What is Acetaminophen-Codeine: Uses, Warnings & Interactions

How to take Acetaminophen-Codeine

• Your doctor will tell you how much medicine to use. Do not take more than the directed dose.

• You may take this medicine with food or milk if it upsets your stomach.

• Use a marked measuring spoon, oral syringe, or medicine cup to get the correct dose. 

• Drink plenty of liquids to help avoid constipation.

• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. 

• Keep the oral liquid in the refrigerator. Do not freeze. 

• Drop off any unused narcotic medicine at a drug take-back location right away. If you do not have a drug take-back location near you, flush any unused narcotic medicine down the toilet. Check your local drug stores and clinics for take-back locations. You can also check the Drug Enforcement Agency (DEA) website for a list of locations. Here is the link to the Food and Drug Administration (FDA) safe disposal of unused medicines website

What to do if you miss a dose of Acetaminophen-Codeine

• If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

Acetaminophen-Codeine contraindications

This medicine is not right for everyone. Do not take acetaminophen-codeine if you:

• Are under 12 years old

• Are under 18 and have had your tonsils or adenoids removed

• Have severe breathing problems or asthma

• Have a blocked stomach or intestines

• Are allergic to acetaminophen (Tylenol), codeine, or other opioid medicines

• Are taking or have you recently taken an MAOI medicine (within the past 14 days)

Acetaminophen-Codeine warnings

• This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative or stool softener to prevent and treat it. 

• Tell your healthcare professional before using this medicine if you: 

  • Are pregnant or breastfeeding, or trying to get pregnant

  • Have kidney disease, liver disease, adrenal problems (including Addison’s disease), or breathing problems (including sleep apnea). 

  • You have an enlarged prostate, trouble urinating, stomach problems, an underactive thyroid, or a history of head injury or brain damage. 

  • Have had an allergic reaction to sulfites, or if you have a history of drug or alcohol abuse.

• This medicine may cause the following problems: 

  • High risk of overdose, which can be life-threatening or can lead to death 

  • Breathing problems, including slowed breathing, especially with high doses or when combined with other sedatives. This can be life-threatening.

  • It may cause sleep-related breathing problems, including sleep apnea or low oxygen levels at night (sleep-related hypoxemia)

  • May cause Serotonin syndrome, a serious condition, which can occur when combined or used with certain medicines, such as certain migraine drugs (most often, triptans) and amphetamines.

  • Serious skin reactions

• This medicine can be habit-forming. Do not use more than the prescribed dose or change your dose without consulting your healthcare provider. Talk to your doctor if you believe that your medicine is not working.

• This medicine contains acetaminophen. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Do not take more than 4 grams (4,000 milligrams) total of acetaminophen in one day.

• Do not stop using this medicine suddenly. Your doctor will guide you on how to slowly decrease your dose before stopping it completely. This medication may cause dizziness or drowsiness. Do not drive, operate heavy machinery, or perform any activity that could be dangerous until you know how this medicine affects you. Sit or lie down if you feel dizzy. Stand up slowly and carefully to avoid feeling lightheaded.

• Tell any doctor or dentist that you are using this medicine. This medicine may affect certain medical test results.

• This medicine could affect fertility. Talk with your doctor before using this medicine if you plan to have children.

• Keep all medicine out of the reach of children and pets. Never share your medicine with anyone.

Acetaminophen-Codeine interactions

• Do not use this medicine if you are using or have used a monoamine oxidase inhibitor (MAOIs) within the past 14 days. Combining MAOIs such as phenelzine, tranylcypromine, or isocarboxazid with codeine can cause serious, life-threatening side effects.

• Some medicines can affect how acetaminophen-codeine works. Tell your doctor if you are using any of the following: 

  • Amiodarone, carbamazepine, erythromycin, ketoconazole, mirtazapine, phenytoin, quinidine, rifampin, ritonavir, tramadol, trazodone, 

  • Diuretic (water pill), which may affect fluid balance or worsen side effects

  • Medicine to treat depression, anxiety, or mood (including bupropion, fluoxetine, paroxetine, quinidine, TCAs), phenothiazine, 

  • Medicine to treat migraine headaches (Triptans) such as sumatriptan, rizatriptan, or similar medications

• Tell your healthcare provider if you use any other medications that cause drowsiness or make you sleepy, such as allergy medicine, sleeping pills, or other opioids. They can increase your risk of severe side effects, such as extreme drowsiness, confusion, or slowed breathing. 

• Tell your doctor if you are using buprenorphine, butorphanol, nalbuphine, pentazocine, or a muscle relaxant (including cyclobenzaprine, metaxalone).

• Do not drink alcohol while you are using this medicine. Acetaminophen can damage your liver, and alcohol can increase this risk. Get emergency help immediately if you think you may have taken too much of this medicine. Signs of an overdose include shallow breathing, fainting, confusion, nausea, vomiting, pinpoint pupils of the eyes, or pale or blue lips, fingernails, or skin.