If you are comparing Co-Codamol vs Co-Dydramol, the main difference is the opioid ingredient.
Co-Codamol combines codeine with paracetamol, while Co-Dydramol combines dihydrocodeine with paracetamol. Both are used for pain relief, but they are not interchangeable names for the same medicine.
That sounds simple, but the strength numbers on the packs can make the comparison confusing. Two products can both end in /500 and still contain different opioid medicines. Understanding what those numbers mean is more useful than judging either medicine by its name alone.
Co-Codamol = codeine + paracetamol.
Co-Dydramol = dihydrocodeine + paracetamol.
That single ingredient difference is the key to understanding the rest of the comparison.
| Feature | Co-Codamol | Co-Dydramol |
|---|---|---|
| Opioid ingredient | Codeine | Dihydrocodeine |
| Other active ingredient | Paracetamol | Paracetamol |
| Common UK strengths | 8/500, 15/500, 30/500 | 7.46/500, 10/500, 20/500, 30/500 |
| Lowest pharmacy strength | 8/500 | 7.46/500 |
| Higher strengths | Prescription only | Prescription only |
| Main practical difference | Contains codeine | Contains dihydrocodeine |
NHS guidance confirms that all common Co-Codamol strengths contain 500mg paracetamol, while the codeine amount changes. Co-Dydramol also contains 500mg paracetamol per tablet, with varying amounts of dihydrocodeine.
Both medicines contain paracetamol, so the important difference is the opioid component.
With Co-Codamol, the opioid is codeine.
With Co-Dydramol, the opioid is dihydrocodeine.
That means the first number on each pack does not describe the same active ingredient.
For example:
So matching strength numbers do not mean the products are equivalent.
If you want to compare Co-Codamol with standalone Dihydrocodeine rather than Co-Dydramol, see our Co-Codamol vs Dihydrocodeine guide.
The two-number format shows the amount of each active ingredient in one tablet.
With Co-Codamol:
With Co-Dydramol:
The MHRA specifically advises that Co-Dydramol should be prescribed and dispensed by strength, because higher-strength versions contain more dihydrocodeine and confusion between strengths can increase the risk of medication errors and accidental opioid overdose.
The /500 part means the same thing in both products: 500mg of paracetamol.
The first number does not.
This is the detail most likely to cause confusion when someone compares Co-Dydramol vs Co-Codamol by looking at the pack alone. A 30/500 Co-Codamol tablet contains codeine; a 30/500 Co-Dydramol tablet contains dihydrocodeine.
So the useful question is not simply “Are they both 30/500?” It is:
30mg of which opioid?
That distinction is one of the main reasons the full medicine name should always be checked alongside the strength.
There is no useful universal answer without knowing the exact strengths being compared.
Both medicines come in different strengths, and the opioid ingredient is different. Comparing 8/500 Co-Codamol with 30/500 Co-Dydramol is not the same question as comparing two products both labelled 30/500.
The more useful comparison is:
This article should therefore not declare one medicine the overall “winner”.
Do not combine them unless an appropriate healthcare professional has specifically told you to.
Both products contain paracetamol, so taking them together can duplicate paracetamol. Each also contains an opioid, meaning you could also be combining codeine and dihydrocodeine.
NHS guidance for Co-Codamol warns against taking it with other medicines containing paracetamol, and specifically lists Co-Dydramol as another paracetamol-containing medicine. NHS Dihydrocodeine guidance also advises against combining Dihydrocodeine with painkillers containing Codeine because this increases the risk of side effects.
If treatment is being changed from one medicine to another, follow the instructions provided rather than trying to calculate an equivalent dose yourself.
Before taking either medicine, check:
/500 paracetamol amount;For broader pain-relief information and relevant treatment categories, visit our Pain Relief hub.
Because both medicines contain paracetamol and an opioid, some effects overlap. NHS lists constipation, nausea and sleepiness among the common side effects of both Co-Codamol and Co-Dydramol.
Both Codeine and Dihydrocodeine can also cause dependence with continued use. This does not mean their effects are identical for every person. The strength, other medicines, individual response and treatment duration all matter.
This article therefore does not treat the two products as interchangeable simply because they are both combination painkillers.
The correct medicine depends on the exact product and strength that has been recommended for your situation.
Do not switch from one to the other simply because one sounds stronger, has a higher-looking number, or shares the same /500 notation. Moreover, if pain is not adequately controlled or side effects are difficult to manage, speak to a pharmacist, prescriber or other appropriate healthcare professional.
NHS – Co-Codamol for adults
NHS – Co-Codamol strengths and how to take it
NHS – Co-Dydramol
NHS – Co-Dydramol strengths and dosing
MHRA – Co-Dydramol strength safety guidance
