Drugs & Vitamins

Active Ingredients: Acetaminophen and Codeine
Other Names: APAP and Codeine Tablets, Tylenol No. 3, Tylenol No. 4, Vopac Tablets
Drug Class: Narcotic Combinations
Rx Status: Available by prescription only
Generic Available: Yes
Product Images & Descriptions:

What is/are Tylenol No. 4? (Back to top)
ACETAMINOPHEN; CODEINE is a pain reliever. It is used to treat mild to moderate pain. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care providers before I take this medicine? (Back to top)
They need to know if you have any of these conditions:

• brain tumor
• Crohn's disease, inflammatory bowel disease, or ulcerative colitis
• drink more than 3 alcohol containing drinks per day
• drug abuse or addiction
• head injury
• heart or circulation problems
• kidney disease or problems going to the bathroom
• liver disease
• lung disease, asthma, or breathing problems
• an unusual or allergic reaction to acetaminophen, codeine, salicylates, other opioid analgesics, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine? (Back to top)
Take this medicine by mouth with a full glass of water. Follow the directions on the prescription label. If the medicine upsets your stomach, take the medicine with food or milk. Do not take more medicine than you are told to take.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

Note: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose? (Back to top)
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine? (Back to top)

• alcohol or medicines that contain alcohol
• antihistamines
• benztropine
• drugs for bladder problems like solifenacin, trospium, oxybutynin, tolterodine, hycosamine, and methscopolamine
• drugs for breathing problems like ipratropium and tiotropium
• drugs for certain stomach or intestine problems like propantheline, homatropine methylbromide, glycopyrrolate, atropine, belladonna, and dicyclomine
• medicines for depression, anxiety, or psychotic disturbances
• medicines for pain like pentazocine, buprenorphine, butorphanol, nalbuphine, tramadol, and propoxyphene
• medicines for sleep
• muscle relaxants
• naltrexone
• phenothiazines like perphenazine, thioridazine, chlorpromazine, mesoridazine, fluphenazine, prochlorperazine, promazine, trifluoperazine
• scopolamine
• trihexyphenidyl

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What side effects may I notice from this medicine? (Back to top)
Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• breathing difficulties, wheezing
• confusion
• light headedness or fainting spells
• severe stomach pain
• yellowing of the skin or the whites of the eyes

• dizziness
• drowsiness
• nausea, vomiting

This list may not describe all possible side effects.

What should I watch for while using this medicine? (Back to top)
Tell your doctor or health care professional if your pain does not go away, if it gets worse, or if you have new or a different type of pain. You may develop tolerance to the medication. Tolerance means that you will need a higher dose of the medication for pain relief. Tolerance is normal and is expected if you take the medicine for a long time.

Do not suddenly stop taking your medicine because you may develop a severe reaction. Your body becomes used to the medicine. This does NOT mean you are addicted. Addiction is a behavior related to getting and using a drug for a non medical reason. If you have pain, you have a medical reason to take pain medicine. Your doctor will tell you how much medicine to take. If your doctor wants you to stop the medicine, the dose will be slowly lowered over time to avoid any side effects.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

The medicine will cause constipation. Try to have a bowel movement at least every 2 to 3 days. If you do not have a bowel movement for 3 days, call your doctor or health care professional.

Do not take Tylenol (acetaminophen) or medicines that have acetaminophen with this medicine. Too much acetaminophen can be very dangerous. Many nonprescription medicines contain acetaminophen. Always read the labels carefully to avoid taking more acetaminophen.

Immediately call your physician or get emergency help if you are breast-feeding and your baby is sleepier than usual, is limp, or has difficulty breastfeeding or breathing.

Where should I keep this medicine? (Back to top)
Keep out of the reach of children. This medicine can be abused. Keep your medicine in a safe place to protect it from theft. Do not share this medicine with anyone. Selling or giving away this medicine is dangerous and against the law.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light. Keep container tightly closed. Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Last Updated:April 03, 2008

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