In this session, we will be discussing the consumer medication information for acetaminophen and codeine.

What it is for & How to take

Acetaminophen and codeine is used to relieve sharp or sudden mild to moderate pain. This medication is an opiate, and it works in the brain to block how the body recognizes pain.

Acetaminophen and codeine is prescribed in the lowest effective dose for the shortest effective treatment cycle. Your dose is based on your condition and response to treatment. Follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any part you do not understand. This medication may be taken with or without food. If you have a sensitive stomach, take with food to lessen the chance of nausea.

Codeine is also available as an ingredient in cough syrups. This session only includes information about the use of codeine for pain control. If you are taking a codeine combination cough product, be sure to read information about all the ingredients in the product you are taking and ask your doctor or pharmacist for more information.

This medication works best when taken at the first sign of pain. If you wait until the pain has worsened, the medication may not work as well or may take much longer for you to notice the expected pain relief.

If you have an ongoing pain syndrome, such as cancer or chronic back pain, you may be taking acetaminophen and codeine along with a long-acting pain medication. This medication is used for sudden or sharp pain that flares up during certain times of the day.

Tell your doctor if your pain is not getting better. Your dose is based on your current condition and may need to be changed as your condition changes. If you have been taking this medication for an extended period, do not suddenly stop taking it because you may feel uncomfortable withdrawal symptoms such as muscle aches, sweating, nausea, and vomiting. Your doctor may decrease your dose over a time to decrease the withdrawal symptoms.

Most Important Warnings

  • If this medication is used on a patient not used to taking narcotics, they may stop breathing. Serious or fatal cases have happened even with the regular dose.
  • This medication has an increased risk of abuse, addiction, and theft. Let your doctor know if you or anyone in your family has a history of substance abuse. Store this medication in a safe place to prevent theft.
  • Acetaminophen and codeine may interact with other medications and cause serious side effects including death. Tell your doctor and pharmacist all your other medications before starting acetaminophen and codeine.
  • If a child accidentally takes even one tablet, they may stop breathing and die.
  • When pregnant mothers use this medication, the unborn child is at risk. The newborn may need prolonged withdrawal treatment.
  • Combining this medication with anxiety medications, such as diazepam or alprazolam, may cause extreme sleepiness, significant breathing difficulties, and death.
  • Acetaminophen is associated with liver failure, usually in patients taking greater than 4000mg acetaminophen per day and 2 or more acetaminophen-containing products. Do not take any over-the-counter acetaminophen products at the same time you are taking this medication.
  • Some children who took codeine to relieve pain after surgery to remove their tonsils or adenoids have had slowed breathing and have died during their treatment. Codeine should not be used to relieve pain in children after surgery to remove the tonsils or adenoids.

Other Warnings & Cautions

  • Rarely, this medication may cause a drug seeking or addictive behavior. This risk is increased if you have a history of alcohol or drug abuse. If you follow the directions on the label and stay in communication with your doctor and pharmacist, the chances for addiction are lower.
  • The elderly may be more sensitive to the side effects of this medication, especially the drowsiness, dizziness, constipation and urinary problems.
  • Do not drive or do any activity that requires focus and attention until you are sure you can do them safely. Avoid alcoholic beverages while using acetaminophen and codeine.
  • Infants born to mothers who are using this medication are at risk. This medication should only be used during pregnancy when the benefit to the mother is greater than the risk to the unborn baby.
  • Codeine passes into breast milk. Breastfeeding is not recommended while using this medication.

Interactions & Side Effects

  • Tell your pharmacist or doctor all your medication allergies so they may determine if acetaminophen and codeine is safe for you to use.
  • Avoid dangerous drug interactions. Tell your pharmacist or doctor all the other medication you are taking, including over the counter supplements, even if you do not take them very often.
  • Ask your doctor if this medication is safe to take with your current health conditions. Tell your doctor if you have a slow bowel, chronic constipation, seizures, slow heartbeat, trouble urinating, low blood pressure, a family history of substance abuse or history of any other disease you have.
  • While using acetaminophen and codeine, you may feel some nausea, vomiting, dizziness, drowsiness or constipation. If these or any other unwanted side effects persist, contact your doctor or pharmacist to talk about it with them.
  • Constipation may be a problem while taking this medication. Talk with your pharmacist about what would work best for you to keep your bowels moving.
  • Call your doctor right away if you have any heartbeat changes, hallucinations, seizure, loss of coordination or any other significant side effects.
  • Call emergency 911 if you have any difficulty breathing.

If you have any questions about what you have heard, contact your pharmacist or doctor. This session does not include all the potential interactions or side effects that this medication may cause. Ask your pharmacist how to store your medication and how you should dispose of it when you are done taking it. Do not share your medication with anyone, ever. Remember, this is not meant to replace your counseling session with your pharmacist. In the case of overdose, call your local poison control center at 1-800-222-1222.

Updated 8/20