Acetaminophen (Tylenol) and Opiod Anagesics
About Your Medicine
Combination medicines containing OPIOID ANALGESICS (O-pE-oid an-al-JEE-zicks) and ACETAMINOPHEN (a-seat-a-MEE-noe-fen) are used to relieve pain.
If any of the information in this leaflet causes you special concern or if you want more information about your medicine and its use, check with your doctor, nurse, or pharmacist.
Remember, keep this and all other medicines out of the reach of children. Never share your medicines with others.
Before Using This Medicine
Tell your doctor, nurse, and pharmacist if you:
▪ Are allergic to any medicine, either prescription or nonprescription
▪ Are pregnant or intend to become pregnant while using this medicine
▪ Are breast-feeding
▪ Are taking any other prescription or nonprescription medicine, especially
carbamazepine, and naltrexone
▪ Have any other medical problems, especially colitis; emphysema, asthma, or
chronic lung disease; heart disease; or hepatitis or other liver disease
Proper Use of This Medicine
Take this medicine only as directed by your medical doctor or dentist. Do not take more of it and do not take it more often or for a longer period of time than directed. All analgesics are best taken before the pain begins to worsen. In some cases, this may mean that the medicine must be taken on a regular daily schedule, rather than on an as needed basis. Small, regular doses will likely provide continuing relief with minimal or no side effects. If you are taking this medicine regularly and you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double doses.
Common Questions or Concerns
If I take the medicine now, will it work if I need it later? (What about tolerance?)
Tolerance occurs when the body adapts to a medicine so that its effectiveness decreases. Tolerance is rarely a problem if the medicine is taken as directed.
Isn't this medicine "habit-forming"? (What about addiction?)
Addiction means a person is taking a medicine to get a “psychological” high, instead of pain relief. It is extremely rare that addiction begins through the use of medicine for pain relief. Addiction is often confused with “physical dependence”. Physical dependence occurs after you have been using an opioid for prolonged periods of time (more than two weeks). Physical dependence is a chemical change your body undergoes which causes withdrawal symptoms if the medicine is abruptly stopped. This is avoided by slowly reducing the medicine over several days.
Remember, once the pain is gone, you will no longer need pain medicine. The medicine can then be slowly discontinued. “Toughing it out” by not taking your medicine until the pain is intense does not decrease the risks of tolerance, addiction, or physical dependence, but only subjects you to unnecessary pain.
Precautions While Using This Medicine
CHECK THE LABELS OF ALL NONPRESCRIPTION AND PRESCRIPTION MEDICINES YOU NOW TAKE. If any contain acetaminophen or an opioid, be especially careful, since taking them while taking this medicine may lead to overdose. Do not take 4000mg of acetaminophen within a 24-hour period.
This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system). Check with your doctor before taking any such depressants while you are using this medicine. Do not drink alcohol while taking these medicines.
This medicine may cause some people to become drowsy, dizzy, or lightheaded, or to feel a false sense of well-being. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert and clearheaded.
If you have been taking this medicine regularly for several weeks, do not suddenly stop taking it without first checking with your doctor. Your doctor may want you to slowly reduce the amount you are taking before stopping completely.
If too much acetaminophen is taken above the amount prescribed, it may lead to medical problems because of an overdose. If the prescribed amount does not relieve your pain, call your doctor or nurse.
IF YOU THINK YOU OR SOMEONE ELSE MAY HAVE TAKEN AN OVERDOSE, GET EMERGENCY HELP AT ONCE. Taking an overdose or taking alcohol or CNS depressants with this medicine may lead to unconsciousness or death.
Possible Signs of Overdose
▪ Convulsions (seizures)
▪ Severe nervousness or restlessness, dizziness, drowsiness, or weakness
▪ Unusually slow or troubled breathing
Possible Side Effects of this Medicine
Drowsiness: This usually passes within a few days of starting your medicine.
▪ Avoid situations in which you might hurt yourself or others.
▪ Wait a few days to see if it disappears.
▪ Ask your doctor about a small decrease in the dose.
Constipation: This is a very common side effect. The medicine slows down passage of stool along the intestinal tract which causes it to become hard as more liquid is absorbed.
▪ Drink liquids. Eight to ten glasses of assorted fluids a day will help.
▪ Try to eat foods that are high in fiber or roughage. Fresh fruits, vegetables
and bran are very good.
▪ If you are able, moderate exercise like walking can help.
▪ A stool softener or gentle laxative may be needed. Ask your doctor, nurse,
or pharmacist to recommend one. If you are taking your pain medicine on a
regular basis, consider starting a stool softener as soon as you start the pain
medicine. Constipation is easier to prevent than treat.
Nausea and Vomiting: This problem may occur when opioids are first used. This problem most often disappears within a few days.
▪ Try taking the medicine with food
▪ Ask your doctor to prescribe a different opioid or add a medicine to counteract
the nausea and vomiting.
Dry Mouth: This medicine may cause a decrease in the amount of saliva in your mouth.
▪ Drink liquids, mainly water.
▪ Chew on pieces of chopped or crushed ice.
▪ Suck on hard candy.
▪ Avoid commercial mouthwashes that contain drying substances such as
alcohol or salt. One teaspoon of baking soda in 1 cup of warm water is a safe
and effective mouthwash.
Serious side effects can go with overmedication. Tell your doctor right away if you have
▪ Inability to stay awake
▪ Breathing difficulties (slow or shallow)
▪ Blurred or double vision
▪ Tremors or seizures
▪ Unusually slow heartbeat or pulse rate
Other side effects not listed above may also occur in some patients and should be reported to your doctor.
Call your doctor right away if any of these side effects occur.
▪ Severe pain or tenderness in the stomach
▪ Yellow skin or eyes
▪ Extreme tiredness, weakness, dizziness, confusion, or hallucinations
▪ Shortness of breath or trouble breathing
▪ Trouble swallowing, chest tightness
▪ Swelling of eyelids or face
▪ Intense itching or rash
If you have problems with these less serious side effects, talk with your doctor.
• Mild stomach pain, heartburn, appetite loss
• Dizziness, nervousness
• Headache, blurred vision
If you have other side effects that you think are caused by this medicine, tell your doctor.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 09/19/2012
Copyright © 09/19/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4849
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