Acetaminophen and Codeine - Oral

Warning:

Acetaminophen and codeine has a boxed warning, the most severe warning required by the U.S. Food and Drug Administration (FDA).

The boxed warning states the potential for opioid addiction, abuse, and misuse of this medication. Improper use of acetaminophen and codeine can lead to overdose and death. Therefore, people taking acetaminophen and codeine should be closely monitored. In addition, healthcare providers who prescribe opioid painkillers such as acetaminophen and codeine must participate in a drug safety program called the Risk Evaluation and Mitigation Strategy (REMS). For this program, healthcare providers must complete educational requirements and counsel people and their caregivers on using the medicine safely, among other conditions.

Acetaminophen and codeine can cause respiratory depression (a potentially fatal breathing disorder) and lead to death if accidentally ingested, especially by children.

This medication should not be taken by children under 12 years, children under 18 after having their tonsils and adenoids surgically removed, adolescents ages 12 to 18 with risk factors for respiratory depression, or pregnant people. If taken during pregnancy, opioid medications can cause neonatal opioid withdrawal syndrome.

Acetaminophen has been associated with liver failure, which has resulted in liver transplant and death. Most cases of liver injury occur from high doses of acetaminophen and, in many cases, involve more than one medication that contains acetaminophen.

Opioids like acetaminophen and codeine cause central nervous system (CNS) depression. CNS depression is a slowing down of the brain's activity. Taking this medication with other drugs or substances that cause CNS depression, such as alcohol or anxiety medications, can cause sedation, respiratory depression, coma, and death. Sometimes, the combination of acetaminophen and codeine and another CNS depressant drug cannot be avoided. In this case, you may be prescribed the lowest dose for the shortest time and carefully monitored.

What Is Acetaminophen and Codeine?

Acetaminophen and codeine is a combination oral prescription medication used to treat pain in cases where an opioid is appropriate, and other treatment options have not worked.

Acetaminophen and codeine is a combination of two ingredients. Acetaminophen (also available as a single-ingredient drug under the brand name Tylenol) is categorized as an analgesic or pain reliever. Codeine is an opioid, or narcotic, analgesic. In the body, codeine is converted to its active drug, morphine, and causes pain relief and sedation. These two drugs are combined into tablet form or as a solution (liquid) to be taken by mouth.

Acetaminophen and codeine is available in generic form only. The brand name (Tylenol #3) is no longer available in the United States.

Drug Facts

Generic Name: Acetaminophen and codeine

Brand Name: Tylenol #3 (brand name discontinued)

Drug Availability: Prescription

Therapeutic Classification: Analgesic/opioid analgesic

Available Generically: Yes

Controlled Substance: Yes; schedule III

Administration Route: Oral

Active Ingredient: Acetaminophen and codeine

Dosage Form(s): Tablet, solution

What Is Acetaminophen and Codeine Used For?

The Food and Drug Administration (FDA) approved acetaminophen and codeine to treat mild to moderate pain that requires an opioid when other (non-opioid) drugs are inadequate. This means that other drugs have not provided pain relief, or are not expected to provide enough pain relief, or other drugs cannot be tolerated or are not expected to be tolerated.

Because acetaminophen and codeine is a controlled substance, it has the potential for addiction, abuse, and misuse, even at regular doses.

How to Take Acetaminophen and Codeine

Once prescribed acetaminophen and codeine, it is essential to read the prescription label and medication guide for this medication. Use it exactly as prescribed by your healthcare provider.

Your medication dosage will be based on several factors, including pain severity, prior pain treatment experience, and risk factors for opioid misuse. Follow your healthcare provider's instructions on how much to take and how often to take it.

Here are a few important considerations for acetaminophen and codeine use:

  • Do not take it in larger amounts than prescribed or longer than prescribed. Overdosing on acetaminophen and codeine can cause liver damage or death. Tell your healthcare provider if you feel an urge to use more of this drug.
  • Do not share it with anyone else, even if they have the same symptoms. Misusing this drug can cause addiction, overdose, or death. Keep track of the medicine, so you will know if anyone misuses it.
  • Keep this medication secure and out of reach where others cannot get to it.
  • Do not drink alcohol while taking this medicine, and do not drive until you know how this medicine affects you.
  • Tell the healthcare provider you are taking acetaminophen and codeine if you have an upcoming surgery or medical/lab tests.
  • If you take acetaminophen and codeine for a long time, do not stop taking it suddenly. Doing so could cause withdrawal symptoms. Instead, ask your healthcare provider how to taper off this medicine safely.
  • Do not keep leftover acetaminophen and codeine. Even one pill can cause death if someone takes it improperly or accidentally. Ask your pharmacist about the nearest drug take-back site.

Storage

Store acetaminophen and codeine at room temperature (68 F to 77 F), away from direct light, heat, and moisture. Keep it locked up, if possible, and out of sight and reach of others, including children and pets.

Keep track of the amount of medicine so you know if it is being used improperly. Close the bottle tightly when not in use. Never keep leftover acetaminophen and codeine pills. Ask your pharmacist if a community drug take-back program is available for proper drug disposal.

How Long Does Acetaminophen and Codeine Take to Work?

A dose of acetaminophen and codeine starts to work within about an hour. The highest level (and peak effect) occurs around two hours after the medicine is taken, and pain relief lasts for about four to six hours from when the dose is taken.

What Are the Side Effects of Acetaminophen and Codeine?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Like other medications, acetaminophen and codeine can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.

Common Side Effects

Common side effects of acetaminophen and codeine are:

  • Dizziness and lightheadedness
  • Drowsiness and sedation
  • Stomach problems such as nausea, vomiting, constipation, or stomach pain
  • Dry mouth
  • Excess sweating
  • Headache
  • Rash or itching
  • Urinary retention (difficulty emptying the bladder)
  • Euphoria (a state of excitement and happiness)
  • Dysphoria (feeling unhappy, uneasy, or unwell)

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, swelling around the lips, tongue, and face, and difficulty breathing. An allergic reaction may require emergency medical attention. 
  • Severe skin reaction: Symptoms may include fever, burning eyes, sore throat, red or purple rash, and/or blistering or peeling skin. These symptoms require emergency medical attention.
  • CNS and respiratory depression: Opioids can cause breathing to slow or stop. Family or caregivers should be alert to slow breathing with long pauses, blue-colored lips, or if you are having difficulty waking up. Ask your healthcare provider about naloxone, which can be used in an emergency overdose situation.
  • Sleep apnea: Have family members/caregivers be alert to loud snoring, gasping or choking while sleeping, and/or abnormal breathing.
  • Severely low blood pressure
  • Seizures
  • Liver problems: Symptoms may include nausea, stomach pain, itching, appetite loss, dark urine, clay-colored stools, and/or yellowing of the skin or whites of the eyes (jaundice).
  • Inflamed pancreas: Be alert to stomach pain, nausea, and vomiting.
  • Abuse and dependence: Tell your healthcare provider if you feel like the medicine is not working as well or if you have an urge to take more medicine than prescribed.
  • Serotonin syndrome: This is a life-threatening condition caused by a buildup of serotonin in the body. Be alert to agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, incoordination, nausea, vomiting, and/or diarrhea.

Long-Term Side Effects

While taking acetaminophen and codeine for a short time is generally safe, taking it at higher doses or for longer periods of time can cause problems. For example, taking this drug long-term could cause liver problems, or the drug can become habit-forming.

Long-term use of opioids such as codeine may cause androgen (sex hormone) deficiency. The prescribing information notes that this may occur and may cause sexual problems and infertility. However, one study concluded that this is less likely to occur with codeine, which is shorter-acting in the body, than with longer-acting opioids. Long-term codeine use may also cause symptoms of depression.

Report Side Effects

Acetaminophen and codeine may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Acetaminophen and Codeine Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For mild to moderate pain:
    • For oral dosage form (solution):
      • Adults—15 milliliters (mL) every 4 hours as needed. Your doctor may adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage form (suspension):
      • Adults—15 milliliters (mL) every 4 hours as needed.
      • Children 7 to 12 years of age—10 mL 3 or 4 times per day.
      • Children 3 to 6 years of age—5 mL 3 or 4 times per day.
      • Children younger than 3 years of age—Use and dose must be determined by your doctor.
    • For oral dosage form (tablets):
      • Adults—1 or 2 tablets every 4 hours as needed. Your doctor may adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.

Modifications

Your dose or treatment with acetaminophen and codeine may need to be adjusted if any of the following apply to you:

  • If you are 65 years or older
  • Have certain other medical conditions, such as kidney or liver problems
  • Pregnant or breastfeeding

Older Age

You may need to use caution when using acetaminophen and codeine if you are 65 years or older, especially if you have other medical conditions (such as kidney or liver problems) or take certain other medications. Older adults who take this medication will be prescribed lower doses and closely monitored.

Liver or Kidney Problems

People of any age with liver or kidney problems should consult their healthcare provider. A lower dose may be needed, or the medication cannot be used, depending on the individual situation.

Pregnancy and Breastfeeding

Taking opioids such as acetaminophen and codeine during pregnancy can cause a life-threatening condition in the baby called neonatal opioid withdrawal syndrome. Consult your healthcare provider immediately if you become pregnant while already taking this medication. Acetaminophen and codeine should not be used while breastfeeding.

Additional Warnings

Acetaminophen and codeine is not approved for use in children under 18 years. In some cases, life-threatening respiratory depression and death have occurred in children who took codeine. In most cases, this occurred after surgical tonsil and/or adenoid removal and many of the children were ultra-rapid metabolizers of codeine (which means that these children quickly convert codeine to morphine in the body, increasing the chance of an overdose). Children with sleep apnea are also possibly sensitive to respiratory depression caused by codeine.

Because of these risks:

  • Acetaminophen and codeine should not be used in children under 12 years old.
  • Acetaminophen and codeine should not be used in children younger than 18 years old after surgical removal of the tonsils and/or adenoids.
  • Acetaminophen and codeine should not be used in adolescents between the ages of 12 and 18 with other risk factors such as lung or breathing problems, sleep apnea, obesity, or taking other medications that cause respiratory depression.

Missed Dose

Since acetaminophen and codeine is taken as needed for pain, missing a dose is unlikely. If you miss a dose, skip the missed dose and resume dosing as directed. Do not take extra medicine to make up for a missed dose.

Overdose: What Happens If I Take Too Much Acetaminophen and Codeine?

Taking too much acetaminophen and codeine is an emergency and can cause death. Symptoms may include severe drowsiness and pinpoint (tiny) pupils. Breathing may slow or stop.

Before taking acetaminophen and codeine, you should also get naloxone. Your healthcare provider can issue a prescription for it, or you can buy it from your pharmacy or health department without a prescription in some states. Your family/caregivers should learn how and when to use it. Ask your local pharmacist or healthcare provider for instructions on administering it.

What Happens If I Overdose on Acetaminophen and Codeine?

If you think you or someone else may have overdosed on acetaminophen and codeine, call a healthcare provider or the Poison Control Center (800-222-1222). I

If someone collapses or isn't breathing after taking acetaminophen and codeine, call 911 immediately. Administer naloxone if it is available.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your or your child's progress while you are taking this medicine, especially within the first 24 to 72 hours of treatment. This will allow your doctor to see if the medicine is working properly and to decide if you or your child should continue to take it. Blood tests may be needed to check for unwanted effects.

Do not use this medicine if you are using or have used an MAO inhibitor (MAOI) such as isocarboxazid [Marplan®], linezolid [Zyvox®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]) within the past 14 days.

It is against the law and dangerous for anyone else to use your medicine. Keep your unused medicine in a safe and secure place. People who are addicted to drugs might want to steal this medicine.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

If you think you or someone else may have taken an overdose of this medicine, get emergency help at once. Signs of an overdose include: dark urine, difficult or trouble breathing, irregular, fast or slow, or shallow breathing, nausea, vomiting, pain in the upper stomach, pale or blue lips, fingernails, or skin, pinpoint pupils of the eyes, or yellow eyes or skin.

This medicine may cause sleep-related breathing problems (eg, sleep apnea, sleep-related hypoxemia). Your doctor may decrease your dose if you have sleep apnea (stop breathing for short periods during sleep) while using this medicine.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Using this medicine while you are pregnant may cause serious unwanted effects, including neonatal withdrawal syndrome in your newborn baby. Tell your doctor right away if your child has the following symptoms: an abnormal sleep pattern, diarrhea, a high-pitched cry, irritability, shakiness or tremors, sneezing, weight loss, vomiting, yawning, or failure to gain weight. Check with your doctor right away if you think you are pregnant or if you plan to become pregnant while using this medicine.

Codeine is changed to morphine in the body. Some people change codeine to morphine more quickly than others. These individuals are called "ultra-rapid metabolizers of codeine". Contact your doctor immediately if you experience extreme sleepiness, confusion, or shallow breathing. These symptoms may indicate that you are an "ultra-rapid metabolizer of codeine". As a result, there is too much morphine in the body and more side effects of morphine than usual. Children may be especially sensitive to this effect. Do not give this medicine to:

  • Children younger than 12 years of age.
  • Children younger than 18 years of age who have had surgery removal of tonsils or adenoids.
  • Children 12 to 18 years of age who have a high risk for breathing problems (eg, obstructive sleep apnea, obesity, lung disease).

If a nursing mother is an ultra-rapid metabolizer of codeine, it could lead to morphine overdose in the nursing baby and cause very serious side effects.

For nursing mothers taking this medicine:

  • Talk to your doctor if you have any questions about taking codeine or about how this medicine may affect your baby.
  • Call your doctor if you become extremely tired and have difficulty caring for your baby.
  • Your baby should generally nurse every 2 to 3 hours and should not sleep for more than 4 hours at a time.
  • Check with your doctor or hospital emergency room immediately if your baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, difficulty breathing, or limpness. These may be symptoms of an overdose and need immediate medical attention.

This medicine may cause serious allergic reactions, including anaphylaxis, angioedema, or certain skin conditions (Stevens-Johnson syndrome). These reactions can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, blistering, peeling, or loosening of the skin, fever or chills, trouble breathing or swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.

Dizziness, lightheadedness, or fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help. Also, lying down for a while may relieve dizziness or lightheadedness.

This medicine may make you dizzy, drowsy, confused, or disoriented. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that can make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicine, other prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Also, there may be a greater risk of liver damage if you drink 3 or more alcoholic beverages while you are taking acetaminophen. Do not drink alcoholic beverages, and check with your doctor before taking any of these medicines while you are using this medicine.

Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.

Do not change your dose or suddenly stop using this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent worsening of your condition and reduce the possibility of withdrawal symptoms, such as stomach cramps, anxiety, fever, nausea, runny nose, sweating, tremors, or trouble with sleeping.

Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.

Before you have any medical tests, tell the medical doctor in charge that you or your child are taking this medicine. The results of certain tests may be affected by this medicine.

Using too much of this medicine may cause infertility (unable to have children). Talk with your doctor before using this medicine if you plan to have children.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are the Reasons I Shouldn't Take Acetaminophen and Codeine?

Acetaminophen and codeine is not appropriate for everyone. You should not take this medication if you are allergic to acetaminophen, codeine (or any opioid pain medicines), or any inactive ingredients in acetaminophen and codeine. 

Other people who should not take acetaminophen and codeine include:

  • People who have taken a drug in the monoamine oxidase inhibitor (MAOI) drug class within the past 14 days
  • People who are ultra-rapid metabolizers of the cytochrome P450 2D6 (CYP2D6) enzyme
  • All children under 12 years old
  • Children and adolescents who have had their tonsils and/or adenoids surgically removed
  • Adolescents 12 to 18 years old who are at risk for respiratory depression
  • People with severe kidney problems
  • People with severe respiratory depression
  • People with acute or severe asthma
  • People with a gastrointestinal obstruction or paralytic ileus (intestinal blockage)
  • People who are in circulatory shock (inadequate blood flow that causes damage to tissues)
  • People who are in a coma (a state of prolonged unconsciousness due to illness or injury) or have impaired consciousness

Acetaminophen and codeine may be prescribed with caution in certain instances, only if the healthcare provider determines it is safe. This includes the following:

  • Older age (65 and older)
  • A weakened state
  • Moderate kidney problems
  • Liver or lung problems
  • CNS depression or while taking other medicines that cause CNS depression
  • Alcohol use
  • A history of substance abuse (drugs or alcohol)
  • A history of mental health conditions
  • Head injury
  • Increased intracranial pressure (increased skull pressure due to brain injury)
  • Seizure disorder
  • Gastrointestinal motility (movement) conditions
  • Sudden abdominal pain
  • Inflamed pancreas
  • Narrow urinary tract
  • Hypothyroidism (underactive thyroid)
  • Addison's disease (a condition where the adrenal glands do not produce enough hormones)
  • Hypovolemia (low fluid volume in the body)
  • While trying to conceive (do not use this medication for more than a short time as determined by the healthcare provider)

Additionally, acetaminophen and codeine should not be stopped abruptly (except in the case of a medical emergency). The healthcare provider will give a tapering schedule so you can safely wean off this medication.

What Other Medications May Interact With Acetaminophen and Codeine?

Tell your healthcare provider about all your medicines, including prescription and over-the-counter (OTC) medicines and vitamins or supplements. Many OTC medicines for cold and flu contain acetaminophen. While taking acetaminophen and codeine, do not start any new medications without approval from your healthcare provider. Some drugs may interact by several mechanisms.

Some examples of drug interactions include:

The above-listed drugs have varying degrees of interactions with acetaminophen and codeine. It is important to note that certain drugs can increase the risk of slowed breathing, extreme sedation, coma, and death. These include alcohol, anti-anxiety medications, sleep medications, muscle relaxers, and other opioids. If a combination of these drugs cannot be avoided, the lowest dose should be prescribed for the shortest time possible, and you may be closely monitored. Ask about receiving naloxone for use in the event of an overdose.

While taking acetaminophen and codeine, always communicate with your healthcare provider what medications you are taking. Never start any new medications without their approval.

Other drug interactions may occur with acetaminophen and codeine. Ask your healthcare provider for a complete list of drug interactions.

What Medications Are Similar?

Acetaminophen and codeine is a combination drug containing two active ingredients: acetaminophen, a medicine that helps pain and fever, and codeine, a narcotic or opioid pain medication. Similar drugs include:

Examples of other single-ingredient opioid pain medications (that do not contain acetaminophen) include:

Pain does not always require opioid medications. Depending on the type and cause of pain, a non-opioid medication may suffice. Talk to your healthcare provider about what medication is appropriate for you.

This list is a list of opioid pain medications. It is NOT a list of drugs recommended to take with acetaminophen and codeine. Talk to your healthcare provider or pharmacist if you have questions.

Frequently Asked Questions

  • What is acetaminophen and codeine used for?

    Acetaminophen and codeine is used to treat pain that is severe enough to require an opioid pain medication. It is generally only used when other (non-narcotic) treatment options are not expected to work (or have not worked) or cannot be used or tolerated.

  • How does acetaminophen and codeine work?

    Acetaminophen and codeine works in the central nervous system. It is converted to morphine in the body, resulting in pain relief and sedation.

  • What drugs should not be taken with acetaminophen and codeine?

    Acetaminophen and codeine interacts with many other drugs. It causes CNS depression and should not be combined with other drugs or substances that cause CNS depression, such as alcohol, marijuana, anti-anxiety medications, sleep medications, or muscle relaxants. Acetaminophen and codeine also interacts with many other drugs, such as certain antidepressants and migraine medications. Consult your healthcare provider before taking acetaminophen and codeine to ensure it is safe to take with your other medications.

  • How long does it take for acetaminophen and codeine to work?

    Acetaminophen and codeine starts to work within approximately one hour, and pain relief should last for about four to six hours.

  • What are the side effects of acetaminophen and codeine?

    Common side effects include drowsiness, dizziness, headache, nausea, vomiting, stomach pain, and constipation. Other side effects can occur and can be serious or life-threatening. Discuss the potential side effects with your healthcare provider, so you know what to watch for when taking this medication.

  • How do I stop taking acetaminophen and codeine?

    Your healthcare provider will instruct you on how to stop taking this medication. If you are only taking it for a few days, you can generally stop taking it once you are finished with your prescription. However, if you take it for a longer period, your healthcare provider will instruct you on how to taper off the drug to prevent withdrawal symptoms.

How Can I Stay Healthy While Taking Acetaminophen and Codeine?

It is common for people to hear about opioid overdoses and think, "that can never happen to me." Unfortunately, opioid overdoses are becoming a more common occurrence. An overdose is not always intentional.

It is important to have naloxone on hand when taking opioids such as acetaminophen and codeine. Naloxone, most commonly available in pharmacies as the nasal spray Narcan (naloxone is also available as an injection and auto-injector), can be administered to someone who has overdosed on an opioid. You can get Narcan from your local pharmacy without a prescription in most states.

Once you get naloxone, teach your family, friends, and caregivers how to use it. Tell them to be alert to signs of an overdose. Signs of an overdose may include:

  • Small ("pinpoint") pupils
  • Loss of consciousness or inability to wake up
  • Slow breathing
  • Choking
  • Limp body
  • Skin that is pale, blue, or cold

Know what to do to help others in an overdose situation, and teach your family, friends, and caregivers what to do if you overdose:

  1. Call 911 right away.
  2. Give Narcan if available.
  3. Try to keep the person awake and breathing.
  4. Lay the person on their side. This prevents choking.
  5. Stay with the person until emergency personnel arrives.

Even if the Narcan brings the person back to consciousness, it is essential that they still receive medical care; always call 911 in the event of an overdose. Consult your healthcare provider if you have any questions or concerns.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. DailyMed. Label: acetaminophen and codeine phosphate tablet.

  2. Epocrates. Acetaminophen/codeine.

  3. Rubinstein AL, Carpenter DM. Association between commonly prescribed opioids and androgen deficiency in men: a retrospective cohort analysis. Pain Med. 2017;18(4):637-644. doi:10.1093/pm/pnw182

  4. Romach ML, Sproule BA. Sellers EM, et al. Long-term codeine use is associated with depressive symptoms. Journal of Clinical Psychopharmacology. 1999;19(4):373-376. doi:10.1097/00004714-199908000-00015

  5. Prescribers' Digital Reference. acetaminophen/codeine phosphate - drug summary.

  6. Centers for Disease Control and Prevention. Preventing an opioid overdose.

By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.