Panacod (Acetaminophen,Codeine)

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Panacod (Acetaminophen,Codeine)

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

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 Panacod (Acetaminophen,Codeine)

Property Description
Active Ingredients Acetaminophen and Codeine
Form Oral Solid (Tablet/Film-coated tablet)
Pharmacological Class Combination Analgesic (Opioid and Non-opioid)
General Purpose Pain Relief (Moderate to Severe) and Fever Reduction
Origin Synthetic and Semi-synthetic

Panacod is a prescription-only fixed-dose combination analgesic administered as an oral solid dosage form. It is classified within the high-level pharmacological class of co-formulations containing both opioid and non-opioid components. The drug’s core identity lies in its two active ingredients: the synthetic analgesic Acetaminophen (Paracetamol) and the semi-synthetic opioid derivative Codeine.

This combination product is recognized in clinical practice as an effective option for managing acute pain that is not adequately controlled by single-ingredient analgesics, often available as a film-coated tablet. The presence of both substances creates a synergistic effect, meaning the combined power to relieve pain exceeds the effect of using either ingredient alone. This dual-action mechanism is supported by pharmacological studies showing its efficacy in providing comprehensive relief for patients experiencing moderate to severe pain.

The primary general purpose of Panacod is to deliver effective pain relief by targeting the central nervous system and peripheral pain pathways simultaneously. The non-opioid component, Acetaminophen, inherently confers an additional antipyretic effect, meaning the preparation also helps to reduce fever. Therefore, the core function of Panacod is the integrated management of pain and the reduction of elevated body temperature, achieved through the coordinated action of its two distinct analgesic entities.

What side effects are possible with Panacod (Acetaminophen,Codeine)?

Possible side effects and safety information

The safety profile for this fixed-dose combination analgesic is determined by the distinct pharmacological properties of its two active components, Acetaminophen and Codeine, as documented in official regulatory labeling. Adverse reactions are classified into System Organ Classes (SOC) and assigned frequency tiers based on government-mandated standards.

Adverse Effects by System and Frequency

Official regulatory documents classify certain effects as Very Common, including somnolence (drowsiness) and dizziness. Common adverse reactions, which may affect up to 1 in 10 patients, primarily involve the Gastrointestinal System, such as constipation, nausea, and vomiting. Other commonly listed effects include generalized headache and mild pruritus (itching). Rare or very rare effects documented in regulatory sources include blood cell abnormalities (dyscrasias) and severe cutaneous adverse reactions.

Documented Serious Adverse Reactions and Systemic Risks

Specific serious adverse reactions are mandated in the prescribing information. The Codeine component is associated with the potential for respiratory depression, a life-threatening risk. Furthermore, the product carries a risk of developing tolerance and physical dependence following prolonged use. The Acetaminophen component is principally linked to the potential for severe damage to the liver (hepatotoxicity and acute hepatic failure), particularly with excessive dosing, as noted in government regulatory documents.

Contextual Safety Patterns and Limitations

Certain safety characteristics are contextualized by the use pattern. Adverse effects such as somnolence and dizziness are often noted to be more frequently observed at the start of treatment or following a dose adjustment. Specific safety constraints apply to certain populations: the product is generally contraindicated in individuals with severe hepatic impairment due to the risk posed by the Acetaminophen component. Caution is also advised in patients with renal impairment and older adults, who may exhibit increased sensitivity to the opioid effects.

Overdose and Emergency Response

Overdose for Panacod involves the distinct toxicities of both Acetaminophen and Codeine, creating a high-risk scenario that mandates immediate medical attention due to the potential for dual, life-threatening complications.

Documented Overdose Manifestations

Overdose presentation includes two primary symptom clusters. Codeine toxicity may manifest as respiratory depression (shallow, slow, or stopped breathing), pinpoint pupils, and loss of consciousness ranging from stupor to coma. Acetaminophen toxicity may initially present with non-specific symptoms such as nausea, vomiting, and abdominal pain. A critical risk is dose-dependent, potentially fatal hepatic necrosis (liver damage), the evidence of which may be delayed for up to 48 to 72 hours post-ingestion.

Official Emergency Requirements

Regulatory documents emphasize that any suspected overdose requires that medical help be sought immediately. Contact with a Poison Control Center is also documented as a required step. Hospital monitoring is necessary, as the severity of internal organ damage may not be reflected by initial symptoms. Accidental ingestion of even one dose by children is cited in labeling as a risk for fatal overdose.

Antidote and Treatment

For the codeine component, an opioid antagonist (such as naloxone) is documented for treating clinically significant respiratory or circulatory depression. For acetaminophen toxicity, N-acetylcysteine is documented as the antidote, with optimal efficacy when administered promptly in a supportive care setting.

Therapeutic Uses of Panacod (Acetaminophen,Codeine)

What Panacod (Acetaminophen,Codeine) Treats: Main Uses and Benefits

The primary role of Panacod is to offer robust, short-term symptomatic relief in situations where standard non-opioid pain management is insufficient. This combination is commonly used to relieve pain, while the acetaminophen component inherently plays a role in managing elevated body temperature.

The product is considered relevant in situations where patients experience pain intensities classified as moderate to severe. It is generally applied in scenarios where additional management of discomfort is required, such as following minor surgical procedures, during acute extremity pain, or for severe dental pain and certain musculoskeletal flares. It helps ease the overall symptom burden when symptoms interfere with daily functioning.

This dual-action approach is helpful in situations where multiple symptoms occur together, including pain and fever. It contributes to easing the overall symptom load and may help patients cope more steadily with symptom fluctuations.


Quick Fact: Relief for Moderate to Severe Pain The product is applied in scenarios where short-term symptomatic assistance is needed, in situations involving certain distressing symptoms when supportive symptom management is appropriate.


Regulatory References

  1. NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

The eligibility for Panacod (Acetaminophen, Codeine) is strictly defined by regulatory authorities based on population safety criteria. Use of this medicine is contraindicated for children younger than 12 years of age. Use is also strictly prohibited in adolescents under 18 years following tonsillectomy or adenoidectomy, regardless of their age within that range.

Absolute contraindications apply to specific populations and conditions, including breastfeeding women and individuals known to be CYP2D6 ultra-rapid metabolizers. Patients with significant respiratory depression, severe bronchial asthma, or known mechanical gastrointestinal obstruction must also not use this medicine.

For other groups, use is restricted or conditional. Caution is mandated for patients with severe hepatic (liver) impairment or severe renal (kidney) impairment. Chronic use is officially not recommended during pregnancy due to the risk of Neonatal Opioid Withdrawal Syndrome. Older adults (geriatric patients) must be managed cautiously, typically starting with a low dose. Adolescents aged 12 to 18 with additional respiratory risk factors should avoid use.

What should I know about interactions with other medicines?

The combination of acetaminophen and codeine carries significant interaction risks primarily due to the codeine component, a prodrug metabolized by Cytochrome P450 (CYP) enzymes. These interactions can alter the levels of the active metabolite, morphine, leading to reduced efficacy or increased risk of serious adverse effects.

Documented Pharmacokinetic Interactions

Interacting Product Category Potential Effect Severity Classification
CNS Depressants (e.g., Alcohol, Benzodiazepines, other Opioids) Increased central nervous system depression, leading to profound sedation, respiratory depression, coma, and death. Contraindicated/Serious Risk
CYP2D6 Inhibitors Reduce conversion of codeine to active morphine, potentially resulting in decreased pain relief. Clinically Significant
CYP3A4 Inhibitors Increase codeine plasma concentration, potentially leading to increased morphine formation and greater risk of opioid toxicity, including respiratory depression. Serious Risk
CYP3A4 Inducers Decrease codeine plasma concentration, potentially resulting in decreased efficacy or withdrawal symptoms. Clinically Significant
Oral Anticoagulants (e.g., Warfarin) Prolonged chronic use of acetaminophen may potentiate the anticoagulant effect. Clinically Significant

Restrictions and Population-Specific Notes

Contraindications include use with Monoamine Oxidase Inhibitors (MAOIs), or within 14 days of MAOI cessation. The product is also contraindicated in patients known to be CYP2D6 ultra-rapid metabolizers and in pediatric patients under 12 years of age. Concomitant use with any other acetaminophen-containing product is strongly restricted to avoid exceeding the maximum daily dose and risking severe liver injury. When combined with other CNS depressants, therapy must be limited to the minimum dosage and duration required.

Mechanism of Action

Central Opioid Receptor Engagement

This domain involves codeine, a prodrug that is primarily metabolized into morphine in the liver. Morphine acts as an agonist, binding to mu-opioid receptors ( MOR) located in the central nervous system (CNS), particularly in the brain and spinal cord. Engaging these receptors initiates inhibitory signaling sequences that modify the brain's processing of nociceptive input, resulting in modulation of pain-signaling activity within the CNS.


Modulation of Prostaglandin Synthesis

This domain is mediated by acetaminophen, which primarily acts centrally. It exerts its effect by selectively inhibiting cyclooxygenase ( COX) enzyme activity within the CNS, which is crucial in the synthesis of prostaglandins. The mechanism modifies early molecular steps that lead to the production of these mediators, thereby contributing to attenuation of central prostaglandin-mediated activity. Acetaminophen's metabolite, AM404, also engages the TRPV1 and cannabinoid CB1 receptors, further influencing the availability and action of relevant signaling mediators within afferent pathways.

Dosage and Administration Information

How to Use Panacod (Acetaminophen,Codeine): Official Administration Guidelines

The usage of this combination analgesic is strictly governed by the instructions detailed in regulatory labeling, establishing defined limits on the dose, frequency, and duration of administration. This fixed-dose product is exclusively approved for the oral route as tablets, capsules, or liquid formulations, with dosing patterns designed for intermittent, short-term use.

Dosing Schedule and Restrictions

Official prescribing information outlines that the standard adult dose is typically 1 to 2 tablets taken every 4 to 6 hours as necessary. A critical constraint is the mandated daily maximum intake: the total dose of the Acetaminophen component from all sources must not exceed 4000 mg in 24 hours. The Codeine component is also limited, with a maximum daily intake of 240 mg defined in international regulatory documents.

Administration Rules for Specific Populations

Usage of this combination product is contraindicated (prohibited) in children younger than 12 years of age. Furthermore, the product should not be administered to adolescents (under 18) following surgery for the removal of tonsils or adenoids. Patients with significant hepatic or renal impairment may require an official dose reduction or an extension of the interval between doses.

Contextual Use and Duration

Administration should be limited to the shortest possible duration. This is formalized in many regulatory documents by restricting continuous treatment to a maximum of 3 consecutive days. For the oral tablet, administration is typically with a glass of water, and it may be taken with or without food. If a liquid form is administered, it must be accurately measured using a designated dosing device.

Recent Clinical Evidence

Research Evidence / Overview of Studies

What Was Evaluated in Research

Studies evaluated this regimen across several different parameters. Research examined the combination's effect on pain management outcomes, with some research observing a change in pain scores early in the treatment period. Further studies have evaluated whether the combination affects pain intensity in comparison to standard monotherapy alone. Overall findings suggest that studies have evaluated the regimen over an extended duration.


Research on Long-Term Pain Score Outcomes

Several randomized controlled trials (RCTs) reported findings that patients on the studied regimen reported a difference in Visual Analog Scale (VAS) scores over periods such as 6 months, compared to placebo.

Research also included an evaluation of sleep quality in specific populations, such as in the early post-operative period. These trials sometimes examined patients who had previously failed standard treatments, suggesting a focus on refractory pain populations.


Research Evaluating Potential Side Effects

Studies observed common side effects including mild nausea and fatigue. Research evaluated whether co-administration with food affected common gastrointestinal reports.

Research indicates that individuals with pre-existing liver conditions were often excluded from trials or monitored closely due to potential risks associated with one component. The reported incidence of severe adverse events (SAEs) across all trials was monitored closely. Safety profiles must be interpreted within the context of the trial populations and specific drug formulations studied.

Key Studies & References

  1. Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects
  2. Codeine for Pain Related to Osteoarthritis of the Knee and Hip: A Review of Clinical Effectiveness
  3. Investigating the efficacy and safety of over-the-counter codeine containing combination analgesics for pain and codeine based antitussives (Systematic Review)
  4. Acetaminophen and Codeine Phosphate Tablets - FDA Label and Warnings (DailyMed)
  5. Acetaminophen and Codeine: MedlinePlus Drug Information (for safety/side effect context)

Frequently Asked Questions (FAQ)

Common questions about Panacod (Acetaminophen,Codeine) (FAQ)

Q: How quickly can a person typically expect to feel the effects of Panacod?

A: According to official product information, the analgesic effect from the codeine component typically begins within 15 to 30 minutes following oral administration. This onset time indicates when the medicine is described as beginning to modify pain signaling.


Q: How long does the effect of Panacod usually last?

A: The duration of the pain-relieving effect is generally described in regulatory documents as lasting for approximately four to six hours. This duration is consistent with the general time interval for subsequent administration.


Q: Why do official sources mention codeine metabolism in relation to Panacod?

A: Official documents mention codeine metabolism because it is a prodrug that must be converted into active morphine in the liver to provide pain relief. Because this conversion process is highly variable, official warnings exist regarding unpredictable effects like lack of pain relief or potential adverse effects.


Q: How is the use of Panacod described for patients with kidney issues?

A: Regulatory documents advise caution when Panacod is used by patients with kidney issues or renal impairment. Due to a potentially slower rate of medicine removal from the body, the effects of the drug may be increased, sometimes necessitating a change in administration frequency.


Q: Why is Panacod often subject to stricter regulatory controls than over-the-counter pain relievers?

A: The combination product is typically subject to stricter controls because the codeine component is classified as an opioid. Official warnings confirm that opioids carry documented risks of addiction, abuse, misuse, and life-threatening respiratory depression, necessitating tighter regulatory oversight.


Q: What is the main difference between Panacod and regular pain relievers?

A: The primary difference is the presence of the opioid codeine alongside acetaminophen. Regulatory documents state this combination is for the management of pain that may be inadequately addressed by non-opioid pain relievers alone.


Q: Are there common signs of an allergic reaction to Panacod?

A: Official adverse reaction profiles list signs of a severe allergic reaction, which can include a rash, hives, itching, or swelling of the face, tongue, or throat. They also warn of difficulty breathing or swallowing.


Q: Is there a known risk of dependence associated with the codeine component in Panacod?

A: Yes, official warnings exist because the codeine component is an opioid. Regulatory documents state that psychic dependence, physical dependence, and tolerance may develop upon repeated administration of this drug.


Q: Are there different strengths of Panacod available?

A: Yes, this combination medicine is available in various strengths. These strengths contain different amounts of acetaminophen and codeine phosphate to meet regulatory specifications for acute moderate pain relief.


Q: Is it normal for some people to experience nausea after taking Panacod?

A: Yes, regulatory adverse reaction profiles frequently list nausea and vomiting as commonly observed effects. These effects are commonly observed and are listed in regulatory adverse reaction profiles.


Q: What is the official guidance on Panacod use and driving or operating machinery?

A: Official labeling warns that the codeine component may impair the mental and physical abilities needed to perform hazardous tasks. Patients are warned of the potential effects before driving a car or operating machinery.


Q: What is the official position on using Panacod during pregnancy?

A: The safety of this medicine during pregnancy is described in official documents as not having been established. If prolonged opioid use is required during pregnancy, the patient should be advised of the risk of Neonatal Opioid Withdrawal Syndrome (NOWS) in the newborn.


Q: Are there any specific concerns about Panacod use in children?

A: Yes, regulatory documents specify serious concerns. The medicine is contraindicated (prohibited) in children under 12 years of age and in adolescents under 18 following surgery for the removal of tonsils or adenoids.


Q: Is Panacod often used for muscle pain or tension?

A: The medicine is indicated for the management of acute moderate pain. This indication, according to regulatory documents, encompasses conditions often involving muscle pain, such as backache, strains, and sprains.


Q: Are there any diet or food restrictions mentioned for people taking Panacod?

A: While there are no general food restrictions, regulatory documents warn against the simultaneous use of the medicine with alcohol. This is because combining them increases the risk of profound sedation and respiratory depression.


Q: Can taking Panacod lead to constipation?

A: Yes, constipation is listed in official documents as a common adverse reaction. This effect is associated with the use of the codeine component, which can slow down movement in the digestive system.


Q: What is the described risk of developing tolerance to Panacod?

A: Official warnings state that tolerance may develop upon repeated administration. Tolerance is a state where a person may experience a lessened effect over time.


Q: Does Panacod have a different effect on elderly patients?

A: Regulatory information indicates that dosage may need to be reduced in elderly patients. This is because they may be more sensitive to the medicine's effects, and their bodies may clear the medicine more slowly.


Q: Can Panacod cause dizziness?

A: Yes, dizziness and lightheadedness are listed in official adverse reaction profiles as frequently observed effects. These are common central nervous system effects associated with opioid-containing medicines.


Q: What does official research indicate about Panacod's effectiveness for headaches?

A: In regulatory indications, this medicine is recommended for the relief of acute moderate pain, which specifically includes headache and migraine pain.


Q: What kinds of pain is Panacod typically used to manage?

A: The combination is officially indicated for the treatment of acute moderate pain when single non-opioid analgesics are deemed insufficient.


Q: Are there any genetic factors mentioned in official sources that influence how Panacod works?

A: Yes, regulatory documents note that genetic variations related to the CYP2D6 enzyme influence the conversion of codeine to its active form. Being an ultra-rapid metabolizer of this enzyme is listed as a contraindication.


Q: Is Panacod described as being a prescription-only medicine in most regions?

A: Due to the codeine component, this combination is classified as a controlled substance in many regions. As such, it is typically regulated and dispensed as a prescription-only medicine internationally.


Q: What does 'opioid analgesic' mean in the context of Panacod?

A: An opioid analgesic refers to the codeine component, which is a narcotic. Its mechanism of action involves modifying how the body senses and responds to pain signals.


Q: What research evidence exists for Panacod in managing post-operative pain?

A: Regulatory documents contain strong warnings based on research into post-operative use. They specifically contraindicate its use in children and adolescents following tonsillectomy or adenoidectomy due to the risk of serious adverse effects.


Q: Are there any official warnings about combining Panacod with herbal supplements?

A: Yes, official documents warn that certain nonprescription products, such as St. John's wort and tryptophan, may interact with the medicine. Patients should discuss all supplements being taken with a healthcare provider.


Q: What are the signs of withdrawal if Panacod is stopped suddenly?

A: If the medicine is stopped suddenly after prolonged use, a patient may experience withdrawal symptoms. These symptoms can include restlessness, anxiety, increased heart and breathing rates, sweating, and difficulty sleeping.


Q: Is Panacod associated with any changes in mood or behavior?

A: Yes, official adverse reaction profiles mention potential changes in mood or feelings. These can include states such as euphoria (feeling high) and dysphoria.


Q: What happens if someone takes Panacod too close to the time of another dose?

A: The drug is not intended to be taken more frequently than the specified interval (typically every four to six hours). Regulatory guidance emphasizes this to prevent exceeding the maximum daily dose, which increases the risk of serious adverse effects, including liver injury.


Q: Is Panacod used for long-term chronic pain management?

A: Regulatory guidance limits continuous treatment to the shortest possible duration, generally not more than three consecutive days for acute pain. Long-term use is strongly advised against due to documented risks like dependence and tolerance.


Q: Why do some people say Panacod did not work for their pain?

A: Official documents note that certain factors can reduce the medicine's effectiveness. This includes genetic variations in the metabolism of codeine, or the use of specific concomitant drugs, which can prevent the conversion of codeine to its active form.


Q: Is the risk of side effects higher with higher doses of Panacod?

A: Yes, the risk of adverse effects is noted to increase with higher doses and with longer duration of use. The risk of life-threatening respiratory depression is highlighted especially following a dose increase.


Q: What does 'hepatic impairment' mean in relation to Panacod use?

A: Hepatic impairment refers to decreased liver function. Regulatory documents advise caution in patients with this condition because their bodies may clear the acetaminophen component more slowly, potentially increasing the effects of the drug.


Q: Are there known interactions between Panacod and common cold or flu medications?

A: Yes, a key official warning is against combining the medicine with any other products that contain acetaminophen. Since many common cold and flu preparations contain acetaminophen, this combination must be strictly avoided to prevent liver injury.


Q: What are the official warnings about potential accidental overdose of Panacod?

A: Official warnings state that accidental ingestion, especially by children, can result in a fatal overdose. This is characterized by respiratory depression from the codeine and potential acute hepatic toxicity (liver damage) from the acetaminophen component.


Q: How is the use of Panacod for dental pain described in research?

A: The medicine is recommended in some regulatory documents for the treatment of acute moderate pain. This indication specifically includes common pain conditions such as dental pain.


Q: What is the purpose of adding codeine to acetaminophen in this combination drug?

A: The combination is described as being intended to produce an analgesic effect greater than that of either component used alone. This is because the acetaminophen component is described as increasing the overall pain-relieving effects of the codeine.

How should Panacod (Acetaminophen,Codeine) be stored and disposed of?

How to Store and Dispose of Acetaminophen and Codeine Tablets

This medication must be stored according to regulatory requirements to ensure its stability and to comply with controlled substance security mandates.

Storage and Security

Acetaminophen and Codeine tablets require secure storage due to the opioid component. The product must be stored out of the sight and reach of children and in a location inaccessible to others.

Store the medication at Controlled Room Temperature, typically between 20 C and 25 C (68 F and 77 F), and keep the container tightly closed. It must be protected from excessive moisture, heat, and freezing.

Official Disposal

The preferred method for disposing of unused or expired tablets is through an approved drug take-back program or DEA-authorized collector. If these options are unavailable, the tablets should be mixed (not crushed) with an unpalatable material, sealed in a bag, and then discarded in the household trash. This product is not recommended for disposal by flushing.

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

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