Co-codamol comes in three strengths, and only the lowest one, 8/500, is available over the counter. The two stronger versions, 15/500 and 30/500, are prescription-only in the UK, and that split exists because higher codeine doses carry a real risk of dependence and misuse.
Every co-codamol strength pairs codeine with the same 500mg of paracetamol per tablet. According to NHS guidance on co-codamol dosing, co-codamol tablets and capsules come in three different strengths, containing 8mg, 15mg or 30mg of codeine.
Only the codeine amount changes between strengths , the paracetamol dose doesn’t move.
The two numbers on a co-codamol pack aren’t random , they’re a direct dosage label. The strength of co-codamol appears as 2 numbers on the packet, so 8/500 means each tablet or capsule contains 8mg of codeine and 500mg of paracetamol.
Reading a pack this way makes it easy to compare strengths at a glance, whether you’re checking your own supply or explaining it to someone else.
Only 8/500 co-codamol is available over the counter, and even then, only from a pharmacy rather than a general shop. You’ll usually need a short conversation with the pharmacist before they hand it over.
8/500 is the only strength you can buy without seeing a doctor first. You can buy the lowest strength of co-codamol (8/500) without a prescription but only from a pharmacy.
It sits behind the counter rather than on an open shelf, so a pharmacist has to hand it to you directly.
Every OTC codeine pack carries a clear warning: don’t use it for more than three days without medical advice. This isn’t just cautious labeling. The MHRA introduced this rule in 2009 after reviewing addiction risks tied to codeine-based painkillers sold without a prescription, and pack labels across brands still carry that same three-day warning today.
OTC codeine products are capped at a specific pack size for a reason , it limits how much you can stockpile in one purchase. Following the MHRA’s 2009 intervention, pack sizes for over-the-counter opioids like co-codamol were limited to 32 pills per pack, with prominent warnings added not to take them for more than three days.
That 32-tablet cap still applies to 8/500 co-codamol sold today.
15/500 and 30/500 co-codamol are classed as prescription-only medicines (POM), meaning a pharmacist can’t sell them to you directly, no matter how you ask. A GP has to assess your pain and write the prescription first.
Both of the stronger co-codamol doses sit above the OTC codeine limit. The higher strengths (15/500 and 30/500) are only available on prescription from a doctor.
There’s no pharmacy workaround for either strength , a prescription is the only legal route.
The line between OTC and prescription-only codeine isn’t arbitrary. Higher codeine content raises the risk of both dependence and accidental overdose, so UK regulators keep it under a doctor’s supervision rather than leaving the dosing decision to the person buying it.
A GP can also check what else you’re taking and rule out interactions the pharmacy counter can’t screen for.
Doctors typically reach for 15/500 or 30/500 when pain hasn’t responded to lower-strength options or to plain paracetamol and ibuprofen. It’s a step up in the pain ladder, not a first-choice painkiller, and GPs usually review how well it’s working before renewing the prescription.
The table below lines up all three strengths so you can see the legal status, typical use, and access route for each one in a single glance.
| Strength | Codeine per Tablet | Legal Status | Where You Get It | Typical Use |
| 8/500 | 8mg | Pharmacy (P) medicine | Behind the counter at a pharmacy | Mild to moderate short-term pain |
| 15/500 | 15mg | Prescription-only (POM) | GP prescription | Moderate pain not helped by lower strengths |
| 30/500 | 30mg | Prescription-only (POM) | GP prescription, following clinical assessment | Moderate to severe pain |
The right strength depends on how severe the pain is and whether lower-strength options have already failed. Mild pain rarely needs anything beyond 8/500, while pain that’s disrupting daily function usually needs a GP’s input rather than a pharmacy purchase.
A pharmacist can advise on 8/500 and flag when it’s not appropriate for you, but they can’t prescribe anything stronger.
A doctor’s assessment is required for 15/500 and 30/500 because it involves reviewing your pain history, current medications, and risk factors before deciding codeine is the right approach at all.
30/500 sits at the top of the codeine range for co-codamol, and it’s not treated like a routine painkiller upgrade. A GP needs to weigh the benefit against real risks before prescribing it.
Codeine dependence can develop even at prescribed doses if it’s taken regularly for too long.
Opioids like codeine should only be taken occasionally rather than every day, because taking them regularly leads to tolerance, meaning you need higher and higher doses over time for the same effect. That’s a core reason GPs review 30/500 prescriptions rather than issuing repeats indefinitely.
Every co-codamol strength carries the same paracetamol overdose risk, since the paracetamol dose doesn’t change with strength. It’s dangerous to take more than 2 co-codamol tablets, or any other paracetamol-containing product, at a time, or more than 8 in 24 hours.
Taking co-codamol alongside separate paracetamol tablets or cold and flu remedies is a common way people accidentally exceed the safe daily limit.
30/500 combines the highest codeine dose available with the same liver-damage risk as every other strength, which is exactly why it stays behind a full clinical assessment rather than a pharmacy conversation.
A doctor reviewing your history can catch risk factors, like existing liver issues or other opioid use, that a quick pharmacy transaction simply isn’t set up to check.
Taking codeine painkillers too often can actually cause more headaches, not fewer , a pattern known as medication-overuse headache.
Sticking to the lowest effective dose, spacing doses properly, and not reaching for co-codamol daily out of habit are the main ways to avoid this cycle.
No. 30/500 is prescription-only regardless of how you ask or explain your pain. A pharmacist has no legal ability to sell it to you without a prescription from a doctor.
That depends on your GP practice. Some issue repeat prescriptions for a set period, while others review codeine-containing prescriptions more frequently because of dependence risk. It’s worth checking your specific practice’s policy rather than assuming automatic repeats.
The tablet limit is the same across all three strengths. Per NHS dosing guidance, adults can take 1 or 2 tablets, of any strength, up to 4 times in 24 hours, with at least a 4 to 6 hour gap between doses. What changes between strengths is the total codeine you’re taking at that dose, not the number of tablets allowed.
