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 or pharmacist.
Important Safety Information
This service operates under German pharmaceutical law (HWG). For risks and side effects, read the package leaflet and consult your doctor or pharmacist. All medications are dispensed from a licensed pharmacy in Germany.