Can I take co-dydramol while pregnant or breastfeeding?

A plain-words look at what the NHS, the US drug label and LactMed say about co-dydramol.

In short

Pregnancy: If you need to, you can take co-dydramol in pregnancy.

Breastfeeding: If your doctor or midwife tells you your baby is healthy, you can usually take co-dydramol while breastfeeding.

Your doctor, midwife or pharmacist can help you decide.

What this means for you

Pregnancy

Breastfeeding

When to get help

Talk to your doctor or pharmacist

This page is educational, not advice for your own situation. Talk to your doctor, midwife or pharmacist before you start, stop or change any medicine in pregnancy or while breastfeeding.

The details: what each source says

Co-dydramol in pregnancy

The NHS says

If you need to, you can take co-dydramol in pregnancy.

Co-dydramol is made up of paracetamol and dihydrocodeine. Paracetamol is safe to take at any stage of pregnancy, but dihydrocodeine taken near the end of pregnancy may lead to withdrawal symptoms in your baby after birth, such as drowsiness. Your baby may need to stay in hospital longer to be observed.

Treating pain in pregnancy is important. Co-dydramol might sometimes be the best choice for pain while you're pregnant, but talk to your doctor, who can help you work out what is right for you and your baby.

In our words, from the NHS page Co-dydramol (nhs.uk). Contains public sector information licensed under the Open Government Licence v3.0 (OGL v3.0). The NHS does not endorse this site.

Co-dydramol while breastfeeding

The NHS says

If your doctor or midwife tells you your baby is healthy, you can usually take co-dydramol while breastfeeding. But only take it if your doctor advises it, and try to keep to low doses for a short time only.

While breastfeeding, taking paracetamol by itself is usually a better choice.

Co-dydramol is made up of paracetamol and dihydrocodeine. Small amounts of paracetamol reach breast milk. How much dihydrocodeine reaches breast milk is not known, but it's also thought to be small. Co-dydramol is unlikely to give your baby side effects.

If anything about your baby worries you while you're breastfeeding, speak to your doctor, pharmacist, midwife or health visitor. This includes if your baby is feeding less well than normal or is constipated.

Call 111 (NHS 111 in the UK) for advice, or go to A&E straight away, if your baby is unusually sleepy or has problems with breathing.

These effects are very rare, though, and unlikely to happen, particularly if you take low-strength co-dydramol for only a short time.

In our words, from the NHS page Co-dydramol (nhs.uk). Contains public sector information licensed under the Open Government Licence v3.0 (OGL v3.0). The NHS does not endorse this site.

LactMed says

Acetaminophen is a good choice for analgesia, and fever reduction in nursing mothers. Giving acetaminophen and ibuprofen on a fixed schedule for 24 hours after vaginal delivery appears to increase the breastfeeding rate. There is no difference in breastfeeding initiation rate between ibuprofen or acetaminophen alone after vaginal delivery. Amounts in milk are much less than doses usually given to infants. Adverse effects in breastfed infants appear to be rare.

“Summary of Use during Lactation”, LactMed record “Acetaminophen” (LM330), quoted verbatim. Everything LactMed reports about Acetaminophen while breastfeeding.

Dihydrocodeine products are no longer marketed in the United States. Maternal use of oral opioids during breastfeeding can cause infant drowsiness, which may progress to rare but severe central nervous system depression. Like codeine, pharmacogenetics probably plays a role in the extent of central nervous system depression with dihydrocodeine. Newborn infants seem to be particularly sensitive to the effects of even small dosages of narcotic analgesics. Dihydrocodeine possibly caused severe respiratory depression in one newborn infant whose mother was taking the drug for cough. If dihydrocodeine is required by the mother of a newborn, it is not a reason to discontinue breastfeeding; however, once the mother's milk comes in, it is best to provide pain control with a nonnarcotic analgesic and limit maternal intake of dihydrocodeine to 2 to 3 days at a low dosage with close infant monitoring. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately. Withdrawal symptoms can occur in breastfed infants when maternal administration of an opioid analgesic is stopped, or when breastfeeding is stopped. Because there is little published experience with dihydrocodeine during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.

“Summary of Use during Lactation”, LactMed record “Dihydrocodeine” (LM1123), quoted verbatim. Everything LactMed reports about Dihydrocodeine while breastfeeding.

Other names

UK brand names (per the NHS): Paramol, Remedeine, Remedeine Forte.

Sources

  1. NHS, Co-dydramol (nhs.uk), page last reviewed 9 August 2023. Paraphrased. Contains public sector information licensed under the Open Government Licence v3.0.
  2. Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Acetaminophen” (LM330), bulk release of 22 September 2026. LactMed on NCBI Bookshelf. Public domain; quoted verbatim. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
  3. Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Dihydrocodeine” (LM1123), bulk release of 22 September 2026. LactMed on NCBI Bookshelf. Public domain; quoted verbatim. LactMed is a registered trademark of the U.S. Department of Health and Human Services.

Sources checked 26 September 2026. How we source and check every page.

Educational summary of named sources, not medical advice.