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acetaminophen vs codeine

Side-by-side comparison of acetaminophen and codeine. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

minor Known Drug Interaction

Drug Interactions Anticoagulants Chronic oral acetaminophen use at a dose of 4000 mg/day has been shown to cause an increase in international normalized ratio (INR) in some patients who have been stabilized on sodium warfarin as an anticoagulant. As no studies have been performed evaluating the short term use of acetaminophen and codeine phosphate tablets in patients on oral anticoagulants, more frequent assessment of INR may be appropriate in such circumstances. The concomitant use of acetaminophen and codeine phosphate tablets and CYP2D6 inhibitors (e.g., paroxetine, fluoxetine,...

Recommendation: Make sure you do not take other medicines that contain acetaminophen to avoid hurting your liver.

Drug Class
acetaminophen Analgesic / Antipyretic
codeine Opioid Analgesic
Type
acetaminophen Over-the-Counter
codeine Prescription
Summary
acetaminophen

Acetaminophen (Tylenol) is a medicine that can relieve pain and reduce fever. It is available over-the-counter.

codeine

This medicine contains acetaminophen and codeine. It is used to treat mild to moderate pain when other pain medicines are not strong enough.

What It Treats
acetaminophen

This medicine temporarily relieves minor aches and pains. It can help with headaches, the common cold, backaches, and minor arthritis pain. It can also help with toothaches, muscle aches, premenstrual and menstrual cramps. Acetaminophen can also temporarily reduce fever.

codeine

This medicine is used to manage mild to moderate pain. It is for when an opioid medicine is appropriate. You should only use it if other pain treatments are not working well enough for you.

How It Works
acetaminophen

Acetaminophen's exact mechanism is not fully understood. It is believed to work in the brain to reduce pain signals. It also helps to lower body temperature when you have a fever.

codeine

Codeine works in the brain to change how your body feels and responds to pain. Acetaminophen also helps to relieve pain. Together, they provide pain relief.

Common Side Effects
acetaminophen
  • Headache
  • Nausea
codeine
  • Feeling drowsy
  • Lightheadedness
  • Dizziness
  • Feeling sleepy
  • Shortness of breath
FAERS Reports
acetaminophen
  • Tiredness 34,486
  • Feeling sick to your stomach 29,571
  • Head pain 28,378
  • Aches 28,322
  • Loose stool 23,628
codeine
  • Allergic reaction to the medicine 806
  • Feeling sick to your stomach 487
  • Feeling unwell 374
  • Throwing up 364
  • Head pain 356
Serious Warnings
acetaminophen

Taking more acetaminophen than directed can cause liver damage. Follow the dosage instructions carefully.

codeine

This medicine can be habit-forming, leading to addiction, abuse, and misuse, which can result in overdose and death. Serious, life-threatening breathing problems can occur, especially when starting the medicine or after a dose increase. Accidental ingestion, especially by children, can cause a fatal overdose. Do not give this medicine to children under 12 years old, or to children under 18 after tonsil or adenoid removal, due to the risk of life-threatening breathing problems. This medicine can also harm your liver. Taking this medicine with certain other medicines like benzodiazepines or other CNS depressants can cause serious side effects, including death.

Pregnancy
acetaminophen

If you are pregnant or breastfeeding, talk to your doctor before using this medicine. They can help you weigh the risks and benefits.

codeine

This medicine can cause withdrawal symptoms in newborns if taken during pregnancy. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if this medicine passes into breast milk.

Also Compare, Nearby Drugs

How to Read This acetaminophen vs codeine Comparison

acetaminophen is classified in the Analgesic / Antipyretic drug class, while codeine sits within the Opioid Analgesic class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are split between OTC and prescription status, which affects access and supervision.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, acetaminophen has 144,385 submissions while codeine has 2,387. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known minor interaction flagged in FDA labeling, attributed to these two drugs work in different ways to help stop pain better than they would on their own. one works on the brain's pain centers while the other works on different pain signals in the body.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between acetaminophen and codeine - always consult your physician or pharmacist first.

Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.