uses
What is acetaminophen/codeine used for?Acetaminophen/codeine is commonly used to treat mild to moderate pain when an opioid (narcotic) is needed.Acetaminophen/codeine may also be used for other conditions as determined by your healthcare provider.How does acetaminophen/codeine work (mechanism of action)?Acetaminophen/codeine works to change how your body feels and responds to pain. Acetaminophen may work by blocking pain signals. Codeine works by attaching to specific receptors in the body to reduce the feeling of pain.How is acetaminophen/codeine supplied (dosage forms)?Brands and other namesTylenol with CodeineTylenol #2Tylenol #3Tylenol #4Dosage forms and strengths120 mg/12 mg per 5 mL oral solution300 mg/15 mg, 300 mg/30 mg, 300 mg/60 mg oral tabletsHow should I store acetaminophen/codeine?Acetaminophen/codeine should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
how to use
liquid or tablet that is swallowed
drug interactions
Does acetaminophen/codeine interact with foods or drinks?There are no known interactions between acetaminophen/codeine and foods or non-alcoholic drinks.Do not drink alcohol or use prescription or over-the-counter (OTC) medicines that contain alcohol. Drinking alcohol while taking acetaminophen/codeine can cause you to overdose and die.Does acetaminophen/codeine interact with other medicines (drug interactions)?Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.In particular, make sure that you discuss if you are using any of the following before taking acetaminophen/codeine.A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s diseaseA benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium and others), or lorazepam (Ativan and others), which is a medicine used for anxiety, muscle spasms, or seizuresA macrolide antibiotic, such as clarithromycin or erythromycin (Ery-Tab and others), which is a medicine used for bacterial infectionsKetoconazole, itraconazole (Sporanox, Tolsura), posaconazole (Noxafil), fluconazole (Diflucan), or voriconazole (Vfend), which is a medicine used for fungal infectionsA protease inhibitor, such as ritonavir (Norvir) or nelfinavir (Viracept), which is a medicine commonly used to treat HIVRifampin, which is a medicine commonly used to treat an infection called tuberculosisCarbamazepine (Carbatrol, Tegretol, and others) or phenytoin (Dilantin, Phenytek, and others), which is a medicine used for seizuresAmiodarone (Pacerone and others), which is a medicine used for an irregular heart rhythmA mixed agonist/antagonist or partial agonist opioid analgesic, such as buprenorphine (Butrans, Sublocade), butorphanol, and others, which is used to treat certain types of pain or opioid use disorderA diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressureAn anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problemsAny other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, muscle relaxants, and medicines for anxietyAny medicine that affects serotonin in your body, such as medicines for depression, anxiety, or certain mental health conditions, some migraine medicines, and some medicines for nausea and vomiting. Many other medicines may alter the blood levels of acetaminophen/codeine. Tell your healthcare provider about all medicines that you take or have recently taken.This may not be a complete list of medicines that can interact with acetaminophen/codeine. Always check with your healthcare provider.
side effects
What are the most common side effects of acetaminophen/codeine?The most common side effects of acetaminophen/codeine are listed below. Tell your healthcare provider if you have any of these side effects that bother you.Constipation Nausea or vomitingSleepiness or tirednessHeadacheDizziness Stomach painThere may be other side effects of acetaminophen/codeine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.What are the serious side effects of acetaminophen/codeine?While less common, the most serious side effects of acetaminophen/codeine are described below, along with what to do if they happen.Severe Allergic Reactions. Acetaminophen/codeine may cause allergic reactions, which can be serious. Stop taking acetaminophen/codeine and get help right away if you have any of the following symptoms of a serious allergic reaction.Breathing problems or wheezingRacing heartFever or general ill feelingSwollen lymph nodesSwelling of the face, lips, mouth, tongue, or throatTrouble swallowing or throat tightnessItching, skin rash, or pale red bumps on the skin called hivesNausea or vomitingDizziness, feeling lightheaded, or faintingStomach crampsJoint painRisk of Misuse and Addiction. Misusing acetaminophen/codeine can lead to serious side effects like coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Take acetaminophen/codeine exactly as prescribed. Tell your healthcare provider if you feel that acetaminophen/codeine is not working. Call your healthcare provider right away or go to the nearest emergency room if you have any of the following serious symptoms.Sudden confusion or feeling disorientedFeeling paranoidSuicidal thoughts or actionsSeizuresTrouble breathing Breathing Problems. Acetaminophen/codeine may cause slow or shallow breathing, especially if you have breathing problems from another condition or take other medicines that can slow your breathing. Tell your healthcare provider if you develop severe sleepiness or trouble breathing, especially when you start acetaminophen/codeine or when your dose is increased. Get emergency help if you have any of the following symptoms.Changes in the color of your skin, including bluish color to your lips and fingernailsConfusionShortness of breathFeeling dizzy, lightheaded, or faintingChanges in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeatSlow or shallow breathingExcessive sleepiness or trouble staying awakeLiver Damage (Hepatotoxicity). Liver damage, also called hepatotoxicity, can happen when taking acetaminophen/codeine. Call your healthcare provider right away if you have any of the following symptoms of liver damage.Nausea or vomitingStomach or belly painFeverWeakness or unusual tirednessItchingLoss of appetiteLight-colored poopDark-colored urine (pee)Your skin or the whites of your eyes turning yellowish in color (also called jaundice)Increased Pain Sensitivity (Hyperalgesia). Acetaminophen/codeine can cause an increased sensitivity to pain. It can cause things that normally cause pain to feel more painful than usual. Acetaminophen/codeine can also cause allodynia. This happens when things that normally do not cause pain, such as wearing glasses or brushing your hair, become painful. If your pain increases, do not take extra doses of acetaminophen/codeine. This could cause you to overdose or develop other serious side effects. Call your healthcare provider right away if your pain increases, you feel more sensitive to pain, or if you develop pain in other areas of the body. Reduced Adrenal Function. Long-term use of acetaminophen/codeine can cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your healthcare provider if you have any of the following symptoms of adrenal insufficiency.Nausea and vomitingWeakness, tiredness, or lack of energyLow blood pressureLow Blood Pressure (Hypotension). Acetaminophen/codeine may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.Dizziness, feeling lightheaded, or faintingConfusionFeeling weak or tiredSevere Skin Reactions. Acetaminophen/codeine can cause severe skin reactions, called Acute Generalized Exanthematous Pustulosis (AGEP), Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop acetaminophen/codeine and call your healthcare provider right away. Get emergency help if you have any of the following symptoms of a severe skin reaction.Painful red or purple skin that looks burned and peels offFlat red rash or blisters on your skin, mouth, nose, and genitalsRed, painful, watery eyesSphincter of Oddi Spasm. The sphincter of Oddi is a muscular valve in your body that controls the flow of bile and digestive juices from the pancreas into the small intestine. When this valve spasms, it may feel like getting a tight muscle cramp, causing pain and blocking the flow of these juices, which can lead to discomfort and digestive problems. This is more likely to happen if you do not have a gallbladder. Stop taking acetaminophen/codeine and get emergency help if you have new or worse stomach pain or pain in the upper right side of your stomach-area that travels to your back or shoulder, with or without nausea and vomiting. Seizures. Acetaminophen/codeine may cause seizures, especially if you have a seizure disorder. There are many different types of seizures and some of them are not easy to recognize. Stop taking acetaminophen/codeine and call your healthcare provider if you have any of the following signs that a seizure is happening or could happen.Muscle twitching, jerking, spasms, tremors, or other uncontrolled movementsStiffening of your arms and legsFeeling anxious, nervous, confused, or a sense of dreadFeeling dizzy or lightheadedFalling or losing consciousness
overdose and misseddose
What should I do if I accidentally use too much acetaminophen/codeine?If you or someone else has used too much acetaminophen/codeine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.What should I do if I miss a dose of acetaminophen/codeine?If you miss a dose, skip the missed dose and only take the next dose at your usual time. Do not take double or extra doses.
warnings and Precautions
Who should not use acetaminophen/codeine?Allergies to Ingredients. People who are allergic to any of the following should not take acetaminophen/codeine.AcetaminophenCodeineTylenol with CodeineTylenol #2Tylenol #3Tylenol #4Any of the ingredients in the specific product dispensedYour pharmacist can tell you all of the ingredients in the specific acetaminophen/codeine products they stock.Drug Interactions. Acetaminophen/codeine should not be taken while you are using certain other medicines. Before taking acetaminophen/codeine, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using or have used recently. See the Interactions section for more details.Children. Acetaminophen/codeine should not be used in any child younger than 12 years of age or in a child younger than 18 years of age after a surgery to remove their tonsils or adenoids (tonsillectomy and/or adenoidectomy). Slow or shallow breathing that can lead to death may occur. Gut Blockage. Acetaminophen/codeine should not be used if you have a blockage of your gut (bowel obstruction) or a narrowing of the stomach or intestines. Acetaminophen/codeine can make these conditions worse. Slowed Gut Movement. Paralytic ileus is a type of ileus where your intestines are unable to move food through them. Acetaminophen/codeine can make this condition worse.Lung problems. Acetaminophen/codeine should not be used if you have severe asthma, trouble breathing, or other lung problems. Acetaminophen/codeine can make these conditions worse.What should I know about acetaminophen/codeine before using it?Do not take acetaminophen/codeine unless it has been prescribed to you by a healthcare provider. Take it as prescribed.Do not share acetaminophen/codeine with other people, even if they have the same condition as you. It may harm them.Keep acetaminophen/codeine out of the reach of children. Acetaminophen/codeine is a controlled substance because it can be misused or lead to dependence. Store acetaminophen/codeine in a safe place to protect it from theft. It is illegal to sell or give away this medicine.Use an accurate measuring device to measure your dose of liquid acetaminophen/codeine. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.Some acetaminophen/codeine products may contain an ingredient called sodium metabisulfite, a type of sulfite. If you have asthma, you may be more likely to have a sulfite allergy.Do not take more than 4,000 mg of acetaminophen per day. Taking too much acetaminophen can cause serious liver problems that could lead to death. Talk to your pharmacist about which medicines contain acetaminophen. It can be found in Tylenol, some cough and cold medicines, some sleep medicines, and others. If you take too much acetaminophen, get emergency help right away, even if you do not feel sick.Acetaminophen/codeine can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how acetaminophen/codeine affects you.People who are 65 and older can be at greater risk for some side effects from acetaminophen/codeine. Talk to your healthcare provider about your risks if you are in this age group.If you have been taking acetaminophen/codeine on a regular basis, do not stop taking the medicine without talking to your healthcare provider. Stopping too quickly may cause serious side effects. Call your healthcare provider right away if you have any of the following symptoms. Feeling restlessWatery eyes or runny noseYawningSweating or chillsMuscle, joint, or back painDilated pupils Irritability, anxiety, or trouble sleepingNausea, vomiting, diarrhea, or loss of appetiteIncrease in blood pressure, breathing rate, or heart rateDispose of expired, unwanted, or unused acetaminophen/codeine right away by taking your medicine to an authorized DEA-registered collector or drug take back program. If one is not available, you can mix medicine with dirt, coffee grounds, or cat litter, then place the mixture in a sealed plastic bag and throw the bag in the trash. Long-term use of acetaminophen/codeine may affect your ability to become pregnant or get a partner pregnant. Talk with your healthcare provider if you have any concerns.Talk to your healthcare provider about whether you should keep naloxone with you. Naloxone is a medicine that is used for the emergency treatment of an overdose.Acetaminophen/codeine may cause severe constipation. Talk with your pharmacist or other healthcare provider about ways to prevent constipation.What should I tell my healthcare provider before using acetaminophen/codeine?Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if acetaminophen/codeine is right for you.In particular, make sure that you discuss any of the following.Current and Past Health Conditions. Tell your healthcare provider if you have any of the following. Head injury or brain problems, such as brain tumors or increased pressure around the brainSeizuresLiver, kidney, or thyroid problemsPancreas or gallbladder problemsBreathing problems, such as asthma or chronic obstructive pulmonary disease (COPD)Obstructive sleep apneaProblems peeing DiabetesSubstance use disorder or live with someone with this problemAlcohol use disorderOpioid overdoseMental health problemsRecent or upcoming surgery to remove your tonsils or adenoids Have been told by your healthcare provider that you are a rapid metabolizer of certain medicinesPregnancy. Acetaminophen/codeine may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take acetaminophen/codeine while you are pregnant or trying to get pregnant. If you take acetaminophen/codeine on a regular basis during pregnancy, your baby may have withdrawal symptoms that can be life-threatening. Tell your healthcare provider if you took acetaminophen/codeine during your pregnancy, especially near the end of your pregnancy.Breastfeeding. Acetaminophen/codeine passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop acetaminophen/codeine.
about
Acetaminophen/codeine is used to treat certain types of pain. It reduces pain signals and changes how your body feels pain. Common side effects include constipation and feeling sleepy or tired. Serious side effects are rare. Notify your healthcare provider right away if you develop a rash. It comes in a liquid if you have trouble swallowing tablets.