What is Talvosilen forte®?
Talvosilen forte® is a prescription combination preparation of paracetamol and codein. The combination of two active compounds with different points of attack allows greater pain relief than the individual substances alone.
Paracetamol has a pain-relieving and fever-reducing effect on central mechanisms. Codein is a weak opioid that is partly converted into morphine in the body and dampens pain perception in the brain.
Talvosilen forte® is available as capsules and suppositories (pots) and is used with moderately strong to severe pain if simple analgesics are not sufficient.
Active Ingredients & Mechanism of Action
Active ingredient: Paracetamol 500 mg + Codeinphosphat 30 mg
The combination uses two different mechanisms of action:
Paracetamol (500 mg):
- inhibits prostaglandin synthesis in CNS
- Works pain-relieving and fever-reducing
- No inflammatory effect
Codein (30 mg):
- weak opioid agonist (μ-receptor)
- Partly converted to morphine in the body by CYP2D6
- Steams the pain redirection in the CNS
- Has an additional cough-stilling effect
Synergistic effect: The combination of both active ingredients is stronger than the sum of the individual effects. The overadditive effects allow better pain control at lower Opioid dose.
Pharmacokinetics:
- Effect entry: 30–60 minutes
- duration of action: 4–6 hours
Who is it suitable for?
Talvosilen forte® is suitable for:
- Moderately strong to severe pain
- Pain that do not respond to simple analgesics
- Postoperative pain
- tooth pain (after intervention)
- Headache (if individual analgesics fail)
- Short-term treatment of acute pain conditions
**WHO Level 2: * * Talvosilen forte® corresponds to the WHO scale 2 (low Opioid + Non-Opioid).
Not suitable:
- With breathing depression
- In acute asthma attack
- For paralytic ileus
- For children under 12 years
- With known ultra-fast CYP2D6 metabolism
Available Dosages
Capsules:
- Paracetamol 500 mg + codein phosphate 30 mg
Suppositories:
- Paracetamol 500 mg + codein phosphate 30 mg
Dosing (adults):
- 1–2 capsules every 4–6 hours
- Maximum daily dose: 8 capsules (4000 mg paracetamol / 240 mg codein)
Recommendation:
- lowest effective dose
- As short as possible
- Not longer than 3 days without medical consultation
How to Take
Capsules:
- Take water with a glass
- Independent meals
- Minimum distance between single doses: 4–6 hours
Suppositories:
- Introduction of rectal
- Especially suitable for nausea or swallowing
Important notes:
- Do not combine with other Paracetamol-containing medications (overdose!)
- No alcohol (increased sedation and liver damage)
- Restriction of traffic
- Can cause constipation – pay attention to sufficient liquid
- dependency potential for longer intake
Contraindications
**Talvosilen forte® must not be accepted at:* *
- hypersensitivity to the active ingredients
- Breathing
- Acute asthma attack
- Heavy liver failure
- Paralytic Ileus
- Children under 12 years
- Known ultra-fast CYP2D6 metabolism
- Simultaneous intake of MAO inhibitors (or within 14 days)
- Still time
Preview at:
- Older or weakened patients
- Kidney failure
- Hypothyroidism
- Prostate hyperplasia
- Chronic obstructive lung disease (COPD)
- Easy liver failure
Possible Side Effects
Certificate (code-related):
- Blocking
- nausea, vomiting
- fatigue, fatigue
- Squeeze
Occasionally:
- Mouth dryness
- Headaches
- Miosis (enge pupils)
- Harnverhalt
Selten, but seriously:
- Respiratory depression (dose dependent)
- Heavy liver damage (paracetamol in overdose)
- Crampfans
Sustainability: Codein can lead to physical and psychological dependence upon prolonged intake. Even with a short application, withdrawal phenomena can occur.
CYP2D6 ultrafast metabolizer: In these patients, codein is converted too quickly into morphine – increased risk for severe side effects.
Interactions
Contraint with:
- MAO inhibitors (14 days off!)
Intensified CNS damping with:
- Alcohol
- benzodiazepines
- Other opioids
- Antihistamines
- Antidepressants
- Neuroleptics
Paracetamol interactions:
- Warfarin (INR can increase)
- Rifampicin, carbamazepine (increased liver toxicity)
Codein interactions:
- CYP2D6 inhibitors (Paroxetin, Fluoxetin, Chinidine) reduce the effect
- Serotonic drugs (Serotoninsyndrom risk)
Frequently Asked Questions
Similar Medications
Is Talvosilen forte® right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor. Read the package leaflet before use.