers
Even after detox, cravings and emotional challenges can linger. Ongoing support is vital for staying drug-free. Many people benefit from aftercare programmes that include peer-support groups, relapse prevention sessions, and continued therapy.
Support networks like Narcotics Anonymous (NA) or community recovery groups can help you stay accountable. With regular check-ins and ongoing guidance, you’ll have the tools needed to manage stress and avoid turning back to Zapain.
Contact Castle Craig Codeine Detox Centre
Castle Craig is located in West Linton, Edinburgh, United Kingdom, EH46 7DH. Our serene surroundings in the Scottish Borders provide the ideal privacy for a focused recovery from painkiller misuse, while the secure and discreet environment supports your progress towards a healthier future.
Frequently Asked Questions On Zapain Use
Here are some of the most commonly asked questions about Zapain. If you experience any concerning side effects, please seek immediate medical advice in person.
-
Is Zapain an Opioid?
Yes. Zapain contains paracetamol and codeine, and codeine is an opioid painkiller. This means Zapain is classed as an opioid medication, which can cause dependence if used for too long or in higher doses than prescribed.
-
Can you Detox from Opioid Painkillers at Home?
Detoxing from opioid painkillers like Zapain at home can be risky. Withdrawal symptoms range from nausea and anxiety to severe complications. Medically supervised detox is the safest option, providing monitoring, tapering plans, and support to reduce health risks.
-
What Are the Strengths of Zapain?
Co-codamol comes in three formulations, each has 500mg of paracetamol and then either 8mg, 15mg, or 30mg of codeine. The lowest strength version is available over the counter at your local pharmacy, the other two can only be obtained on prescription. Zapain is the branded version of the highest-strength co-codamol (500mg paracetamol with 30mg codeine).
-
Is Zapain Codeine Strong?
Zapain is for severe pain or moderate pain which cannot be controlled with painkillers like paracetamol or aspirin. It contains codeine, which belongs to a group of medicines called opiates, which can be addictive so it is only suitable for short-term use.
-
What Brand Is the Same as Zapain?
Zapain is the branded version of co-codamol. Your doctor will most likely prescribe you the generic version, but the brand version (which is the highest strength of co-codamol) is available.
-
Will Co-Codamol Stop Contraception Working?
While co-codamol won’t stop your contraception from working, it can make you vomit. If you vomit and are on contraceptive pills, you may no longer be protected from pregnancy. Consult your pill packet or speak with your doctor or pharmacist for advice specific to your situation.
-
Will Co-Codamol Affect My Fertility?
Taken in the short term, which here means no longer than 3 days, there is no clear evidence it will impact fertility.
But if you take it for more than three days, there is a risk that it can temporarily reduce fertility in both sexes. This is because it can cause hypogonadism, which is where you no longer make enough sex hormones which can make it harder to conceive
-
What Should I Avoid While Taking Zapain?
Do not take Zapain with additional paracetamol or with other paracetamol-containing products.
-
Zapain vs Cocodomol – What Is the Difference?
Zapain is simply a brand name for co-codamol. Zapain is the higher-strength version of co-codamol and comes with 30mg codeine and 500mg paracetamol. They are the same medication, one is the generic version and the other is branded.
-
Can I Take Zapain With Citalopram?
Some antidepressants do not mix well with Zapain. Citalopram, an SSRI, can reduce the effectiveness of codeine. You should discuss this with your doctor or healthcare professional, as they may need to adjust your dose.
-
Is Zapain a Controlled Substance?
Yes, codeine is a controlled substance. This means that its use is controlled by the government, as it could lead to abuse or addiction. This is why you can only get higher-strength versions of co-codamol, like Zapain, via a prescription from a licensed healthcare professional.
