Adco-Napacod is a pain reliever that’s available in South Africa. It’s meant to be used as short-term therapy to treat acute pain. It contains two drugs:
- 10 mg codeine
- 500 mg paracetamol (known as acetaminophen in the U.S.)
Adco-Napacod is used to treat various types of pain, including:
- Low back pain
- Headache
- Joint pain
- Fever
- Menstrual cramps
- Toothache
Side effects include:
- Constipation
- Sweating
- Sleepiness
- Nausea and vomiting
- Low blood pressure
- Decreased appetite
- Risk of respiratory depression
Before taking the tablets, dissolve them in water.
- The typical adult dosage is 1 to 2 tablets taken every 4 to 6 hours.
- The maximum dose is 8 tablets in 24 hours.
- The dosage in children ages 12 to 18 is 1 tablet taken every 4 to 6 hours with a maximum dose of 4 tablets in 24 hours.
- Adco-Napacod should not be given to children under 12 years of age.
Adco-Napacod is metabolized by an enzyme in the liver known as CYP2D6. This process converts Adco-Napacod to the active drug, morphine. In certain people, this conversion happens more quickly than usual. They are classified as CYP2D6 rapid metabolizers. This quicker metabolism can lead to unsafe morphine levels in the body. People who are CYP2D6 rapid metabolizers should not take Adco-Napacod.
Adco-Napacod is not available in the U.S. A comparable product that is available by prescription is acetaminophen with codeine. These tablets contain 300 mg acetaminophen combined with different strengths of codeine:
- 300 mg acetaminophen/15 mg codeine
- 300 mg acetaminophen/30 mg codeine. The typical adult dosage is 1 to 2 tablets taken every 4 hours as needed for pain.
- 300 mg acetaminophen/60 mg codeine. The typical adult dosage is 1 tablet taken every 4 hours as needed for pain.
It is recommended that the lowest effective dose for the shortest possible time be prescribed.
The following chart shows the maximum recommended amounts of acetaminophen and codeine:
| Maximum amount per dose | Maximum amount per day | |
|---|---|---|
| Acetaminophen | 300 mg to 1,000 mg | 4,000 mg |
| Codeine | 30 mg to 60 mg | 360 mg |
The U.S. product carries the same warnings as Adco-Napacod. Acetaminophen with codeine is a schedule III controlled substance. Due to the potential for addiction, abuse and misuse, the Food and Drug Administration (FDA) requires a Risk Evaluation and Mitigation Strategy (REMS) for these products.