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Drugs

Side Effects
Serious

See Overdose and Special Concerns.
Common

Dizziness, lightheadedness, nausea or vomiting, drowsiness, constipation, unusual fatigue.
Less Common

Stomach pain, allergic reaction, false sense of well-being (euphoria), depression, loss of appetite, blurring or change in vision, nightmares or unusual dreams, dry mouth, general feeling of illness, headache, nervousness, insomnia.
Acetaminophen with Codeine Phosphate


Drug Class:
Opioid (narcotic) analgesic/antipyretic

Available OTC?: No

Available Generic?: Yes

Tylenol With Codeine 300/60 mg
(McNeil)
Available In
Why Prescribed
How It Works
Range and Frequency
Onset of Effect
Duration of Action
Dietary Advice
Storage
Missed Dose
Stopping the Drug
Prolonged Use
Over 60
Driving and Hazardous Work
Alcohol
Pregnancy
Breast Feeding
Infants and Children
Special Concerns
Overdose Symptoms
What to Do
Drug Interactions
Food Interactions
Disease Interactions

 


Available In
Capsules, tablets, oral solution, oral suspension

Why Prescribed
To relieve mild to severe pain when nonprescription pain relievers prove inadequate. A narcotic analgesic such as codeine, in combination with acetaminophen, may provide better pain relief than either medicine used alone. Used together, pain relief may be achieved at lower doses of the two medications.

How It Works
Acetaminophen appears to interfere with the action of prostaglandins, naturally occurring substances in the body that cause inflammation and make nerves more sensitive to pain impulses. It also relieves fever, probably by acting on the heat-regulating center of the brain. Unlike aspirin, however, acetaminophen does not reduce inflammation. Codeine, a narcotic analgesic, is believed to relieve pain by acting on specific areas in the spinal cord and brain that process pain signals from nerves throughout the body.

Range and Frequency
Adults-- Capsules or tablets: 1 or 2 capsules containing 15 or 30 mg of codeine with acetaminophen or 1 capsule containing 60 mg of codeine with acetaminophen, every four hours as needed. Oral solution or suspension: 1 tablespoon every 4 hours as needed. Children-- Oral solution or suspension: Ages 3 to 6: 1 teaspoon 3 or 4 times a day as needed. Ages 7 to 12: 2 teaspoons 3 or 4 times a day as needed.

Onset of Effect
Acetaminophen: Rapid. Codeine: Within two hours.

Duration of Action
Up to four hours.

Dietary Advice
Take it with meals or milk to avoid stomach upset, unless doctor directs you to do otherwise.

Storage
Store in a tightly sealed container away from heat, moisture, and direct light. Keep liquid forms from freezing.

Missed Dose
If you are taking acetaminophen with codeine on a fixed schedule, take it as soon as you remember. If it is near the time for the next dose, skip the missed dose and resume your regular dosage schedule. Do not double the next dose.

Stopping the Drug
You should take the medication as prescribed for the full treatment period, but you may stop taking it if you are feeling better before the scheduled end of therapy. This drug should never be stopped abruptly after long-term regular use.

Prolonged Use
Narcotic drugs such as codeine may cause physical dependence. Taking too much acetaminophen may cause liver damage. Therapy with acetaminophen and codeine should not continue for more than 2 weeks and may actually cease to be effective before then.

Over 60
Adverse reactions may be more likely and more severe in older patients.

Driving and Hazardous Work
Acetaminophen with codeine can cause dizziness or drowsiness; proceed with caution.

Alcohol
Avoid alcohol. The combination of alcohol and this drug may increase the depressant effects of the medicine. Drinking alcohol-containing beverages while taking acetaminophen greatly increases the risk of liver damage.

Pregnancy
Use of this drug during pregnancy can cause fetal addiction and may cause breathing problems in the newborn infant if taken during or just before delivery. Consult your doctor for specific guidelines and advice and discuss the relative risks and benefits of using this drug while pregnant.

Breast Feeding
Acetaminophen with codeine passes into breast milk; avoid or discontinue nursing while taking this drug.

Infants and Children
This medicine should not be given to infants. The drug may be used by children over the age of three, but only with extreme caution and under the careful supervision of your doctor. Children are generally prescribed the oral solution or suspension instead of the capsule or tablet.

Special Concerns
Taking a narcotic such as codeine for an extended period of time can lead to physical dependence. When discontinuing the drug after using it for an extended period, it is important to decrease the dosage gradually under the supervision of your doctor to reduce the risk of suffering from withdrawal symptoms. Call your doctor if you notice these symptoms after discontinuing the drug: shivering or trembling; insomnia; gooseflesh; nausea or vomiting; body aches; loss of appetite; stomach cramps; weakness; diarrhea; restlessness, nervousness, or irritability; rapid heartbeat; runny nose, sneezing, or fever; increased yawning; or increased sweating. Overuse of acetaminophen with codeine may also lead to anemia, liver problems, or central nervous system disorders. Contact your doctor as soon as possible if you experience any of the following symptoms during or after the use of this drug: bloody, dark, or cloudy urine; severe pain in the lower back or side; frequent urge to urinate; painful or difficult urination; sudden decrease in urine output; pale or black, tarry stools; yellow discoloration of the eyes or skin (jaundice); hallucinations; unusual bleeding or bruising; skin rash, hives, or itching; pinpoint red spots on skin; sore throat and fever; unusual excitability; trembling or uncontrolled muscle movements; redness, flushing, or swelling of the face.

Overdose Symptoms
Severe dizziness or drowsiness; cold, clammy skin; difficult or slow breathing or shortness of breath; severe confusion; seizures; stomach cramps or pain; diarrhea; low blood pressure; increased sweating; constricted pupils; nausea or vomiting; irregular heartbeat; severe weakness.

What to Do
Call your doctor, emergency medical services (EMS), or the nearest poison control center immediately.

Drug Interactions
Some drugs may interact with acetaminophen and codeine. Consult your doctor for specific advice if you are taking any prescription or over-the-counter drugs, especially if they contain acetaminophen; central nervous system depressants such as antihistamines or medicine for hay fever, allergies, or colds; barbiturates; seizure medicine; muscle relaxants; anesthetics; or tranquilizers, sedatives, or sleep medications.

Food Interactions
No significant food interactions have been reported.

Disease Interactions
Consult your doctor if you have a head injury or brain disease, an under active thyroid, an enlarged prostate, seizures, kidney or liver disease, gallbladder problems, a blood disorder, or a history of alcohol or drug abuse. These conditions may increase the likelihood of side effects from acetaminophen and codeine.

Date Published: 04/13/2005
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