Zapain Side Effects and Benefits


Have you just been prescribed Zapain? In this article, we’ll take a look at what it is, how it works, and what it can be used to treat. We’ll also cover common questions such as how long it takes to kick in and how long the effects last. 

As zapain contains two key painkillers, paracetamol, and codeine, we’ll take a look at what happens in the body when you take it, how it makes you feel, and at what doses you might take it.

All drugs come with potential side effects and zapain is no different. We’ll take a look at some of the more common side effects, such as constipation and vomiting, and look at some ways you can ease them. We’ll also explore the serious side effects, which can include allergic reactions and vision problems. 

Again, like most medications, zapain is not suitable for all people. Further down the article, we’ll take a look at who should avoid zapain and who should exercise caution when using it. We’ll also explore the implications of taking zapain while pregnant and breastfeeding, as well as look at its impact on fertility. 

Because zapain contains codeine, it can lead to physical dependence and addiction. So we’ll take a look at some of the symptoms of this along with the side effects of zapain addiction and withdrawal symptoms that may be experienced when getting off of it.

What is Zapain? 

Zapain is the brand name for co-codamol, a painkiller comprised of two drugs: paracetamol and codeine. Co-codamol comes in three strengths, the weakest is available over the counter in pharmacies but the two stronger strength versions are only available on prescription. Zapain is the brand name version of the strongest strength of co-codamol. 

It is typically used for severe pain or moderate pain where other painkillers like paracetamol, ibuprofen, and aspirin haven’t helped relieve pain. 

Because it contains codeine, which belongs to the drug class known as opioid analgesics, it can be addictive. Before you start a course of treatment of zapain, it is crucial that you discuss a strategy for ending the treatment so as to minimise the risk of developing an addiction to the codeine and experiencing drug withdrawal symptoms. 

How Strong Is Zapain?

Zapain, also known as co-codamol, is available as a tablet or capsule and can be found in three different strengths. Each contains 500mg of paracetamol, and then either 8mg, 15mg or 30mg of codeine. 

When looking at the strength on your packet, you will see it written as two numbers. So if you have 30/500, that would be 500mg of paracetamol and 30mg of codeine. 

You can purchase 8/500 over the counter at your local pharmacy. If that doesn’t help, you might like to try either a 15/500 or 30/500, but you will need to visit your GP to get a prescription for this strength. 

How Long Does It Take for Zapain to Kick In?

It can take up to an hour for the pain-relieving properties of co-codamol to kick in. Once they do, you will experience relief for around five hours. 

How Long Does Zapain Last?

While it can take up to an hour to feel the results, you could enjoy pain relief for up to five hours. 

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. 

What Is Zapain Used For?

Zapain is used for pain relief whereas 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 like backache, headaches, and migraines along with toothache. It can be a very effective pain relief option. 

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What Happens to Your Body When You Take Zapain?

Co-codamol, also known by the brand name zapain, is made up of two painkillers: paracetamol and codeine. Each of these works in a different way to reduce the pain experienced. 

It’s believed that paracetamol works by stopping the brain from receiving the chemical messengers involved with pain. Codeine is part of a class of drugs known as opiates. Codeine turns into morphine in the liver, this is the substance that creates pain relief. It works by blocking pain signals between the pain receptors in the central nervous system and brain and the rest of the body.

What Are Normal Doses of Zapain?

Co-codamol is available in three strengths. Each will have 500mg of paracetamol, and then either 8mg, 15mg or 30mg of codeine. Zapain, a branded version of co-codamol, refers to the highest strength dose of 500mg of paracetamol with 30mg of codeine. 

People over the age of 16 can take up to two tablets of any strength up to four times in 24 hours, so long as they leave at least four hours in between doses. You should never exceed eight tablets in 24 hours. 

It is vital that you leave at least four hours between doses, as taking more than this can cause damage to your liver. 

You should not take zapain for more than three days. If your symptoms persist, speak with your doctor or healthcare provider. 

How Does Zapain Make You Feel?

Codeine is an opioid medication and along with relieving pain, it could cause you to feel relaxed, sleepy, confused, or sick. Because it can make some people drowsy, some people with the highest strength might seem a little bit ‘out of it’.

How Strong Is Zapain?

It is available in three strengths. Each will have 500mg of paracetamol, and then either 8mg, 15mg or 30mg of codeine. 

What Are the Most Common Side Effects of Zapain?

As is the case with all drugs, co-codamol comes with the risk of side effects including common ones like feeling sick or constipated as well as more serious ones including addiction. 

Common Side Effects

  • Constipation 
  • Nausea 
  • Vomiting 
  • Sleepy
  • Headaches

Most of these can be alleviated. For example, if you experience constipation it’s important to drink enough water and engage in some movement over the course of the day. 

If a feeling or being sick is a side effect, only take Zapain with food or shortly afterward. If you experience ongoing nausea, drink water in small amounts but often. It should ease in a few days but if it continues consult your doctor or healthcare profession. 

While you assess whether zapain is making you sleepy, avoid driving or working with machinery. You’ll also want to avoid mixing it with alcohol, as that will only make you feel more tired. 

If you get a headache, again avoid drinking alcohol and make sure you’re hydrated. If the headache persists, see your doctor. 

Serious Side Effects

  • Rash 
  • Issues urinating 
  • Eyesight changes
  • Dizziness
  • Allergic reactions
  • Hearing loss
  • Feel very happy or very low
  • Changes in blood cells

If you show any signs of anaphylaxis including an itchy or red rash, wheezing, chest tightness, facial swelling, or issues breathing you need to see a doctor immediately. Call 999 or get to A&E. 

Taking more codeine than has been prescribed to you can lead to additional side effects, including: 

  • Low blood pressure
  • Abnormal breathing 
  • Respiratory arrest
  • Kidney failure 
  • Liver failure 
  • Bleeding from the stomach 

Who Should Avoid 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?

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. 

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. 

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. 

How Long Does Zapain 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?

While codeine is what makes Zapain so effective as pain relief, unfortunately, it can lead to physical dependence and 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.

Symptoms 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 

Side Effects of Zapain Addiction

Long-term use of Zapain can lead to addiction and abuse of the drug. Unfortunately, this comes with the risk of dangerous side effects including: 

  • Liver damage
  • Kidney damage
  • Seizures 
  • Respiratory depression
  • Overdose (can be fatal)

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Can You Get Withdrawal Symptoms From Zapain?

While coming off of co-codamol, particularly if you have developed a physical dependence on it, you may suffer withdrawal symptoms. These could include: 

  • Anxiety 
  • Agitation 
  • Restlessness
  • Trouble sleeping
  • Shaking 
  • Pins and needles
  • Ringing in your ears 
  • Sweating 
  • Chills 
  • Palpitations 
  • Tremors
  • Abdominal cramps 
  • Nausea and vomiting
  • Diarrhoea 
  • Increased blood pressure 
  • Increased respiratory rate 

What Should I Avoid While Taking Zapain?

Do not take zapain with additional paracetamol or with other paracetamol-containing products.

Foods to Avoid When Taking Zapain?

You should avoid alcohol while taking zapain, but otherwise, there are no food or drinks you need to avoid. 

Most Common Questions About Zapain

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. 

What Is the Drug Zapain Used For?

Zapain is the brand version of the highest strength of co-codamol. It contains 30mg of codeine and 500mg of paracetamol and is for the short-term relief of severe pain or moderate pain which is not helped by other painkillers like paracetamol, aspirin, or ibuprofen. 

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. 

Can Zapain Make Pain Worse?

If you have a headache, you might experience further headaches as a side effect of Zapain. 

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. 

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