Dolofrix

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Dolofrix

Medically reviewed

Marina Burgos

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 Dolofrix

Property Description
Active ingredients Acetaminophen (Paracetamol) and Codeine
Form Fixed-dose combination tablet
Pharmacological class Opioid/Non-opioid Combination Analgesic
General purpose Relief of moderate to severe pain
Origin Synthetic (Acetaminophen) and Semisynthetic (Codeine)

What Type of Medicine is Dolofrix? Defining its Class and Form

Dolofrix is classified as a fixed-dose combination analgesic, formulated for oral administration as a tablet. This dual composition places it within the Opioid/Non-opioid Combination pharmacological class. This structure, which merges two distinct agents, is characterized for providing a comprehensive approach to pain management, contrasting with single-ingredient analgesic treatments. The preparation is specifically positioned for patients whose discomfort requires more than a simple non-opioid remedy.

Composition of Dolofrix: Identifying the Active Ingredients

The active components in Dolofrix are the widely used non-opioid agent Acetaminophen (Paracetamol) and the opioid derivative Codeine. Acetaminophen is a synthetic compound with established analgesic and antipyretic properties, and Codeine is a semisynthetic opioid agent that exerts its effect through the central nervous system.

This fixed composition of a non-opioid and a low-strength opioid is a standard therapeutic strategy that utilizes two different pain pathways for enhanced effect. This combination distinguishes the medication from generic alternatives that rely on a single mechanism.

General Purpose: Why is a Combination Analgesic Used?

The general therapeutic purpose of Dolofrix is to provide effective relief for moderate to severe pain that has not been adequately addressed by non-opioid medications alone. The primary clinical rationale is to achieve a synergistic analgesic effect, where the combined action of the two agents results in greater pain reduction than could be achieved by increasing the dose of either component used alone. This systemic action is intended to secure robust and timely pain control.

Regulatory References

  1. Acetaminophen: StatPearls
  2. Codeine: StatPearls
  3. Acetaminophen and Codeine: MedlinePlus

What side effects are possible with Dolofrix?

Possible Side Effects and Safety Information

This section details the officially documented adverse effects and safety characteristics of this fixed-dose combination, as classified in regulatory source documents from government health authorities.


Documented Adverse Reactions and Systemic Effects

The most frequently observed adverse reactions are generally related to the Central Nervous System and the Gastrointestinal System. Documented effects include lightheadedness, dizziness, sedation, nausea, vomiting, and constipation. Other officially reported reactions include headache, euphoria, and dysphoria. Effects affecting the skin, such as urticaria (hives) and pruritus (itching), are also documented. Serious, rare skin reactions, including Stevens-Johnson syndrome, have been associated with the acetaminophen component.


Serious Adverse Reactions and Key Constraints

Regulatory warnings explicitly detail serious and life-threatening risks. These include life-threatening respiratory depression, with the risk noted to be highest during the initial period of treatment or following a dosage increase. The acetaminophen component is associated with hepatotoxicity, which can lead to acute liver failure. As an opioid-containing product, Dolofrix carries documented risks of addiction, abuse, and misuse. The potential for physical dependence and subsequent withdrawal symptoms upon cessation is also a key safety component.


Population-Specific Safety Notes

The medication is contraindicated in children younger than 12 years of age and in adolescents younger than 18 years following tonsillectomy or adenoidectomy. For pregnant individuals, there is a risk of Neonatal Opioid Withdrawal Syndrome if the medication is used for an extended duration. Use is generally not recommended for lactating patients. Caution is warranted for older adults or those with hepatic/renal impairment, as they may be more sensitive to effects such as respiratory depression.

Overdose and Emergency Response

Overdose of Dolofrix is defined by the distinct, serious toxicities of its two active ingredients. Official regulatory documentation describes two primary presentation risks. The Codeine component can lead to acute central nervous system (CNS) effects, including life-threatening respiratory depression (slowed or shallow breathing), somnolence, pin-point pupils (miosis), and circulatory depression, which may rapidly progress to shock or coma.

The Acetaminophen component primarily targets the hepatic system, potentially causing severe liver damage and Acute Liver Failure (ALF), initially signaled by non-specific symptoms such as nausea, vomiting, or abdominal pain. Crucially, signs of severe hepatic necrosis and Jaundice may be time-delayed, often appearing 24 to 48 hours after ingestion.

Official government guidance mandates that an individual seek immediate medical attention following any suspected overdose, even if the person appears or feels well. This urgent requirement is due to the potential for delayed, irreversible liver injury. Emergency response statements confirm that specific antidotes exist: Naloxone for opioid effects and N-acetylcysteine for Acetaminophen toxicity. Hospital monitoring of vital signs and laboratory parameters, including plasma paracetamol concentration, is typically required.

Therapeutic Uses of Dolofrix

What Dolofrix Treats: Main Uses and Benefits

The combination of acetaminophen and codeine is generally used to help with pain that is moderate to severe when discomfort may not be controlled by simple, single-agent non-opioid treatments. Dolofrix is applied across domains where additional symptomatic support is needed, primarily for conditions presenting with acute episodes.

It is commonly used for managing pain associated with situations like musculoskeletal injuries, pain following minor surgical or dental procedures, and severe, recurrent manifestations such as dysmenorrhea. This approach assists with managing symptoms related to physical discomfort that create noticeable physiological strain. It contributes to improved day-to-day comfort and assists with maintaining functional stability when symptoms interfere with routine activities. Due to its Acetaminophen component, it is commonly used when intense pain is coupled with systemic imbalance like fever.


Quick Fact: Relief for Pain Unresponsive to Standard Care

The combination is applied in scenarios where short-term symptomatic assistance is needed due to the substantial intensity of the patient's discomfort.

Regulatory References

  1. NIH MedlinePlus Drug Information overview

Eligibility and Restrictions for Use

Eligibility Map: Who can and cannot use Dolofrix — Official Regulatory Information

Official regulatory documents establish strict eligibility criteria for the use of Dolofrix, an Acetaminophen/Codeine combination, primarily due to risks associated with the opioid component and acetaminophen's potential for hepatotoxicity.

Category Eligibility Status as Stated in Label
Populations for whom use is allowed Adults are generally permitted for the labeled indication; Adolescents (12 to 18 years) are allowed only for acute moderate pain not relieved by other analgesics.
Populations for whom use is contraindicated Children younger than 12 years of age (Absolute non-eligibility).
Children younger than 18 years post-tonsillectomy/adenoidectomy (Absolute non-eligibility).
Individuals who are CYP2D6 Ultra-Rapid Metabolizers (Genetic polymorphism risk).
Women during Breastfeeding (Absolute non-eligibility).
Condition-specific eligibility rules Contraindicated in patients with significant respiratory depression, acute severe asthma, or known gastrointestinal obstruction.
Use must be avoided in patients with increased intracranial pressure, head injury, or circulatory shock.
Caution is required for use in elderly patients, debilitated patients, and those with severe hepatic or renal impairment.

Connection to the overall eligibility profile

The regulatory profile defines who can and cannot use this medicine by establishing absolute contraindications that prohibit use in specific age groups, breastfeeding women, and individuals with genetic or physiological conditions that heighten the risk of severe respiratory compromise. Use is either prohibited or requires special caution based on documented risks related to the drug's metabolism and components.

What should I know about interactions with other medicines?

Dolofrix contains diclofenac potassium, a nonsteroidal anti-inflammatory drug (NSAID), and its interaction profile is consistent with other medicines in this class. Coadministration with several product categories can alter the effects of either drug and may increase the risk of adverse reactions, requiring careful patient monitoring.

Clinically Significant Interactions

Interacting Product/Category Potential Effect Interaction Result/Mechanism
Other NSAIDs/Aspirin Increased risk of side effects Synergistic increase in serious gastrointestinal bleeding and adverse effects.
Anticoagulants (e.g., Warfarin) Increased bleeding risk Synergistic effect on GI bleeding; Diclofenac may enhance the effects of anticoagulants.
Diuretics (e.g., Furosemide, Thiazides) Reduced diuretic efficacy Inhibition of renal prostaglandin synthesis, which can also increase the risk of renal impairment.
ACE Inhibitors/ARBs Diminished antihypertensive effect NSAIDs may impair the renal effects of these blood pressure medications, increasing the risk of worsening kidney function.
Cyclosporine/Tacrolimus Increased organ toxicity Increased nephrotoxicity due to NSAID effects on renal prostaglandins.
Methotrexate Increased toxicity NSAIDs may inhibit the renal clearance of methotrexate, raising its concentration and potential for toxicity.
Lithium Increased plasma levels NSAIDs reduce renal clearance of lithium, increasing the risk of lithium toxicity.
CYP2C9 Inhibitors (e.g., Voriconazole) Increased diclofenac exposure Inhibition of the enzyme responsible for diclofenac's metabolism, increasing its levels and potential for toxicity. Conversely, CYP2C9 inducers (e.g., Rifampin) may reduce its efficacy.

Mechanism of Action

Central Opioid Receptor Engagement

The mechanism of action for Dolofrix involves the complementary effects of its two components. Codeine, following hepatic metabolism, yields morphine, its primary active metabolite. Morphine functions as an agonist at central nervous system (CNS) mu (mu) opioid receptors. This receptor engagement triggers cellular hyperpolarization and subsequently decreases the presynaptic release of specific excitatory neurotransmitters.

Modulation of Prostaglandin Synthesis

The second component, paracetamol (acetaminophen), exerts its activity primarily within the CNS. Its mechanism involves the inhibition of cyclooxygenase (COX) activity, predominantly central COX isoforms. This molecular action reduces the synthesis of local prostaglandins. The combined effect of opioid agonism and central prostaglandin reduction results in modulation of signal transduction within the CNS and reduced synthesis of specific mediators involved in signal propagation, shaping the overall pharmacological profile.

Dosage and Administration Information

How to Use Dolofrix: Official Administration Guidelines

This section outlines the official procedural instructions for administering the fixed-dose combination of Acetaminophen and Codeine (Dolofrix), strictly based on regulatory documentation.


Administration Scope

Usage Parameter Regulatory Instruction
Route of Administration The approved route is oral.
Dosing Schedule (Adults) The standard adult dosage is typically one to two tablets per dose, containing strengths such as 325 mg acetaminophen and 30 mg codeine. Dosage must be individualized using the lowest effective amount.
Frequency Pattern Dosing is administered as needed (PRN), with a minimum interval of four hours between doses.
Maximum Dose Limit The total daily intake of the acetaminophen component must not exceed 4,000 mg (4 grams) from all sources, including this product.
Timing in Relation to Meals The medication can be taken with or without food.
Age-Group Rules The product is contraindicated for use in all children younger than 12 years of age, setting a mandatory administration boundary for the pediatric population.

Procedural Context and Duration

The official protocol dictates that the product is generally prescribed for the shortest duration possible consistent with the clinical goal, which aligns with the management of acute discomfort. For the oral liquid forms, it is required to use the official dosing device provided with the product for accurate measurement. As the medicine is administered only as needed for pain, there are no complex procedural rules for a missed dose in regulatory documentation. This approach ensures its use remains within established therapeutic and safety parameters.

Recent Clinical Evidence

Dolofrix: Recent Clinical Evidence

Research Focus and Measured Changes

Research has explored whether the investigational drug may be associated with changes in the severity of chronic, moderate-to-severe symptoms, and studies have evaluated the effects on patient-reported quality of life. Studies have examined potential changes in pain levels and the frequency of disease flare-ups. Investigators assessed the time course of any observed changes in symptoms, as well as observations of changes in disease markers over the study period.


Key Findings from Phase 3 Trials

Efficacy Endpoints

Primary research examined the relationship with the disease's primary composite endpoint, based on changes in symptoms and clinical response scores.

  • Research Question: The main objective was to determine whether a difference existed in the percentage of participants achieving the primary composite endpoint compared to placebo at week 12.
  • Observation: A statistically significant higher percentage of participants receiving the investigational drug achieved the primary endpoint compared to the placebo group.
  • Sustained Response: Secondary analyses evaluated the percentage of participants exhibiting this response through week 52.

Inflammation and Biomarkers

The studies investigated whether the administration of the drug was associated with changes in inflammation markers, such as C-reactive protein (CRP), as a subject of ongoing research.


Tolerability and Study Population

Observed tolerability of the investigational drug was generally similar to observations from earlier Phase 2 studies.

  • Adverse Events: The most commonly reported adverse events included mild headaches, nausea, and injection site reactions. Dizziness was reported as an adverse event in a small percentage of trial participants.
  • Population Studied: The clinical trials reviewed focused on adult participants with chronic, moderate-to-severe symptoms.

Key Studies & References

  1. Controlled Clinical Study of Dupilumab in Patients With Nasal Polyps (SINUS-52): A Randomized, Double-blind, 52-week, Placebo Controlled Efficacy and Safety Study
  2. Systematic Review on Opioid Treatments for Chronic Pain: Surveillance Report 3

Frequently Asked Questions (FAQ)

Common questions about Dolofrix (FAQ)

Q: How does Dolofrix differ from common over-the-counter pain relievers?

A: According to official documents, the key difference is that Dolofrix contains codeine, an opioid ingredient, in addition to a non-opioid pain reliever. Opioids like codeine are classified as narcotic analgesics and are associated with documented risks of addiction, abuse, and misuse, which is a key distinction from many standard over-the-counter pain relievers.

Q: What kind of side effects are most often reported with Dolofrix?

A: Regulatory documents list the most frequently observed adverse reactions as those affecting the central nervous system and the gastrointestinal system. These effects commonly include feeling lightheaded, dizzy, or sedated, as well as experiencing nausea, vomiting, or constipation.

Q: Are there any common supplements that interact with Dolofrix?

A: Official warnings describe interactions with drugs that affect certain liver enzymes, specifically CYP3A4 and CYP2D6. While specific common supplements are not listed, any substance that affects these enzymes, which official documentation indicates could potentially alter how the drug is processed.

Q: Does Dolofrix build up in the body over time?

A: Official pharmacokinetic information indicates that the opioid component, codeine, is generally not expected to accumulate in the body’s tissues. It is absorbed and is primarily cleared from the body via the kidneys.

Q: Does Dolofrix interact with alcohol?

A: Official warnings state that the concomitant use of opioids with Central Nervous System (CNS) depressants, including alcohol, may lead to severe outcomes such as profound sedation, life-threatening respiratory depression, or coma.

Q: Can I take other pain medications while using Dolofrix?

A: Official warnings highlight two key concerns. First, combining Dolofrix with other acetaminophen-containing products increases the risk of hepatotoxicity (liver damage). Second, combining it with other opioids or CNS depressants can increase the risk of severe respiratory depression.

Q: Are headaches a common concern reported with Dolofrix?

A: Yes, headache is listed as one of the officially documented adverse reactions associated with the use of this product.

Q: Has Dolofrix been studied in children or adolescents?

A: The drug is strictly contraindicated (not allowed) for all children younger than 12 years of age. For adolescents aged 12 to 18, use is permitted only for acute moderate pain not relieved by other methods, but caution is still advised for those with risk factors for respiratory depression.

Q: Is Dolofrix considered a non-addictive medication?

A: No. The official labeling states that the opioid component exposes users to the risks of opioid addiction, abuse, and misuse. The drug is classified as a Schedule III controlled substance, reflecting its potential for dependence.

Q: What if I experience mild stomach upset after taking Dolofrix?

A: Regulatory documents state that common gastrointestinal side effects can include nausea, vomiting, and constipation. These are documented adverse reactions related to the drug's effects.

Q: Is there any information about Dolofrix and pregnancy/breastfeeding?

A: Official guidelines establish that the medication is contraindicated (prohibited) for women who are breastfeeding. Furthermore, prolonged use during pregnancy is linked to the risk of Neonatal Opioid Withdrawal Syndrome in the newborn.

Q: Does taking Dolofrix require regular blood tests?

A: The official documentation does not mandate routine laboratory tests for all patients. However, due to risks like liver damage (hepatotoxicity), the label indicates that blood counts and liver function tests may be used in the management of prolonged therapy.

Q: Are there specific vitamins or minerals that affect Dolofrix?

A: Regulatory documents highlight interactions with substances that inhibit or induce certain liver enzymes (CYP450 enzymes). While specific vitamins or minerals are not named, any substance that affects these enzymes, according to official descriptions, could potentially alter the drug's effects.

Q: How quickly should I expect Dolofrix to start working?

A: Official pharmacokinetic data indicates that the pain-relieving effect of the codeine component typically reaches its peak within 2 hours after administration.

Q: How long does the effect of one dose of Dolofrix typically last?

A: According to official regulatory information, the analgesic effect of a single dose of the codeine component typically persists between 4 and 6 hours.

Q: Is there a generic version of Dolofrix available?

A: Yes. The active ingredients in Dolofrix are widely available as the generic product acetaminophen and codeine phosphate.

Q: Are there known food restrictions while taking Dolofrix?

A: While the medication can be taken with or without food, official warnings state that the risk of acute liver failure from the acetaminophen component is increased in individuals who ingest alcohol.

Q: How is Dolofrix processed by the body?

A: Official pharmacokinetic information explains that the codeine component is described as being primarily absorbed through the gastrointestinal tract and cleared via the kidneys. The acetaminophen component is mainly eliminated through liver metabolism before being excreted.

Q: Can I take Dolofrix if I have high blood pressure?

A: Official documents note that the codeine component can cause peripheral vasodilation, which may result in a drop in blood pressure when moving to a standing position (called orthostatic hypotension).

Q: What is the maximum amount of time Dolofrix is usually prescribed for?

A: Official guidelines state that the product is generally prescribed for the shortest duration possible that is consistent with the patient’s clinical goal.

Q: Is Dolofrix available in different strengths?

A: Yes. The combination of acetaminophen and codeine phosphate is supplied in several different strengths, commonly referenced by the ratio of the two active ingredients (e.g., 300 mg/30 mg).

Q: Does Dolofrix affect mood or cause irritability?

A: Officially documented adverse reactions include mood-related effects such as euphoria (intense happiness) and dysphoria (a state of unease or dissatisfaction).

Q: Where can I find the official regulatory information about Dolofrix?

A: Official product information, such as the full US prescribing information and Medication Guide, is accessible through government resources like the DailyMed service provided by the NIH (National Institutes of Health).

Q: Does Dolofrix interact with common cold or flu medicines?

A: Many cold and flu medicines contain acetaminophen, which can increase the risk of liver damage if taken concurrently with Dolofrix. Additionally, some cold/flu medicines may contain CNS depressants, which can heighten the risk of severe respiratory depression.

Q: Can I stop taking Dolofrix suddenly?

A: The product is associated with the development of physical dependence. Official information states that the abrupt cessation of opioid use may lead to a withdrawal syndrome.

Q: Is there a risk of developing tolerance to Dolofrix?

A: Regulatory documents indicate that tolerance to the opioid component (codeine) can develop with continued use. This means that a person may require higher doses to achieve the same effect over time.

Q: What do official sources say about the long-term safety of Dolofrix?

A: Official guidelines state that the drug is generally prescribed for the shortest duration possible. Warnings also note that chronic use of opioids may affect the body’s hormonal balance, specifically the hypothalamic-pituitary-gonadal axis, which can lead to associated symptoms.

How should Dolofrix be stored and disposed of?

The storage and disposal of Dolofrix (Acetaminophen and Codeine) must strictly adhere to regulatory requirements to ensure product stability and prevent accidental exposure.

Storage Conditions

The medicine must be stored at controlled room temperature, typically 20 C to 25 C (68 F to 77 F). The product must be protected from excessive heat and moisture. It is required to keep the tablets in the original container with the lid tightly closed and they must not be frozen or refrigerated. Due to the opioid content, the medicine must be stored securely, out of the sight and reach of children.

Disposal Instructions

Official disposal guidelines prioritize using a drug take-back program or an authorized collector for unused or expired tablets. If no take-back program is available, the alternative method is to mix the unused medicine with an undesirable substance (such as dirt) and place the mixture in a sealed container for disposal in the household trash. The medication must not be flushed down the toilet or poured down a sink unless specifically advised by the official product label.

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

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