How old are you?
Who is this medicine for?
What is your biological sex?

We ask because it affects some safety checks (for example pregnancy).

What are you using this medicine for?
This medicine is for short-term pain not relieved by paracetamol, ibuprofen or aspirin alone. Have you already tried one of those?
Have you used this or another codeine or opioid painkiller (for example dihydrocodeine) in the last few weeks?

We ask to help prevent dependence, which can develop quickly with these medicines.

Have you taken an over-the-counter codeine medicine for longer than three days in a row recently?
Have you ever had a problem with dependence on painkillers, other medicines, or other substances?
Are you pregnant, trying to become pregnant, or breastfeeding?
Do you have any of these: breathing problems, a recent head injury, bowel problems or blockage, or liver or kidney problems?
Are you taking any other medicine that contains paracetamol (including other painkillers or cold/flu remedies)?
Are you taking any other medicines that cause drowsiness, sedatives, sleeping tablets, or other opioid painkillers?
Do you understand that this medicine can be addictive, should be used for no more than three days, that you must not take other paracetamol products with it, and that you should see your doctor if pain continues?