Skip to Content

Tylenol With Codeine Patient Tips

Medically reviewed on Oct 31, 2017 by C. Fookes, BPharm.

How it works

  • Tylenol With Codeine is a combination acetaminophen/codeine tablet. Acetaminophen and codeine are two different pain-relieving medicines with two different mechanisms of action.
  • Experts aren't sure exactly how acetaminophen works, but suspect it blocks a specific type of cyclo-oxygenase (COX) enzyme, located mainly in the brain. Codeine is metabolized to morphine in the liver through liver enzymes such as CYP2D6. Morphine binds to specific receptors known as opioid receptors that block pain signals on their way to the brain.
  • Tylenol With Codeine belongs to the group of medicines known as combination narcotic analgesics.


  • May be used to relieve mild-to-moderately severe pain. Use is limited by the addiction and dependence potential of codeine; codeine can also cause constipation.
  • Some people find taking fixed-dose combination tablets easier to take than taking two different medicines.
  • Tylenol With Codeine is available as a generic under the name Acetaminophen/Codeine.


If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Stomach upsets including drowsiness and sleepiness, constipation, headache, sometimes abdominal pain or nausea (codeine component).
  • Drowsiness may impair a person's reaction time and affect their ability to drive or operate machinery (codeine component). Avoid alcohol.
  • Codeine is potentially addictive and may be sought out by drug misusers. Do not overuse Tylenol With Codeine. Tolerance can also develop to codeine's analgesic effect and codeine may no longer work at the prescribed dosage.
  • Marked differences may exist in the analgesic effect experienced between individuals due to genetic variations in the way codeine is metabolized to morphine (the active component).
  • Rarely, serious, life-threatening, breathing problems may occur (attributable to the codeine component. Risk is increased with higher dosages).
  • Rarely, liver failure especially at dosages greater than 4000mg/day (acetaminophen component). Avoid taking extra acetaminophen while taking Tylenol With Codeine.
  • People who are ultra fast metabolizers of codeine through CYP2D6 may be at risk of morphine toxicity. Babies exposed to breast milk of rapid codeine metabolizers who are taking Tylenol With Codeine are also at risk of morphine toxicity which may be fatal or life-threatening; symptoms include increased sleepiness, difficulty breastfeeding, breathing difficulties or floppiness - seek urgent medical help if you notice these signs. Avoid taking Tylenol With Codeine if you are breastfeeding or pregnant.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Tylenol With Codeine is an effective combination analgesic for the relief of mild-to-moderately severe pain. However, the codeine component can be addictive and may also cause constipation and/or drowsiness.


  • May be taken with or without food.
  • Short-term use only (typically three days unless your doctor has told you to take for longer). Not recommended for long-term use.
  • May cause drowsiness which may impair reaction skills and affect your ability to drive or operate machinery (codeine component). Avoid alcohol.
  • Different strengths of Tylenol With Codeine are available. These are usually designated numbers (such as #2 or #3). Make sure you take the correct tablet and do not exceed the recommended dosage.
  • Seek urgent medical advice if you experience any breathing difficulties, wheezing, itching, or facial swelling.
  • Keep up your fluid and fiber intake to reduce the risk of developing constipation. Tell your doctor if you experience constipation and consider taking a laxative.
  • Tell your doctor if you think you have become addicted to this combination drug or the usual dosage does not appear to be working.
  • Do not double up on other medications containing either acetaminophen or codeine while taking this combination product. Check product labels thoroughly to ensure these ingredients are not "hidden" in other products.

Response and Effectiveness

  • Peak concentrations of codeine are reached within two hours and the analgesic activity of codeine lasts between four to six hours. Peak effects of acetaminophen (Tylenol) are reached within 30-60 minutes of administration and the analgesic effects of acetaminophen last between three and four hours.


Tylenol with Codeine. Revised 09/2017. Janssen Pharmaceuticals, Inc.

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Tylenol With Codeine only for the indication prescribed.

Copyright 1996-2018 Revision Date: 2017-10-31 23:25:51

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.