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  • If you experience mild to moderate pain, your health care provider may prescribe Tylenol With Codeine. When taken as prescribed, this combination drug can provide great relief.

    Unfortunately, some people abuse Tylenol with codeine to feel euphoric or “high.” Abuse can lead to addiction and overdose. If you or someone you love misuses this medicine, it’s important to seek medical help. 

    What Is Tylenol With Codeine?

    As its name suggests, Tylenol with codeine consists of two medications: acetaminophen (brand name Tylenol) and codeine. 

    It comes in two formulations:

    • Tylenol 3, which contains 300mg of Tylenol and 30mg of codeine
    • Tylenol 4, which contains 300 mg of Tylenol and 60mg of codeine 


    Tylenol is a pain reliever (analgesic) and fever reducer (antipyretic). It cools the body and alters the way it processes pain to reduce problems like headache, sore throat, muscle aches, and menstrual cramps.


    Like Tylenol, codeine is a pain reliever (analgesic). It’s also a cough suppressant (antitussive). It belongs to a group of natural opioids called opiates, which are derived from the opium poppy plant. 

    Codeine reduces pain and suppresses cough by impacting the brain and central nervous system (CNS).

    While Tylenol by itself is available over the counter, Tylenol with codeine requires a prescription. That’s because, like other opioids, codeine can be addictive. 

    Side Effects Of Tylenol With Codeine

    Possible side effects of Tylenol With Codeine include:

    • constipation
    • trouble urinating
    • drowsiness 
    • dizziness
    • stomach pain
    • headache

    Call your doctor if you experience more serious side effects, such as:

    • confusion    
    • loss of appetite
    • extreme drowsiness
    • shallow breathing, noisy breathing, or other breathing problems
    • loss of coordination
    • jaundice (yellowing of the skin or eyes), which could indicate liver damage
    • fainting
    • hallucinations (hearing, seeing, or feeling things that aren’t there)
    • increased heart rate

    People who live with substance use disorder, liver disease, kidney disease, or issues with the pancreas, gallbladder, and thyroid are more likely to experience these serious side effects. 

    In addition, codeine can pass into breast milk and cause breathing problems, extreme drowsiness, confusion, and other side effects in breastfed infants. 

    The United States Food and Drug Administration (FDA) recommends not taking Tylenol with codeine while breastfeeding. 

    Tylenol With Codeine Abuse & Addiction

    When taken at high doses, codeine can produce a sense of relaxation and euphoria, also called a “high.” That’s why some people abuse Tylenol with codeine. Abuse occurs when you take it in a manner not prescribed by your doctor. 

    For example, you may:

    • take it at higher doses than prescribed
    • take it more frequently than prescribed
    • take it without a prescription
    • mix it with other drugs, such as alcohol or marijuana

    As with most forms of drug abuse, continued abuse of Tylenol with codeine can lead to addiction. 

    Signs Of Codeine Addiction

    If you’re wondering whether you or someone you know is addicted to Tylenol with codeine, look for these signs:

    • tolerance (needing increasingly higher doses of the drug to feel effects once felt at lower doses)
    • physical dependence (experiencing unpleasant withdrawal symptoms when trying to stop using the drug) 
    • avoiding friends and family to spend more time getting and using the drug
    • avoiding responsibilities at work or school to spend more time getting and using the drug
    • visiting multiple doctors to get multiple prescriptions of the drug, also called “doctor shopping”
    • needing the drug to get through the day
    • wanting to stop using the drug but feeling unable to do so

    Tylenol With Codeine Withdrawal Symptoms

    When you abuse or are addicted to Tylenol with codeine, you may experience withdrawal symptoms when you try to stop using the medication. 

    Symptoms may include:

    • anxiety
    • irritability
    • restlessness
    • watery eyes
    • runny nose
    • loss of appetite
    • nausea and/or vomiting
    • diarrhea 
    • excessive yawning
    • sweating
    • chills
    • enlarged pupils
    • faster breathing and/or heartbeat

    Whether you have a prescription or not, talk to a doctor before you try to stop using it. The doctor will help you avoid or decrease withdrawal symptoms by gradually reducing your dosage. This process, known as “tapering,” lets your body slowly adjust to life without the drug. 

    Acetaminophen & Codeine Overdose

    When you abuse Tylenol with codeine, you face the risk of overdose. Overdose can occur when you take a higher dose than prescribed or mix the medication with other drugs. 

    Signs of overdose may include:

    • sleepiness
    • nausea and/or vomiting
    • cold, clammy skin
    • sweating
    • shallow breathing, noisy breathing, or other breathing problems
    • lightheadedness 
    • fainting
    • low blood pressure
    • slowed heartbeat
    • loss of consciousness

    A Tylenol with codeine overdose can be fatal. Seek emergency medical attention immediately if you or someone you know experiences the above symptoms. 

    In most cases, the person who overdosed will be given naloxone, which is an opioid antagonist that can quickly reverse the deadly effects of overdose. 

    The risk of overdose increases if you drink alcohol while taking Tylenol with codeine or if you mix it with drugs that cause sedation. These drugs include benzodiazepines such as Xanax (alprazolam), Klonopin (clonazepam), and Ativan (lorazepam).

    Treatment Options For Tylenol With Codeine Addiction

    Recovering from an addiction to a prescription pain medication can just be as difficult as recovering from an addiction to an illegal drug. That’s why you should seek help from experienced health care professionals. 

    Medical Detox

    Most people addicted to Tylenol with codeine will need to undergo supervised medical detox. During this process, a team of medical professionals will gradually reduce your dosage until you’re fully weaned off the drug.

    As you detox, your doctors will give you and your loved ones important medical advice to keep you as healthy and comfortable as possible. For example, you may be given medications to lessen the adverse effects of withdrawal. 


    Various types of therapy can support your recovery and help you avoid relapse. 

    In individual therapy, for instance, you and a mental health care professional will work together to identify relapse triggers and find healthy ways to cope. 

    You may also benefit from group therapy, where you can share your experiences with others who are addicted to opioid pain medicines. 

    Inpatient Treatment

    If your doctor determines that your addiction is severe, you may need to stay at an inpatient treatment center. There, you can undergo medical detox and attend therapy in a safe, supervised environment. 

    Before you leave the center, you and your treatment team will design a personalized treatment plan to reduce the risk of relapse. The plan will likely include ongoing therapy and support.

    If you or a loved one is abusing or addicted to Tylenol with codeine, please contact an Ark Behavioral Health specialist to learn more about our treatment options.

    Tylenol With Codeine FAQ

    Is Tylenol With Codeine #3 A Controlled Substance?

    Due to its potential for abuse, Tylenol (acetaminophen) with codeine #3 is classified as a Schedule III controlled substance.

    Read Is Tylenol With Codeine #3 A Controlled Substance? to learn more

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Accessdata.fda.gov - Drugs@FDA: FDA-Approved Drugs
    University of Michigan: Michigan Medicine - Acetaminophen and Codeine
    U.S. National Library of Medicine: MedlinePlus - Acetaminophen and Codeine
    U.S. National Library of Medicine: MedlinePlus - Opiate and opioid withdrawal

    Medically Reviewed by
    Kimberly Langdon M.D.
    on October 30, 2020
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