Updated on February 6, 2024
5 min read

Is Tylenol 3 (Acetaminophen and Codeine) Addictive?

Key Takeaways

What is Tylenol with Codeine #3?

Tylenol with codeine #3 is the brand name for the combination drug of codeine/acetaminophen or codeine/paracetamol. It treats mild, moderate, and sometimes severe pain, especially when non-steroidal anti-inflammatory drugs (NSAIDs) don’t provide relief.1

Acetaminophen adjusts the way the body senses pain and cools it down. Meanwhile, codeine changes how the brain and nervous system respond to pain. It’s an opiate that has significant side effects of nausea and constipation.

Is Tylenol 3 a Narcotic?

Codeine is a narcotic pain reliever. That makes Tylenol #3 a narcotic-analgesic combination.

Codeine targets the central nervous system to alleviate pain. However, long-term use of codeine can lead to addictive tendencies, resulting in both psychological and physical dependence.


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Is Tylenol 3 Addictive?

Although Tylenol #3 has a low potential for addiction, it can still occur. Codeine, the drug’s narcotic substance, can lead to opioid addiction, abuse, and misuse.4,5 

Stopping this medication may also cause withdrawal symptoms similar to those from narcotic substances like hydrocodone and oxycodone. High doses and long-term use of codeine phosphate can lead to dependency and liver damage. 

Because of this, doctors assess each person’s risk before prescribing this medication. Combination products with codeine are only available through a prescription in the United States and the United Kingdom.

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What are Tylenol #3 Addiction Symptoms?

Addiction to Tylenol #3 can lead to harmful side effects. With long-term use, the combination can cause serious liver damage. 

Sometimes this is serious enough to cause death or require liver transplantation. As such, you should always follow medical advice from a doctor. 

Side effects and symptoms of Tylenol-codeine abuse include:3

  • Mental illnesses such as anxiety or depression 
  • Mood disorders
  • Sleep apnea
  • Nodding off 
  • Loss of appetite 
  • Weight loss 
  • Clammy hands or feet 
  • Stomach pain 
  • Constipation 
  • Itching 
  • Slow breathing 
  • Vision changes

What are Tylenol #3 Overdose Symptoms?

If you take a dose of acetaminophen and codeine that’s higher than recommended, you can experience an opioid overdose. When this happens, you should seek medical attention immediately.

Tylenol with codeine can lead to serious or life-threatening breathing problems. This is primarily during the first 24 to 72 hours of treatment and any time the dose increases.1

The symptoms of a Tylenol-codeine overdose include:3,6

  • Nausea 
  • Vomiting 
  • Loss of appetite 
  • Increased sweating 
  • Unusual bleeding or bruising 
  • Pain in the upper right area of the stomach 
  • A yellowing skin reaction
  • Difficulty breathing 
  • Sleepiness 
  • Lightheadedness
  • Loss of consciousness 
  • Loss of muscle tone 
  • Narrowed or widened pupils 
  • Cool and clammy skin 
  • Fainting 
  • Slow heartbeat
  • Acute liver failure (after several days of very high doses) and death

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What are the Side Effects of Tylenol #3?

Tylenol with codeine can cause mild and severe side effects. Mild side effects include constipation and difficulty urinating.

More serious side effects include:1

  • Nausea
  • Vomiting
  • Loss of appetite
  • Weakness or dizziness 
  • Lightheadedness
  • Irritability 
  • Hallucinations 
  • Fever
  • Increased sweating
  • Confusion
  • Increased heartbeat
  • Shivering
  • Severe muscle stiffness or twitching
  • Diarrhea 
  • Red, peeling, or blistering skin
  • Rashes 
  • Hives 
  • Itching 
  • Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs 
  • Difficulty breathing
  • Difficulty swallowing
  • Irregular menstruation 
  • Lack of sexual desire

If any of these symptoms are severe or persist, contact a doctor or call for emergency medical help as soon as possible.

Can Tylenol 3 Interact with Other Drugs?

Yes, certain drugs can interact with Tylenol #3 and cause severe life-threatening side effects. These drugs include:3

  • Breathing problems
  • Serotonin syndrome
  • Sedation
  • Coma

If you’re taking Tylenol #3 for pain, avoid drinking alcohol or prescription drugs. You should also avoid over-the-counter medications and stop consuming tobacco. Follow your doctor’s instructions carefully regarding this medication.

What Drugs Interact With Tylenol #3?

Before taking Tylenol #3, inform your doctor if you take any of the following medications:3

  • Certain antifungal medications (e.g. itraconazole, ketoconazole, and voriconazole)
  • Benzodiazepines (e.g. Xanax, diazepam, estazolam, flurazepam, lorazepam, and triazolam)
  • Carbamazepine
  • Erythromycin 
  • Certain medicines used for HIV (e.g. indinavir, nelfinavir, and ritonavir)
  • Muscle relaxants 
  • Blood pressure medication
  • Other pain medications, including phenytoin, rifampin, oxycodone, and hydrocodone 
  • Sedatives

For more information about the acetaminophen and codeine pain medication combination, read the medication guide provided by your healthcare provider. You should also check the drug information on the prescription label. 

Who is at Risk When Using Tylenol #3?

Depending on a few factors, your doctor will have to weigh the risks and benefits of using Tylenol with codeine.

People with the following conditions should use Tylenol 3 carefully due to the increased risk of experiencing more serious side effects:3 

  • Allergies to the medicine or its ingredients
  • Children younger than 12
  • Elderly people with age-related liver, kidney, heart, or lung problems
  • Breastfeeding women
  • History of drug or alcohol abuse
  • Previous head injury 
  • Breathing problems
  • Sleep apnea
  • Enlarged prostate
  • Hypothyroidism (underactive thyroid)
  • Problems with passing urine
  • Older adults with a weakened physical condition

Treatment Options for Tylenol #3 Abuse

Speak to a doctor if you’re experiencing codeine addiction. A healthcare provider will support you through withdrawal symptoms and addiction recovery during treatments.

Available treatment options for Tylenol 3 abuse include:

  • Medical detox: Medically supervised detox to avoid harmful withdrawal symptoms
  • Inpatient treatment: Involves checking yourself into a rehab facility for 24-hour medical supervision for several days to several weeks 
  • Outpatient treatment: A treatment program where you’re freely allowed to leave the rehab facility and receive treatment during daytime hours while residing in your home 
  • Support groups and aftercare programs: Provide a much-needed community to help maintain sobriety after treatment

Tylenol #3 vs. Other Pain Medications

Tylenol #3 isn’t an effective pain relief medication. However, its Schedule 3 rating makes it much easier to obtain than the more effective analgesics, such as Vicodin (Hydrocodone with acetaminophen) or Percocet (Oxycodone with acetaminophen). 

This drug is a Schedule III controlled substance. It means it has a low to moderate potential for abuse and dependency.6


Tylenol with codeine #3 is the brand name for a combination of codeine/acetaminophen or codeine/paracetamol. It treats mild, moderate, and occasionally severe pain.

This drug is a Schedule III substance with low to moderate abuse or dependency. However, you can still get addicted to it after prolonged use.

Tylenol #3 abuse can lead to dangerous and severe side effects. Contact a medical professional immediately if you or someone you know misuses this medication.

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Updated on February 6, 2024

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