Ibuprofen and Codeine

What are ibuprofen and codeine?

They are a combination painkiller that contains two active ingredients[1]: 

• Ibuprofen (usually 200mg) – a non-steroidal anti-inflammatory drug (NSAID) 

• Codeine phosphate (usually 12.8mg) – an opioid analgesic 

It is used for short-term relief of acute, moderate pain that is not relieved by other painkillers such as paracetamol, ibuprofen, or aspirin alone. Nurofen Plus is a brand name of combined ibuprofen and codeine. Ibuprofen with codeine is a pharmacy medicine, so you can buy it from a pharmacy without a doctor’s prescription[1].  

What are ibuprofen and codeine used for?

They are commonly used to relieve several types of pain, including[1]: 

• Migraines and headaches 

• Dental pain 

• Period pain 

• Back pain 

• Rheumatic and muscular pain 

• Neuralgia (nerve pain) 

How do ibuprofen and codeine work?

The two ingredients work in different but complementary ways. Ibuprofen reduces inflammation, pain, and fever by blocking prostaglandin production – chemicals in the body that cause inflammation. Codeine works on opioid receptors to reduce pain transmission. Together, they provide stronger pain relief than either medicine alone[1]. 

Who can take ibuprofen and codeine?

You can take ibuprofen and codeine as a single medicine if you[1]: 

• Are aged 12 years or older 

• Have moderate pain that hasn’t been relieved by other painkillers 

You should speak to a doctor first if you[1]: 

• Are under 12 years old 

• Are breastfeeding 

• Have had stomach ulcers or gastrointestinal bleeding 

• If you have worsening asthma, or allergic reactions to NSAIDs, codeine or any other ingredient listed in the medicine 

• Have severe liver, kidney, or heart problems 

• Have chronic constipation 

• Are taking other NSAIDs, aspirin above 75mg/day, or monoamine oxidase inhibitors (MAOIs) in the last 14 days 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2]. 

What are the typical doses of ibuprofen and codeine?

The recommended dosage for adults and children over 12 is[1]: 

• 1-2 tablets every 4 to 6 hours as needed up to three times a day 

• Do not take more than 6 tablets in 24 hours 

• Do not use for more than 3 consecutive days without medical advice due to the risk of addiction and withdrawal from codeine 

How do you take ibuprofen and codeine?

It should be taken by mouth[1]: 

• Swallow tablets whole with water 

• Take with or after food to reduce the risk of stomach irritation 

• Do not crush or chew the tablets 

Can you stop taking ibuprofen and codeine?

Yes, you should stop taking it as soon as your pain improves. Do not continue for more than 3 consecutive days unless advised by a doctor or pharmacist. Long-term use can lead to dependence and withdrawal symptoms[1]. 

What do you do if you take too ibuprofen or codeine?

Taking too much can be dangerous. Symptoms may include[1]: 

• Nausea or vomiting 

• Drowsiness 

• Stomach pain 

• Breathing problems 

• Liver or kidney damage 

Seek immediate medical help or call NHS 111 if you suspect an overdose. 

What do you do if you forget to take ibuprofen or codeine?

If you forget a dose[1]: 

• Take it as soon as you remember, if still needed 

• If it’s nearly time for your next dose, skip the missed one 

• Do not double the dose  

How do you store ibuprofen and codeine?

Store in the original packaging and out of the reach of children. Do not use after the expiry date displayed on the packaging[1].  

What medicines can’t you take with ibuprofen and codeine?

Certain medicines can interact with this combination, so caution is needed. Avoid using it with[1]: 

• Other NSAIDs (e.g. naproxen, diclofenac) 

• Aspirin (if over 75mg daily) 

• Some anticoagulants (e.g. warfarin) 

• MAOIs (e.g. phenelzine) 

• Other opioids or sedatives 

• Antidepressants (SSRIs, tricyclics) 

• Diuretics, ACE inhibitors, or beta-blockers (these may increase the risk of kidney issues) 

Please note this is not a complete list, always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of ibuprofen and codeine?

Common side effects may include[1]: 

• Nausea or vomiting 

• Constipation 

• Drowsiness or dizziness 

• Indigestion or stomach pain 

Serious side effects  include[1]: 

• Breathing difficulties 

• Black or bloody stools 

• Signs of addiction (craving, irritability, withdrawal symptoms) 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2].  

Frequently asked questions about ibuprofen and codeine

Can I take them with paracetamol? 
Yes but avoid taking it with other NSAIDs or opioid painkillers[1]. 

Is it addictive? 
Yes. Codeine can cause dependence if taken for more than three days[1]. 

Can I drive after taking it? 
Avoid driving if you feel sleepy or light-headed[1]. 

Can I drink alcohol with it? 
No. Alcohol can increase the risk of drowsiness, stomach bleeding, and other side effects[1]. 

Can I take it while pregnant? 
No. It is not recommended, especially in the third trimester. Speak to your doctor or pharmacist[1]. 

Can I take it while breastfeeding? 
No. Codeine passes into breast milk and can harm your baby[1]. 

How quickly does it work? 
Pain relief usually begins within 30 to 60 minutes[1]. 

Can I take it on an empty stomach? 
It’s better to take it with food to protect the stomach and reduce the chance of stomach upset[1]. 

What happens if I take it for too long? 
You may develop tolerance, addiction, or serious side effects such as ulcers or liver/kidney damage[1]. 

Is it available over the counter? 
Yes, commonly as Nurofen Plus, but only in limited pack sizes and under the supervision of a pharmacist[1]. 

For the official NHS guide for ibuprofen and codeine, visit their website.