Acetaminophen and codeine overdose
Acetaminophen (Tylenol) and codeine is a prescription pain medicine. It is an opioid pain reliever used only for pain that is severe and is not helped by other types of painkillers.
Acetaminophen and codeine overdose occurs when someone takes more than the normal or recommended amount of this medicine, either by accident or on purpose.
This article is for information only. Do not use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Overdose
An overdose is when you take more than the recommended amount of something, often a medicine or drug. An overdose may result in serious, harmful sym...
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Acetaminophen combined with codeine
Where Found
Acetaminophen with codeine is commonly sold under the name Tylenol #3.
Symptoms
Below are symptoms of an overdose of acetaminophen combined with codeine in different parts of the body.
AIRWAYS AND LUNGS
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Shallow breathing
Shallow breathing
Most people take breathing for granted. People with certain illnesses may have breathing problems that they deal with on a regular basis. This arti...
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Slow and labored breathing
Slow and labored breathing
Most people take breathing for granted. People with certain illnesses may have breathing problems that they deal with on a regular basis. This arti...
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EYES
- Very small pupils
HEART AND BLOOD VESSELS
- Low blood pressure
NERVOUS SYSTEM
- Coma (lack of responsiveness)
- Convulsions (seizures)
Seizures
A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...
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Drowsiness
Drowsiness
Drowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep when they do not want to or at times whic...
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SKIN
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Bluish skin (fingernails and lips)
Bluish skin
A bluish color to the skin or mucous membrane is usually due to a lack of oxygen in the blood. The medical term is cyanosis.
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- Heavy sweating
STOMACH AND GASTROINTESTINAL SYSTEM
- Nausea and vomiting
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Spasms of the stomach and intestines
Spasms
Muscle cramps are when a muscle gets tight (contracts) without you trying to tighten it, and it does not relax. Cramps may involve all or part of on...
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URINARY SYSTEM
- Kidney failure
Home Care
Seek medical help right away. This type of overdose can cause death. Do not make the person throw up unless poison control or a health care provider tells you to.
Before Calling Emergency
Have this information ready:
- The person's age, weight, and condition
- Name of the medicine and the strength of the medicine (if known)
- Time it was swallowed
- Amount swallowed
- If the medicine was prescribed for the person
Poison Control
Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.
Poison control center
For a POISON EMERGENCY call:1-800-222-1222ANYWHERE IN THE UNITED STATESThis national hotline number will let you talk to experts in poisoning. This ...
Read Article Now Book Mark ArticleThis is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
What to Expect at the Emergency Room
Take the container with you to the hospital, if possible.
Your provider will measure and monitor your vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated. You may be admitted to the hospital.
Tests that may be done include:
- Blood and urine tests
- Chest x-ray
- CT scan (advanced imaging) of the brain
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Electrocardiogram (ECG)
Electrocardiogram
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
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Treatment may include:
- Activated charcoal
- Breathing support, including oxygen, tube through the mouth into the lungs, and breathing machine (ventilator)
- Fluids through a vein (IV)
- Laxative
- Medicine to reverse the effects of the overdose and treat symptoms.
If there is a high level of acetaminophen in the blood, the person will be given N-acetyl cysteine (NAC) as soon as possible.
This medicine is called an antidote. It counteracts the effects of the acetaminophen. Without it, deadly liver failure may occur. Several doses may be required until the blood level drops to a safer value.
If there are signs of a severe opioid overdose, the antidote naloxone will be given.
Outlook (Prognosis)
How well a person does, depends on the amount of medicine swallowed and how quickly the treatment was received. The faster a person gets medical help, the better the chance for recovery. If breathing has been depressed for a long period before treatment, brain injury may occur.
If an antidote can be given, recovery from an acute overdose often occurs within 24 to 48 hours. Recovery takes longer, if the liver is affected, and the person may not fully recover.
Acute
Acute means sudden. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.
Read Article Now Book Mark ArticleReviewed By
Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Aronson JK. Opioid receptor agonists. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:348-380.
Ganetsky M. Acetaminophen. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 138.
Hatten BW. Aspirin and nonsteroidal agents. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 139.
Nikolaides JK, Thompson TM. Opioids. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 151.
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