ə/set’ ə/men’ ō’/fen kō dēn

Brand Names: Tylenol®, Capital® (with Codeine)

  • Generic Available

Common Dosage Forms:

  • No.2 Tablets: Each tablet contains 300 mg acetaminophen (APAP) and 15 mg codeine phosphate.
  • No.3 Tablets: Each tablet contains 300 mg APAP and 30 mg codeine phosphate.
  • No.4 Tablets: Each tablet contains 300 mg APAP and 60 mg codeine phosphate.
  • Solution: Each 5 mL contains 120 mg APAP and 12 mg codeine phosphate (C-V medication).
  • Suspension: Each 5 mL contains 120 mg APAP and 12 mg codeine phosphate (C-V medication).

FDA Indications/Dosages:

  • Relief of mild to moderate pain: Adults: One to two No.2 or No.3 tablets every four hours as needed. Children 7 to 12 years of age: 2 teaspoonsful 3 to 4 times a day. Children 3 to 6 years of age: 1 teaspoonful 3 to 4 times a day.
  • Relief of moderate to severe pain:  One No.4 tablet every four hours as needed.
  • It may be necessary to exceed the above dosage ranges for patients with more severe pain or when there is a tolerance to narcotic anal- gesics.

Pharmacology/Pharmacokinetics:

Acetaminophen produces analgesia by inhibiting prostaglandin synthesis in the CNS and through a peripheral action by blocking pain impulse generation. Codeine is a weak µ-opiate receptor agonist and the majority of its analgesic effect is due to metabolism to morphine. Both acetaminophen and codeine are metabolized in the liver via cytochrome P450 (CYP) isoenzymes and excreted through the kidney.

Drug Interactions:

Use with other CNS depressants and/or alcohol may increase CNS depression. Hepatotoxicity potential is increased when used with hydantoins or sulfinpyrazone.

Contraindications/Precautions:

Use with caution in patients with increased intracranial pressure, head injury, severe hepatic or renal impairment, prostatic hypertrophy or urethral stricture, and in the presence of acute abdominal conditions. Pregnancy Category C.

Adverse Effects:

Common adverse effects include dizziness, drowsiness, constipation, nausea, vomiting and excessive sweating.

Patient Consultation:

  • May cause drowsiness. Use caution while operating machinery or when mental alert- ness is required.
  • Avoid alcohol while taking this medication.
  • May take with food or milk to avoid GI upset.
  • Do not exceed prescribed dosage.
  • WARNING: This medication may be habit- forming.
  • Store in a cool, dry place away from children.
  • Contact a physician if the above side effects are severe or persistent.
  • If a dose is missed, skip it and return to normal dosing schedule.
  • Shake suspension well before dosing.