Co-proxamol is a medicine belonging to the class of analgesics, used to relieve pain and inflammation. This drug is a combination of two pain-killing agents and is generally used in the following conditions:

  • Rheumatic and muscular pain
  • Sprains and strains
  • Backache
  • Headache
  • Sore throat
  • Toothache
  • Period pain

The Working Principle

Co-proxamol contains two active ingredients, namely dextropropoxyphene hydrochloride (32.5 mg) and paracetamol (325 mg). Here we briefly describe how each of the ingredients works to produce the desired effect as a part of the co-proxamol drug.

Dextropropoxyphene hydrochloride

Dextropropoxyphene hydrochloride belongs to a class of medicines called opioids. Opioid painkillers work by mimicking the action of naturally occurring pain-reducing chemicals called endorphins. Endorphins are found in the brain and spinal cord and reduce pain by combining with opioid receptors. This ingredient mimics the effect of natural endorphins by combining with opioid receptors in the brain and spinal cord, blocking the transmission of pain signals sent by the nerves to the brain.


Though experts differ on how paracetamol actually works, yet the modern theory states that it works by reducing the production of prostaglandins in the brain and spinal cord. Prostaglandins are produced by the body in response to injury and some diseases. One of their main actions is to sensitise nerve endings, causing pain when the injury is stimulated. Paracetamol is believed to reduce the production of these nerve sensitising prostaglandins, thus increasing our pain threshold. Hence, though the injury will still exist, it will be felt less.

Dosage and Administration

Co-proxamol should be consumed as per the exact prescription of the doctor. Under no circumstances, should an individual consume more than 8 tablets within a twenty-four hour period. In addition, experts strongly advise that you should never pass on co-proxamol to any one else, even if the symptoms of the other person are similar.


Certain precautions need to be observed before you start on a prescription of the co-proxamol drug. The most important amongst these are:

  • Co-proxamol is known to cause drowsiness. You are advised not to drive, operate machinery or take alcohol when taking this medicine.
  • Never exceed the recommended dosage, which is stated on the product packaging or the information leaflet.
  • Seek immediate medical attention if you take an overdose, even if you feel fine.
  • Do not take co-proxamol with other medicines that contain paracetamol.
  • Children and adolescents below 18 years of age should not take co-proxamol.
  • People who have suicidal tendencies, are prone to addiction or are dependent on alcohol are strongly advised against taking co-proxamol.

In addition, this medicine should be prescribed with caution in the following cases:

  • Decreased kidney function
  • Decreased liver function
  • Elderly people
  • Pregnant women
  • Lactating mothers

Side Effects

Co-proxamol can have varying side effects on different people. Here we list some of the most common side effects associated with this medicine.

  • Dizziness
  • Drowsiness and sedation
  • Nausea
  • Constipation
  • Skin rashes
  • Abdominal pain
  • Headache
  • Visual disturbances
  • Weakness
  • Jaundice
  • Hallucinations
  • Alteration in results of liver function tests

It is important that you consult your doctor immediately if any of the above side-effects aggravate or persist beyond a few days.

Other Medication

Experts strongly advise against taking co-proxamol in combination with any of the below:

  • Antipsychotics
  • Antidepressants
  • Opioid painkillers
  • Muscle relaxants
  • Sedating antihistamines
  • Sedatives
  • Alcohol
  • Tranquilisers
  • Sleeping tablets

Moreover, it is also important to check with your pharmacist before you taken any over-the-counter medications, while you are on a prescription of co-proxamol.

Important Information

Reports state that the Medicines and Healthcare products Regulation Agency (MHRA) took a decision in January 2005 to withdraw co-proxamol from the market. This development presumably came following the advice from the Committee on Safety Medicines (CSM), an independent expert body advising the government on medicines. According to CSM, co-proxamol has barely been found to be more effective in providing pain relief than paracetamol alone. Moreover, around 300-400 self-poisoning deaths are reported each year in England and Wales, involving co-proxamol, though around a fifth of these are said to be accidental. However, experts suggest that those who are already on the prescription need not panic. Nevertheless, it is advisable for them to consult their doctor for an alternative painkiller.