Acetaminophen and Codeine is a combination analgesic medication composed of two ingredients: the non-steroidal anti-inflammatory drug "Acetaminophen" and the opioid analgesic "Codeine." This medication is primarily used to relieve moderate to severe pain, such as post-surgical pain, chronic osteoarthritis, or cancer-related pain. The combination of these two components produces a synergistic effect: Acetaminophen reduces inflammation, while Codeine acts on the central nervous system to diminish pain perception, providing a more comprehensive pain relief.
This medication must be prescribed by a physician and cannot be purchased or adjusted independently. Strict adherence to the prescribed dosage is essential, as Codeine has addictive potential and respiratory depression risks. Long-term or excessive use may lead to serious complications. The medication is usually supplied in oral tablets or liquids, with specific dosing adjusted according to the patient's age, weight, and severity of the condition.
This combination drug may have different brand names in various countries or regions. Common brands include:
The generic name is "Acetaminophen and Codeine." The ingredient ratios may vary depending on the formulation; always confirm the specific content on the medication label provided by the pharmacist.
This medication falls under the category of "Opioid Combination Analgesics," with Codeine classified as a mild opioid analgesic (weak opioid receptor agonist), and Acetaminophen as a non-steroidal anti-inflammatory drug (NSAID). The combination provides both peripheral and central pain relief effects, suitable for cases requiring enhanced analgesia.
Such drugs are classified as controlled substances because of their opioid content, which may lead to dependency. In Taiwan and Hong Kong, this medication can only be purchased with a prescription issued by a licensed healthcare provider.
Primarily used to treat moderate to severe acute and chronic pain. Common indications include:
This medication is not suitable for mild pain or long-term chronic pain management. Physicians will decide whether to prescribe based on pain assessment tools such as the Visual Analog Scale (VAS). It should not be combined with other opioids to avoid increased central nervous system depression risks.
Mild side effects include:
Severe side effects require immediate medical attention:
Patients who should avoid this medication include:
Black Box Warning: The U.S. FDA explicitly states that this medication may cause respiratory depression and addiction, especially with prolonged use exceeding three weeks. Pregnant women should weigh the risks and benefits; use during the second and third trimesters may increase the risk of neonatal respiratory depression.
Concurrent use with the following medications may enhance side effects:
Combining with anticoagulants (such as warfarin) may increase bleeding risk. Alcohol consumption should be avoided during treatment, as it can exacerbate liver toxicity. Consult a healthcare professional before using herbal supplements (such as honeysuckle or fish oil), as some natural products may affect liver metabolism pathways.
The typical adult dose is 1-2 tablets every 4-6 hours, with a maximum daily dose of:
Swallow tablets whole; do not chew. Taking with food can reduce gastrointestinal discomfort. Dose adjustments are necessary for patients with liver or kidney impairment. Children and elderly patients should start with a lower dose and be closely monitored. Do not split tablets or combine with other analgesics.
If a dose is missed, follow these principles:
If double dosing occurs accidentally, seek medical attention immediately to prevent acute liver damage or respiratory depression. Consider setting medication reminders and store medications safely out of children's reach.
In case of suspected overdose, immediately:
Signs of acute poisoning include: deep coma, pinpoint pupils, and respiratory rate below 8 breaths per minute. Overdose of Acetaminophen can cause liver failure; antidote (acetylcysteine) should be administered within 6 hours.
How can I avoid the risk of overdose when taking combination products of Acetaminophen and Codeine?
Use strictly according to the dosage instructions provided by your healthcare provider or pharmacist. Do not increase the dose or frequency on your own. If you miss a dose, determine whether to take a replacement based on the drug’s half-life, and avoid concomitant use of other Acetaminophen-containing medications (such as cold remedies) to reduce liver toxicity risk.
What should I do if I experience dizziness or drowsiness while using this medication?
Codeine may cause central nervous system depression, leading to dizziness or drowsiness. Avoid operating machinery or driving during treatment. If symptoms are severe or persistent, stop medication and consult your healthcare provider for possible dose adjustment.
What interactions should I be aware of when combining with other painkillers or herbal medicines?
This medication should not be combined with other opioids or excessive Acetaminophen preparations, as it may cause respiratory depression or liver damage. When using herbal medicines, inform your healthcare provider of the ingredients, especially those containing opioids, to avoid additive effects.
How should liver function be monitored during long-term use?
Long-term use may increase the risk of liver damage. Liver function tests should be performed every 3-6 months. If symptoms such as jaundice, dark urine, or right upper quadrant pain occur, discontinue medication and seek medical evaluation.
Does use during breastfeeding affect the infant?
Codeine can be secreted into breast milk and may cause respiratory depression in the infant. Breastfeeding women should consult their healthcare provider to weigh the risks and benefits. If necessary, breastfeeding may need to be temporarily stopped or alternative medications considered. Monitor the infant for signs of drowsiness or poor sucking reflex.
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