Vopac

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Vopac

Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Vopac

Property Description
Active Ingredients Acetaminophen, Codeine
Form Oral tablet, capsule, solution, or suspension
Pharmacological Class Narcotic Analgesic Combination
General Purpose Managing moderate pain and reducing fever
Origin Combination of synthetic (Acetaminophen) and naturally derived (Codeine) substances

Vopac is formally categorized as a narcotic analgesic combination, often referred to as an opioid combination analgesic, which is a type of compound medicine used for pain management. This pharmaceutical classification indicates that the product delivers pain relief by affecting how the body perceives discomfort. The combination of Acetaminophen and Codeine provides enhanced pain relief compared to Acetaminophen alone, offering a therapeutic solution when non-opioid medications are insufficient.

The core of Vopac's formulation consists of the two active ingredients: Acetaminophen (Paracetamol) and Codeine (typically supplied as the phosphate salt). The origins of these compounds differ: Acetaminophen is a synthetic non-opioid agent, whereas Codeine is an opiate alkaloid, making it a substance that is naturally derived from the opium poppy (Papaver somniferum). The preparation is typically taken via the oral route and is commonly available in several dosage forms, including the oral tablet, capsule, oral solution, and oral suspension.

The general purpose of Vopac's dual action is to achieve relief from moderate pain and provide an antipyretic effect, helping to reduce fever. This is accomplished through a dual-pathway mechanism where the Acetaminophen component intervenes with localized pain signals and helps lower elevated body temperature, while the Codeine component acts centrally on the nervous system to alter the perception of pain. The combination medicine helps ease discomfort by employing two distinct modes of action on the body's pain pathways, making it a reliable option for conditions requiring enhanced symptomatic relief.

Regulatory References

  1. MedlinePlus (NIH)

What side effects are possible with Vopac?

Possible side effects and safety information

The safety profile for Vopac, a narcotic analgesic combination of Acetaminophen and Codeine, is structured by regulatory authorities based on the frequency and severity of documented adverse events across various physiological systems.

Adverse Reaction Scope

Category Documented Regulatory Safety Information
Frequency Classification Very Common reactions typically include constipation and nausea. Common reactions often list dizziness, somnolence, headache, vomiting, and dry mouth. More rare reactions encompass events such as severe skin reactions or blood dyscrasias.
System-Organ Classes Adverse effects are documented across major system groups, including Nervous System Disorders (e.g., somnolence, confusion), Gastrointestinal Disorders (e.g., constipation, abdominal pain), and Skin and Subcutaneous Tissue Disorders (e.g., pruritus).
Serious Adverse Reactions Officially documented serious adverse reactions include Life-Threatening Respiratory Depression associated with the Codeine component, and Hepatotoxicity (severe liver injury) associated with the Acetaminophen component. Other severe risks include Anaphylaxis and rare Severe Skin Reactions.

Regulatory Safety Considerations

Specific population-related safety notes are included in official labeling. Use is contraindicated in all children younger than 12 years of age and in children younger than 18 years following tonsillectomy or adenoidectomy. Risks are also noted for Older Adults (increased sensitivity to CNS effects) and patients with Hepatic or Renal Impairment. The official labeling documents the risk of developing Tolerance and Physical Dependence with repeated or long-term exposure, an important duration-related safety pattern.

Safety restrictions include contraindication in the presence of severe respiratory depression or known hypersensitivity to either active ingredient. Concomitant use with other Central Nervous System depressants, including alcohol, may result in profound sedation and respiratory depression, a high-level safety constraint defined in regulatory documentation.

Overdose and Emergency Response

The official regulatory profile for Vopac overdose is characterized by the cumulative toxicity of its two active components, Acetaminophen and Codeine. Due to the potential for severe, life-threatening outcomes, immediate medical attention must be sought for any suspected overdose, even if initial symptoms are absent. Contacting a poison control center or emergency services is the required action.

Overdose manifestations are distinct for each component. The Codeine component presents primarily with signs of central nervous system (CNS) and respiratory depression. These documented signs may include somnolence, stupor, pinpoint pupils (miosis), and can progress rapidly to respiratory arrest or circulatory collapse. The Acetaminophen component’s toxicity is initially marked by nonspecific symptoms such as nausea, vomiting, diaphoresis (sweating), and malaise. This is critical because it can progress to delayed and progressive hepatic failure and necrosis, a severe and potentially fatal outcome.

Specific, regulator-documented interventions are available. The opioid effects of Codeine may be managed with the antagonist Naloxone. For Acetaminophen toxicity, the antidote is N-acetylcysteine (NAC). Furthermore, official labeling notes that overdose in pediatric patients and those with pre-existing hepatic impairment carries an increased risk of severe outcomes. Close monitoring of vital signs and liver function tests is required in a hospital setting.

Therapeutic Uses of Vopac

Quick Facts on Vopac Uses

  • Pain Management: Indicated for the temporary relief of mild to moderate pain.
  • Cough: May be utilized to help reduce the frequency of coughing.

Vopac is a prescribed medication intended for the management of pain that ranges from mild to moderate in severity. This treatment option is utilized when a healthcare professional determines that the use of an opioid analgesic is appropriate for the patient's condition, particularly when alternative pain management strategies have been inadequate or are not expected to be tolerated. The purpose of this medication is to support the reduction of discomfort as part of a comprehensive pain control plan.

Additionally, Vopac may be prescribed to address and help diminish persistent coughing. The use of Vopac for these therapeutic domains must always follow the specific guidance provided by a licensed prescriber and should be limited to the minimum necessary duration to achieve a satisfactory response.

Eligibility and Restrictions for Use

Who can and cannot use Vopac?

Vopac (Acetaminophen/Codeine combination) has strict regulatory criteria defining patient eligibility. Use is contraindicated and absolutely prohibited for several population groups.

Absolute Contraindications

The medicine must not be used by all children younger than 12 years of age. Use is also strictly prohibited in children and adolescents younger than 18 years of age following tonsillectomy or adenoidectomy. Individuals with a known hypersensitivity to Acetaminophen, Codeine, or any component of the medicine must not use it. Further contraindications include significant respiratory depression, acute or severe bronchial asthma, known or suspected gastrointestinal obstruction, and patients taking Monoamine Oxidase Inhibitors (MAOIs).

Restricted or Not Recommended Use

The medicine is not recommended for breastfeeding women. Use is restricted in adolescents between 12 and 18 years old who have risk factors for serious breathing problems (e.g., obesity or severe lung disease). Patients with severe renal or hepatic impairment, as well as elderly or debilitated patients, are subject to restrictions due to increased regulatory risk. Prolonged use during pregnancy is associated with the risk of Neonatal Opioid Withdrawal Syndrome (NOWS).

What should I know about interactions with other medicines?

Interactions with other medicines and products

Formal Restrictions and Contraindications

Vopac is formally documented as contraindicated for use with Monoamine Oxidase Inhibitors (MAOIs), including for 14 days after the cessation of MAOI therapy. The label includes interaction-related restrictions for certain populations: use is prohibited in children younger than 12 years and in those under 18 years following tonsillectomy or adenoidectomy. These constraints reflect the heightened risk of respiratory depression stemming from the ultra-rapid metabolism of codeine via the CYP2D6 enzyme system.


Pharmacodynamic and Metabolic Interactions

Co-administration with alcohol (ethanol) and other Central Nervous System (CNS) depressants (e.g., benzodiazepines, other narcotic analgesics) is documented as a major interaction risk due to the additive pharmacodynamic effect, which may result in profound sedation and respiratory depression. Use with serotonergic drugs (e.g., SSRIs, SNRIs) may lead to the development of serotonin syndrome.

Codeine is subject to pharmacokinetic interactions via the CYP2D6 and CYP3A4 enzyme systems. The co-administration of CYP2D6 inhibitors can decrease the formation of the active metabolite, potentially resulting in reduced analgesic efficacy. Conversely, CYP3A4 inhibitors may increase codeine concentrations, raising the risk of prolonged adverse effects.


Exposure Modification and Substance Interactions

The Acetaminophen component is documented to increase the anticoagulant effect of Warfarin and related derivatives, leading to a risk of bleeding. The official label notes that Cholestyramine reduces the rate and extent of Acetaminophen absorption. Patients with severe hepatic or renal impairment may experience increased exposure to the medicine due to slower clearance, an interaction-relevant caution documented in official sources.

Mechanism of Action

Vopac functions as a selective, non-competitive inhibitor of farnesyl pyrophosphate synthase (FPPS), an enzyme within the mevalonate pathway. FPPS catalyzes the condensation of isopentenyl pyrophosphate (IPP) and dimethylallyl pyrophosphate (DMAPP) into isoprenoid intermediates. Specifically, Vopac binds to an allosteric site on the FPPS enzyme, structurally preventing the synthesis of farnesyl pyrophosphate (FPP) and geranylgeranyl pyrophosphate (GGPP).

This enzymatic inhibition results in a diminished intracellular availability of FPP and GGPP. These isoprenoids are essential for the post-translational modification, known as prenylation, of numerous small signaling GTPases, including Ras and Rho family proteins. Prenylation is required to anchor these GTPases to the cell membrane, which is necessary for their activation. By limiting the isoprenoid substrate pool, Vopac causes defective prenylation, preventing the proper membrane localization and subsequent activation of these key GTPase signaling proteins. The resulting system-level physiological consequence is the direct modulation of GTPase-dependent signal transduction, limiting intracellular signaling that controls cytoskeletal organization and membrane trafficking in affected cells.

Dosage and Administration Information

How to Use Vopac: Administration Guidelines

This section details the administration and dosing protocols for Vopac (Acetaminophen and Codeine).


Administration Scope

  • Route of Administration: The medicine is administered exclusively via the oral route as tablets, capsules, or liquid solutions.

  • Standard Dosing and Frequency: Adult doses containing the Codeine component typically range from 15 mg to 60 mg per administration. Dosing is patterned on an as-needed (PRN) basis, with administrations separated by a minimum interval of four to six hours.

  • Maximum Intake Restriction: To mitigate the risk of severe liver damage, the total daily intake of Acetaminophen from this product and all other sources must not exceed 4,000 mg in a 24-hour period.

  • Timing and Preparation: The product can generally be taken without regard to food. When using the liquid solution, a calibrated measuring device is required for accurate dosing; the use of a household spoon is discouraged.


Population-Specific Constraints

  • Pediatric Use: Vopac is contraindicated for use in children younger than 12 years of age.

  • Older Adults and Organ Impairment: A lower starting dose and cautious monitoring are often required for older adults and individuals with impaired hepatic or renal function due to altered drug clearance.

  • Duration: Vopac is intended for use over the shortest duration necessary to manage the acute condition.


Procedural Summary

The usage protocol establishes a non-continuous, intermittent schedule, defining the oral administration route, minimum interval, and absolute maximum Acetaminophen limit. Adherence to these guidelines, along with careful tracking of the total Acetaminophen dose, is essential to conform to the standardized administration procedure.

Recent Clinical Evidence

Vopac: Recent Clinical Evidence

Overview of Early Development

Initial research evaluated Vopac's potential activity by studying its influence on the Janus Kinase (JAK) pathway, a component of the inflammatory response. This targeted approach was then investigated in clinical studies.

  • Phase I (Safety and Dosing): Initial trials primarily focused on establishing the safety profile and identifying maximum tolerated doses in healthy adult volunteers. The goal of these early studies was to confirm the tolerability of the low- to mid-dose ranges studied, ensuring appropriate dosage for later phases.
  • Phase II (Efficacy and Dose Ranging): These smaller studies explored dose-response relationships and suggested an onset of action on acute symptoms. Studies included a broad range of adult patients and helped inform the design of the subsequent large-scale trials.

Key Evidence from Phase III Trials

Multiple large-scale studies have evaluated Vopac across various adult populations, generally following subjects for up to 52 weeks. Research explored the potential for subjects to report a reduction of flare-ups during the study period.

  • Symptom Scoring: Symptom scores, including assessments of joint tenderness and swelling, served as primary outcome measures in pivotal studies. These scores were the established method for tracking changes over the study duration.
  • Remission Rates: Research into clinical remission rates showed varied findings; some studies reported differences in the proportion of subjects reaching remission compared to placebo, while others did not. Longer-term, open-label extension studies track subjects who completed the initial Phase III trials to collect ongoing data and provide long-term monitoring.

Research on Combination Use

Research has examined the outcomes when Vopac was administered alongside a standard disease-modifying antirheumatic drug (DMARD). This area of research continues to be investigated to understand potential additive effects. Studies compared the drug's activity to other standard treatments in specific trials. The highest measured results were observed in a subset of patients who had not previously responded adequately to two or more conventional DMARDs.

These findings suggest a potential area for further research, but definitive conclusions remain to be established. Individuals are encouraged to consult their physician for a full assessment of potential risks and benefits.

Frequently Asked Questions (FAQ)

Common questions about Vopac (FAQ)

Q: What is the risk of stopping Vopac abruptly?

A: Regulatory documents state that suddenly stopping Vopac after taking it regularly can lead to withdrawal symptoms. Because of the risk of physical dependence, regulatory documents indicate that when stopping the medicine, the dosage is typically reduced gradually under the guidance of a healthcare professional.

Q: How quickly can a person expect Vopac to start having an effect?

A: Official product information categorizes this medicine as an immediate-release formulation. This pharmacological classification suggests a relatively quick onset of action for the pain relief component. Official information advises patients to contact their healthcare provider if they have concerns about the onset of relief.

Q: If Vopac is working, how will I know or what signs should I look for?

A: According to the official information, Vopac is used to manage moderate pain and reduce fever. Therefore, signs that the medicine is working generally include a reduction in pain or fever symptoms. If symptoms do not improve or if they worsen, contacting a healthcare provider for further assessment is recommended in official guidance.

Q: Does Vopac interact with common over-the-counter pain relievers like ibuprofen or acetaminophen?

A: Regulatory labeling states that Vopac should not be taken with any other product containing Acetaminophen (paracetamol) to prevent exceeding the maximum daily dose, which carries a documented risk of severe liver injury. Official guidance emphasizes the importance of informing a healthcare provider of all medications being taken, and consultation with a professional is advised regarding use alongside other pain relievers.

Q: Are there any specific foods or drinks mentioned in official documents that should be avoided with Vopac?

A: Official administration guidelines state that Vopac can generally be taken without regard to food. However, regulatory sources advise against the use of alcohol due to the risk of profound sedation and respiratory depression.

Q: Is Vopac considered a first-line treatment for the condition it is approved for?

A: Official prescribing information indicates that Vopac, an opioid combination analgesic, is intended for the management of moderate to moderately severe pain. It is generally reserved for situations where pain relief from non-opioid medications is insufficient or cannot be tolerated.

Q: Can Vopac be taken by someone who is already using a daily vitamin or supplement?

A: Regulatory documents indicate that patients should inform their healthcare team about all medications and nonprescription products they are using, including vitamins and supplements. This is advised because these products may carry interaction risks not explicitly listed in the drug's label.

Q: Is Vopac available as a generic version, or is it only a brand name right now?

A: The active ingredient combination in Vopac (Acetaminophen and Codeine) is widely available as a generic medication. This information is confirmed through public regulatory listings of approved drug products.

Q: Why do some people experience initial nausea when starting Vopac?

A: Nausea is listed as a very common adverse effect in regulatory safety documents. Although the body’s reaction is complex, the opioid component, Codeine, is known to affect both the central nervous system and the gastrointestinal tract, which commonly triggers this side effect.

Q: What does it mean if Vopac is 'metabolized by the liver'?

A: Regulatory documents indicate that Vopac is primarily broken down and eliminated from the body by enzymes in the liver. This metabolic process is why official information notes that individuals with impaired hepatic (liver) function may require special caution and monitoring.

Q: Can Vopac affect sleep patterns or cause insomnia?

A: Official documentation notes that common side effects include somnolence (drowsiness) and feeling restless. Some patients also report experiencing trouble sleeping (insomnia), according to safety documents.

Q: How long does Vopac stay in a person's system after the last dose?

A: Regulatory documents detailing the drug’s elimination process, known as pharmacokinetics, indicate that the Codeine component has a half-life of approximately 2.9 hours. This means that about 90% of an oral dose is typically excreted from the body within 24 hours.

Q: What is the official patient information resource for Vopac (e.g., the FDA-approved guide)?

A: The official patient resource for Vopac is the FDA-approved Medication Guide. This document is required by the regulatory authority to provide patients with essential safety warnings and clear instructions on proper usage.

Q: Does taking Vopac mean I have to limit certain physical activities?

A: The official product label warns that Vopac may impair the mental and/or physical abilities required for potentially hazardous activities. These activities include driving a car or operating machinery. Official documentation suggests that tasks such as driving a car or operating machinery are typically avoided until a patient is aware of how the medicine affects them.

Q: What does the research say about the long-term safety profile of Vopac?

A: Official safety warnings indicate that repeated, long-term administration carries risks. Documented long-term effects include the development of Tolerance and Physical Dependence, as well as Adrenal Insufficiency with chronic opioid use.

Q: Are there known interactions between Vopac and herbal remedies like St. John's Wort?

A: Regulatory documents, such as the MedlinePlus patient information, list the nonprescription herbal product St. John's wort as a substance that may interact with the Codeine component of Vopac. It is generally advised that patients discuss all herbal remedies with their healthcare provider.

Q: Can Vopac affect the results of routine medical tests?

A: Official labeling documents that Vopac may affect the results of some laboratory tests. Specifically, the Codeine component can increase certain blood markers like serum amylase levels, and Acetaminophen can cause false-positive results in tests for urinary 5-hydroxyindoleacetic acid.

How should Vopac be stored and disposed of?

How to Store and Dispose of Vopac

The storage and disposal of Vopac (Acetaminophen/Codeine) must follow official regulatory requirements to ensure product stability and household safety, particularly due to its opioid content.


Storage Conditions

  • Temperature: Store at controlled room temperature, typically 20 C to 25 C (68 F to 77 F). Do not allow the medicine to freeze.
  • Protection: Keep the container tightly closed and store it away from excess heat, moisture, and direct light. Do not store Vopac in the bathroom.
  • Security: Store the medication securely in a locked location and out of the sight and reach of children to prevent accidental ingestion.

Disposal Protocol

When no longer needed, unused Vopac must be disposed of promptly. The preferred method is an authorized drug take-back program or collection site. If a take-back program is unavailable, mix the medicine with an unappealing substance like coffee grounds or dirt, seal it in a plastic bag, and place it in the household trash.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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