An analgesic is any drug designed to relieve pain. Tylenol 3 is rarely, if ever, used in the first-line treatment of pain. The drug is generally considered when there is breakthrough pain pain that cannot be relieved with over-the-counter analgesics.
Tylenol 3 may also be considered if non-opioid pain relievers are causing intolerable side effects. The combination of acetaminophen and codeine has long been used by dentists, surgeons, pediatricians, and family doctors to treat cough associated with illness such as strep throat or cough following a surgical procedure such as tonsillectomy.
The practice is largely frowned upon today due to the risk of respiratory depression abnormally slow and ineffective breathing. The risk is especially high in children, the elderly, the infirm, or people with severe wasting cachexia. Tylenol 3 is not appropriate for everyone. As an opioid drug, codeine can cause both physical dependence and mental dependence addiction.
To avoid this, healthcare providers must ensure that the benefits of treatment outweigh the risks. This includes evaluating whether a patient is at risk of addiction and providing the necessary counseling to ensure that the drug is used safely. Risk factors include a prior history of substance abuse , a family history of substance abuse, or a mental illness such as major depression. Food and Drug Administration FDA requires manufacturers of drugs with a high risk of serious side effects to provide compliance education to healthcare providers so that they know when the drug is appropriate and when it is not.
Having a history of substance abuse doesn't automatically exclude you from using Tylenol 3 when medically appropriate. It simply indicates a greater need for pre-treatment counseling and medical oversight.
People with untreated alcoholism or substance abuse disorder should not use Tylenol 3. There are certain groups in whom Tylenol 3 should never be used. A great part of the concern is related to the impact of codeine on the respiratory system. Codeine found in certain cough suppressants works by decreasing activity in the part of the brain that triggers the cough reflex. In younger children and people with respiratory illnesses, this action can lead to respiratory depression, hypoxia low blood oxygen , and, in severe cases, death.
Due to the risk of these potentially life-threatening side effects, the FDA contraindicates the use of Tylenol 3 in:. While not contraindicated for use, Tylenol 3 should be used with extreme caution during pregnancy. Doing so may cause neonatal opioid withdrawal syndrome, a condition that can be life-threatening to a newborn. If an opioid of any sort is needed during pregnancy, it is important to speak with your healthcare provider to fully weigh the benefits and risks.
Breastfeeding is not recommended when taking Tylenol 3. Other narcotic analgesic combinations can be used to treat breakthrough pain, although the risk of addiction is generally no less and in some cases greater than with Tylenol 3. These include:. Tylenol 3 is available as a tablet or as an oral solution. Generally speaking, the analgesic effect of Tylenol 3 will reach a peak within two hours of taking a dose and last for between four and six hours. The lowest dose able to deliver pain relief should always be used.
For children 12 and over, the dosage is determined by a healthcare provider. Because the oral solution can be divided into smaller doses, it is more commonly used in smaller or younger children.
Older adolescents and teens may be able to take tablets. When first starting treatment, your healthcare provider will want to monitor for signs of respiratory depression for the first 24 to 72 hours and do the same if the dose is ever increased. This may involve an arterial blood gas test or pulse oximetry to measure oxygen saturation levels.
This is especially important for people with cancer, who are often prescribed the drug to treat chronic pain.
Tylenol 3 can be taken with or without food. If taking the oral solution, be sure to shake the bottle thoroughly before use. Always measure the oral solution with a medication-measuring device, which you can get from your healthcare provider or pharmacist. Ask your doctor or pharmacist how much acetaminophen is safe to take. Do not use with any other drug containing acetaminophen without asking your doctor or pharmacist first.
Check the labels on all your medicines to see if they contain acetaminophen, and ask your pharmacist if you are unsure. Get medical help right away if you take too much acetaminophen overdose , even if you feel well. Daily alcohol use, especially when combined with acetaminophen, may damage your liver. Avoid alcohol. Before using this medication, women of childbearing age should talk with their doctor s about the risks and benefits. Tell your doctor if you are pregnant or if you plan to become pregnant.
During pregnancy, this medication should be used only when clearly needed. It may slightly increase the risk of birth defects if used during the first two months of pregnancy. Also, using it for a long time or in high doses near the expected delivery date may harm the unborn baby.
To lessen the risk, take the smallest effective dose for the shortest possible time. Babies born to mothers who use this drug for a long time may develop severe possibly fatal withdrawal symptoms. Children younger than 12 years should not use products that contain codeine. Also, codeine use is not recommended for children between 12 and 18 years old who are obese or have breathing problems.
Talk with your doctor or pharmacist about the risks and benefits of this medication. This combination medication is used to help relieve mild to moderate pain such as headaches, muscle pain.
It contains an opioid pain reliever codeine , a non-opioid pain reliever acetaminophen , and caffeine. Codeine works in the brain to change how your body feels and responds to pain. Acetaminophen can also reduce a fever. Caffeine increases pain relief, especially for certain types of headaches.
Take this medication by mouth as directed by your doctor, usually every 4 to 6 hours as needed for pain. You may take this drug with or without food. If you have nausea, it may help to take this drug with food. Ask your doctor or pharmacist about other ways to decrease nausea such as lying down for 1 to 2 hours with as little head movement as possible.
The dosage is based on your medical condition and response to treatment. Do not increase your dose or use this drug more often or for longer than prescribed because your risk of side effects may increase. Properly stop the medication when so directed. Pain medications work best if they are used as the first signs of pain occur.
If you wait until the pain has worsened, the medication may not work as well. Suddenly stopping this medication may cause withdrawal, especially if you have used it for a long time or in high doses. To prevent withdrawal, your doctor may lower your dose slowly. When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well.
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.
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. If you miss a dose of the oral solution or tablet, skip the missed dose and go back to your regular dosing schedule. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Acetaminophen and codeine combination oral solution or tablet can cause serious unwanted effects or fatal overdose if taken by children, pets, or adults who are not used to strong narcotic pain medicines.
Make sure you store the medicine in a safe and secure place to prevent others from getting it. 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 store and clinics for take-back locations. You can also check the DEA web site for locations. Here is the link to the FDA safe disposal of medicines website:www. 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. 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. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: slowed breathing, long pauses between breaths, or shortness of breath.
When codeine-containing medication was used in children, serious and life-threatening breathing problems such as slow or difficulty breathing and deaths were reported. Acetaminophen and codeine should not be used in children 12 to 18 years of age who are obese or who have a neuromuscular disease disease that affects the nerves that control voluntary muscles , a lung disease, or obstructive sleep apnea condition in which the airway becomes blocked or narrow and breathing stops for short periods during sleep as these conditions may increase their risk of breathing problems.
Taking too much acetaminophen found in this combination preparation can cause liver damage, sometimes serious enough to require liver transplantation or cause death. You might accidentally take too much acetaminophen if you do not follow the directions on the prescription or package label carefully, or if you take more than one product that contains acetaminophen. Be aware that you should not take more than 4, mg of acetaminophen per day.
Tell your doctor if you have or have ever had liver disease. If you need to take more than one product that contains acetaminophen, it may be difficult for you to calculate the total amount of acetaminophen you are taking. Ask your doctor or pharmacist to help you. Taking certain medications during your treatment with acetaminophen and codeine may increase the risk that you will experience breathing problems or other serious, life threatening breathing problems, sedation, or coma.
Tell your doctor if you are taking or plan to take any of the following medications: certain antifungal medications including itraconazole Onmel, Sporanox , ketoconazole, and voriconazole Vfend ; benzodiazepines such as alprazolam Xanax , diazepam Diastat, Valium , estazolam, flurazepam, lorazepam Ativan , and triazolam Halcion ; carbamazepine Carbatrol, Epitol, Equetro, Tegretol, Teril ; erythromycin Erytab, Erythrocin ; certain medications for human immunodeficiency virus HIV including indinavir Crixivan , nelfinavir Viracept , and ritonavir Norvir, in Kaletra ; muscle relaxants; other pain medications; phenytoin Dilantin, Phenytek ; rifampin Rifadin, Rimactane, in Rifamate ; sedatives; sleeping pills; or tranquilizers.
Your doctor may need to change the dosages of your medications and will monitor you carefully. If you take acetaminophen and codeine with any of these medications and you develop any of the following symptoms, call your doctor immediately or seek emergency medical care: unusual dizziness, lightheadedness, extreme sleepiness, slowed or difficult breathing, or unresponsiveness.
Be sure that your caregiver or family members know which symptoms may be serious so they can call the doctor or emergency medical care if you are unable to seek treatment on your own. Drinking alcohol, taking prescription or nonprescription medications that contain alcohol, or using street drugs during your treatment with acetaminophen and codeine increases the risk that you will experience serious, life-threatening side effects. Do not drink alcohol, take prescription or nonprescription medications that contain alcohol, or use street drugs during your treatment.
Tell your doctor if you are pregnant or plan to become pregnant. If you take acetaminophen and codeine regularly during your pregnancy, your baby may experience life-threatening withdrawal symptoms after birth. Tell your baby's doctor right away if your baby experiences any of the following symptoms: irritability, hyperactivity, abnormal sleep, high-pitched cry, uncontrollable shaking of a part of the body, vomiting, diarrhea, or failure to gain weight.
Your doctor or pharmacist will give you the manufacturer's patient information sheet Medication Guide when you begin treatment with acetaminophen and codeine and each time you refill your prescription.
Read the information carefully and ask your doctor or pharmacist if you have any questions. The combination of acetaminophen and codeine is used to relieve mild to moderate pain. Acetaminophen is in a class of medications called analgesics pain relievers and antipyretics fever reducers. It works by changing the way the body senses pain and by cooling the body.
Codeine belongs to a class of medications called opiate narcotic analgesics and to a class of medications called antitussives. When codeine is used to treat pain, it works by changing the way the brain and nervous system respond to pain.
When codeine is used to reduce coughing, it works by decreasing the activity in the part of the brain that causes coughing. The combination of acetaminophen and codeine comes as a tablet, capsule, and liquid to take by mouth.
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