Codeine/Acetaminophen, Oral

What are other names for this medicine?

Type of medicine: narcotic analgesic (painkiller)

Generic and brand names: codeine and acetaminophen, oral; Capital with Codeine Suspension; Codrix; Tylenol with Codeine

What is this medicine used for?

This medicine is a combination of a narcotic analgesic and a non-narcotic analgesic (acetaminophen). It is taken by mouth to treat moderate to severe pain.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have:

• an allergy to any medicine
• a recent head injury
• Addison's disease
• an underactive thyroid (hypothyroid)
• asthma or lung disease
• depression
• heart disease
• kidney or liver disease
• low blood pressure
• pancreatitis
• problems with drug or alcohol abuse
• prostate problems or trouble urinating
• seizures
• severe diarrhea or constipation
• stomach problems such as colitis

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Take it only for the condition for which it was prescribed. Do not take more or take it for a longer time than prescribed. Taking too much of this medicine may be habit-forming or may lead to an overdose.

Taking too much acetaminophen can cause liver damage. You should not take more than 4000 mg of acetaminophen per day. If you do not know how much acetaminophen is in your medicine, ask your pharmacist. Many nonprescription products such as Drixoral, Sinutab, Excedrin Migraine, and Coricidin contain acetaminophen. Check the label or ask your pharmacist to avoid taking too much acetaminophen.

You may take this medicine with or without food. Taking it with meals may lessen the chance the drug will upset your stomach.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: extreme drowsiness, pinpoint pupils, confusion, breathing that stops, slow or irregular heartbeat, nausea, vomiting, diarrhea, stomach pain, sweating, seizures, dark urine, yellowing of the skin or eyes, coma.

What should I watch out for?

Important notice: Taking an overdose of this medicine can cause very serious problems. If you think you have taken an overdose, get medical care right away.

You may need to take this medicine for a long time. If you need to take this medicine for more than a few days, do not stop taking it suddenly. You may have to reduce your dosage gradually to avoid withdrawal symptoms. Follow your healthcare provider's instructions.

This medicine increases the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may lessen this effect. Also, drinking alcohol may increase this effect.

Contact your healthcare provider if your symptoms do not improve in a few days or if they get worse.

This medicine may make you constipated. You may need to take a laxative or stool softener while taking this medicine. Talk with healthcare provider or pharmacist about this.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

Smoking may decrease the effectiveness of this medicine.

This medicine is a controlled substance. It is illegal for you to give it to anyone else.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Depression; hallucinations; ringing in your ears; severe nausea, vomiting, or diarrhea; trembling; loss of concentration; pounding heartbeat; bloody or dark urine; trouble urinating; yellowish eyes or skin.

Other: Dizziness, drowsiness, faintness, mild nausea or vomiting, constipation, mild skin rash, dry mouth, blurred vision, decreased appetite, mood changes.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• alcohol
• antianxiety medicines such as alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), triazolam (Halcion), temazepam (Restoril), flurazepam (Dalmane), and oxazepam (Serax)
• anticholinergic medicines such as benztropine (Cogentin), dicyclomine (Bentyl), atropine sulfate, belladonna, propantheline (Pro-Banthine), methscopolamine (Pamine), l-hyoscyamine (Levsin, Levsinex), amantadine (Symmetrel), procyclidine (Kemadrin), and trihexyphenidyl (Artane)
• antiseizure medicines such as carbamazepine (Tegretol), primidone (Mysoline), gabapentin (Neurontin), felbamate (Felbatol), lamotrigine (Lamictal), levetiracetam (Keppra), topiramate (Topamax), valproic acid (Depacon, Depakene, Depakote), oxcarbazepine (Trileptal), tiagabine (Gabitril), and phenytoin (Dilantin)
• antihistamines such as diphenhydramine (Benadryl), hydroxyzine (Atarax, Vistaril), and chlorpheniramine (Chlor-Trimeton)
• antinausea medicines such as prochlorperazine (Compazine), and promethazine (Phenergan)
• antipsychotic medicines such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), perphenazine, trifluoperazine (Stelazine), thioridazine, haloperidol (Haldol), clozapine (Clozaril), and olanzapine (Zyprexa)
• barbiturates such as phenobarbital, butabarbital (Butisol), and pentobarbital (Nembutal)
• herbs with sedative effects such as kava, St. John's wort, gotu kola, and valerian
• diflunisal (Dolobid)
• general anesthetics used during surgery
• isoniazid (Laniazid)
• medicines that block or may partially block the effect of other narcotics such as naltrexone (ReVia), buprenorphine (Buprenex, Subutex), and nalbuphine (Nubain)
• other narcotic analgesics such as codeine, hydrocodone (Vicodin, Lortab), oxycodone (Percocet, Tylox, OxyContin), morphine (MS Contin), propoxyphene (Darvocet N-100), pentazocine (Talwin), meperidine (Demerol), fentanyl (Duragesic patches), methadone (Dolophine), and hydromorphone (Dilaudid)
• MAO inhibitor antidepressants such as phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and isocarboxazid (Marplan) (Do not take an MAO inhibitor and this medicine within 14 days of each other.)
• muscle relaxants such as cyclobenzaprine (Flexeril), carisoprodol (Soma), tizanidine (Zanaflex), methocarbamol (Robaxin), and baclofen (Lioresal)
• rifampin (Rifadin, Rimactane)
• sleeping pills such as zolpidem (Ambien), zaleplon (Sonata), and chloral hydrate
• SSRI antidepressants such as sertraline (Zoloft), fluoxetine (Prozac), citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil), venlafaxine (Effexor), and fluvoxamine (Luvox)
• tricyclic antidepressants such as amitriptyline, nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), trazodone (Desyrel), desipramine (Norpramin), and doxepin (Sinequan)
• warfarin (Coumadin)
• zidovudine (Retrovir)

Do not drink alcohol while taking this medicine.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.