Hi,
I'm having good results with 30mg Codeine & 500mg acetaminophen (can only obtain it this way OTC) with 1 dose before bed. How safe is it to continue this regime? Slightly worried about liver (I had HCV but now clear) & dependance.
Thanks in advance. Paul
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If that is all you take you are fine. The maximum acetominophen dose is 3000-4000 mg per day to avoid liver damage. Small doses of daily codeine should not be a big deal, especially since you are using it for the GI effect and not the analgesia. There is no tolerance from long term use for the GI effects.
Jan 
That's a pretty low dose of acetaminophen, so even if there were some residual effect from the HCV you should be fine. I prefer Lomotil to Codeine, since unlike other opioids it has almost exclusively an anti diarrheal (gut slowing) effect, but some people do better with other opioids. They are likely to become harder and harder to obtain for long term use, though.
Many countries outside the US allow codeine with acetominophen or ibuprofen without a prescription.
Jan
Thanks Jan & Scott. I can't get 30mg Codeine OTC & Doc doesn't want to prescribe it, will ask GI in May, but strange how I can get 30/500 OTC. Can't get Lomotil here in Catalunya either.
Paul
The rationale for more loosely offering the combination drugs is that you'll run into major trouble with the other ingredient before overdosing on (or even just taking a high dose of) the opiate. In the case of Lomotil, the atropine becomes very unpleasant if you take much more than a therapeutic dose. In the case of Codeine/acetaminophen it's a bit darker, since the acetaminophen will destroy the liver at high doses, but doesn't feel unpleasant early on. I'm not sure I want to completely contemplate what they were thinking.
I was on 4 endone tablets per day after surgery. After about 6 months, every time I stopped taking I felt nauseous. Realised there was some dependency. Stopped and it took a week before the nausea eventually went.
Recently was on 30mg Codine (with paracetamol) to try and slow the gut (rather than Lomotil). Same thing, after a period of several weeks, stopped the codine because it wasn't doing anything and felt nauseous. Realised that, once again, a dependency had developed. And, yes, even though much lower dose narcotic than Endone, it took about a week after quitting before the nausea eventually went completely, ie. about the same as for the Endone which was surprising.
This was my experience, you may be entirely different, but just exercise caution.
