Management of pain requires intake of pain relievers. These drugs are available both as over the counter (OTC) as well as prescription medications. People use OTC drugs such as nonsteroidal anti-inflammatory drugs (NSAIDS like naproxen, ibuprofen, etc.) as well as drugs like acetaminophen to reduce pains. Under the category of prescribed drugs, doctors widely recommend opioid medications, anticonvulsants, antidepressants and a few types of steroids like corticosteroids, etc. Tylenol 3 is a combination of two types of pain killing substances. Its use though is known to trigger a few adverse side effects. It is necessary to know about its side effects and possible allergic reactions before starting a medication plan.

The prescribed variant of over the counter (OTC) drug Tylenol is known as Tylenol 3. This variant contains an opioid drug known as codeine. The other drug present in Tylenol 3 is acetaminophen – another widely used pain relieving substance. The chief function of acetaminophen is to bring down pain levels as well as decrease fever. It is used for a range of discomforts including pain in your lower back, toothache, headache, muscular pains as well as sore throat. It is also known to reduce fever.

Codeine belongs to another class of drugs called as opiate or narcotic medications. It is used mainly for the treatment of milder to moderate levels of pains. The efficacy of codeine is known to improve when blended with acetaminophen (this blend is called Tylenol 3) or with other non-steroidal anti-inflammatory drugs – NSAIDs like aspirin, naproxen, etc. You may need to remember that codeine mainly offers relief from symptoms than working on the real cause that triggers the pain. This drug works on transmitters in the brain and changes the way your body experiences pain.

Dosage of Tylenol 3 is based on your clinical condition as well as your body’s responses to the drug. However, it is not a good practice to increase the dosage levels or frequencies of doses without consulting your treating doctor. Doses need to be discontinued immediately if your physician advises you to stop taking them. This medicine is taken orally either without or with food. People with nausea are advised to consume it along with a meal. You can also manage nausea by resting (lying flat on your back) for a couple of hours. At times, this medication is also administered in its liquid form; in such cases, you are advised to consume carefully measured quantities. Doses of liquid forms of Tylenol 3 may need to be measured only with a spoon provided along with the drug.

Side effects of Tylenol 3

Common side effects of Tylenol 3 are drowsiness, difficulties to pass stool (constipation), vomiting, nausea as well as being lightheaded or drowsy. A few of these discomforts may last only for a very short term; as soon as your body gets used to the ingredients of the drug, some of these adverse effects may cease to show up. However, if these side effects continue for a longer time, you need to consult your treating doctor or the pharmacist without delay.

Your doctor may recommend a few ways to counter the side effects of Tylenol 3. For instance, episodes of dizziness can be countered by lying down or rising slowly from a seated position. Difficulties to pass stool (i.e., constipation) can be managed by eating foods that contain a lot of fiber in them, working out regularly as well as drinking a lot of fluids. If difficulties continue for long, your treating physician may administer a laxative. Foremost of all things, you need to know that this drug is prescribed to you as its benefits exceed the side effects it causes. It is also a fact that most people who took the drug have not reported major side effects.

A few serious side effects of Tylenol 3

As mentioned, this drug is unlikely to trigger serious side effects. However, if you experience side effects such as mood shifts including depression or restlessness, pain in abdomen, sleep related problems such as sleep apnea, etc., erratic heartbeats, difficulties experienced while passing urine or blurring of vision, you need to inform your treating physician. In some people, this drug may trigger symptoms related to malfunctioning of adrenal gland; the condition may show up as loss of bodyweight, unexplained spell of weariness, decreased level of appetite, etc. Extremely serious reactions may also include severe dizziness, persistent spell of drowsiness, epileptic fits and fainting. These side effects require medical help on an emergency basis.

Likely side effects of codeine

A key ingredient of this drug – i.e., codeine – transforms into morphine (an opioid) as soon as it is absorbed into your system. As the rate at which this change occurs varies from one person to another, the side effects may also vary. If your body processes codeine too very soon, you are likely to experience acute levels of drowsiness, being in a confused state of mind, respiratory problems such as slower rate of breathing, etc. You are advised to get in touch with 911 if you experience any of these discomforts.


It is highly recommended to inform your treating doctor and pharmacist about any known allergies or hypersensitivity associated with the intake of codeine or acetaminophen. In general, allergic reactions linked to the intake of this drug are very remote. But, if you witness rashes on skin, inflammation of facial parts, an acute episode of dizziness, breathing problems or difficulties such as wheezing and gasping, you need to contact your treating doctor or pharmacist without delay. Some people may be allergic to other chemicals or inactive substances present in opioid drugs. If you have known allergies to such inactive chemicals, it is a good practice to tell your pharmacist about them.

Withdrawal symptoms

This medication can be habit forming and hence may lead to an addiction. Discontinuing this drug all of a sudden can trigger a few withdrawal symptoms. Hence, it is advised to decrease the dosages gradually over a period of time. You may need to remember that a long term intake of this drug can make it ineffective; this is because your body gets used to the doses. You are advised to take this medicine strictly as per the medication plan prescribed to you. It is also a good practice to talk to your treating doctor if your pain level is increasing or if the discomforts persist at the same level. The common signs of withdrawal of Tylenol 3 include sleeping problems, mood shifts such as depression, thoughts about suicide, nausea, muscular spams, cramping, etc.

Prior medical conditions and possible side effects of Tylenol 3

Always remember to inform the pharmacist and your treating doctor about the clinical history as well as your family’s medical history. If you have had prior head injuries or epilepsy, your doctor needs to know about them. Never forget to report conditions such as internal blockages, difficulties to pass stools, urinary disorders, diseases in your gallbladder or mood related problems such as depression and being in a confused frame of mind. The medical team needs to know if you are addicted to substances such as alcohol or drugs and if you had prior incidence of renal problems, hepatic disorders or weight management issues.

If you are diabetic, liquid forms of Tylenol 3 must be taken with needful caution; this is because of the sizable levels of alcohol and sugars in such liquids. Similar levels of caution are needed if you are dependent on alcohol or addicted to drugs.

General precautions to be taken before consuming Tylenol 3

If you are planning to become pregnant or already pregnant, you are advised to take this drug only after consulting with your physician. As the drug may injure the fetus, this drug is generally not prescribed to women who are already pregnant. Also, if you are nursing a baby, it is not advised to consume this drug. This is because of the risks of active substances in it can pass through mother’s milk. Babies who drink such milk may experience additional hours of sleep, respiratory problems as well as difficulties associated with feeding.

Precautions for old people

Management of pain for elderly or older people may require additional care. Older people may turn allergic or hypersensitive to Tylenol 3. You may need to be cautious of possible side effects such as excessive drowsiness or acute dizziness, changes in respiratory cycles (marked by shallow or slower breathing patterns) and confusion. Upon noticing any one or more of these signs, it is a good practice to consult the treating doctor or pharmacist at the earliest possible time.

Sleep-inducing medications

You may need to exercise more caution while taking Tylenol 3 along with drugs that can induce sleep or dizziness. If administered with such sleep-inducing medications, you run the risk of fainting or passing out. So, it is important to inform your physician if you are taking opioid-based cough medicines or any pain-relieving drugs. Examples of these drugs include hydrocodone, morphine, lorazepam, alprazolam, etc. You may also need to be cautious about taking anticonvulsants, antiepileptic drugs (like phenytoin and carbamazepine) as well as muscle-relaxants such as cyclobenzaprine.

Interactions with other drugs and reagents used for a few lab tests

Tell your doctor and pharmacist if you are consuming antifungal drugs of the azole genre or antibiotics (of the macrolide category) such as erythromycin. Tylenol 3 may also interact adversely with drugs such as rifampin, rifabutin and in general, with those belonging to a class of medications known as rifamycin. Tylenol 3 may work adversely with antidepressant drugs such as fluoxetine (which is a selective serotonin reuptake inhibitor – SSRI), bupropion (a drug used for restoring a right balance of brain chemicals such as norepinephrine and dopamine).

Tylenol 3 may work with a few lab reagents and can lead to false results. It is known to work actively with reagents used in tests done to detect the levels of lipase / amylase in your blood. It is hence essential to tell the medical team at the lab about intake of Tylenol 3.

Side effects of an overdose

An overdose of Tylenol 3 can trigger several serious side effects like excessive sweating, pain in abdomen, acute levels of weariness or coma. So, if you experience breathing problems or fainting, you are advised to seek medical attention immediately. In the US, you can call 911. If you live in Canada, you can contact a local poison control center or get in touch with Health Canada on an emergency basis.

In sum, the most common side effects of Tylenol 3 are vomiting, nausea, drowsiness, difficulties to pass stool as well as drowsiness. Once your body gets familiar with this drug’s ingredients, most of these effects may stop. But, if they persist for a long time, you are advised to talk to your treating physician or pharmacist immediately.


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