Thank you for consulting with Doctorspring. I understand that you are worried that your husband is in pain because of gout and is also suffering from Atrial Fibrillation (a condition of the heart where the atria beat too fast and the heart is unable to pump blood effectively). An important thing is that you do not administer any OTC preparations to him because it could do more harm than good to your husband because of interactions with cardiac medications he is taking. I take it that your husband is taking Warfarin (to prevent the blood from clotting because his heart is unable to pump them efficiently), Amiodarone (to control the rate of beating of the heart).

The codeine+paracetamol combination is for pain relief due to the gout. Another thing is that it is important that he take his pain relief combination every 6 hours and not on as necessary basis especially during an acute episode. If your husband is having long term gout with an acute exacerbation, talk to your doctor regarding drugs to tackle the chronic problem.

I suggest that you try adequate dosing for the codeine+paracetamol combination for a day or 2 and then visit your doctor if the pain is still not under control. Hope this information was of use to you.