Phone: (817) 800-9634 Fax: (817) 549-2060

Tylenol #4

Generic Name:  Acetaminophen & Codeine


This combination medication is used to help relieve mild-to-moderate pain. It contains an opioid (narcotic) pain reliever (codeine) and a non-opioid pain reliever (acetaminophen). Codeine works in the brain to change how your body feels and responds to pain. Acetaminophen can also reduce a fever.


Take this medication by mouth as directed by Dr. Starck. You may take this drug with or without food, but if you have nausea, it may help to take this drug with food. Take this medication as prescribed. Follow the dosing schedule carefully. 


Nausea, vomiting, constipation, lightheadedness, dizziness, or drowsiness may occur. Some of these side effects may decrease after you have been using this medication for a while. This is not a complete list of possible side effects. If you notice other effects not listed above, or if any of these effects persist or worsen, notify Dr. Starck immediately.


Before using this medication, tell Dr. Starck if you are allergic to acetaminophen or to codeine; or to other opioid pain medications (such as morphine); or, if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems.

Before you take this drug, tell Dr. Starck if you are pregnant, think that you may be pregnant, or are trying to become pregnant. Do not take this medication if you are pregnant or nursing unless first notifying Dr. Starck.

Before taking this medication, Dr. Starck should be familiar with your entire medical history, particularly if you have: brain disorders (such as head injury, tumor, seizures), breathing problems (such as asthma, sleep apnea, chronic obstructive pulmonary disease/COPD), kidney disease, liver disease, mental/mood disorders (such as confusion, depression), personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol), obesity, stomach/intestinal problems (such as blockage, constipation, diarrhea, due to infection, paralytic ileus), difficulty urinating (such as due to enlarged prostate), gallbladder disease, or disease of the pancreas (pancreatitis).

This drug may make you dizzy or drowsy. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana.

If you have diabetes, this drug may increase your blood sugar level. Test your urine/blood for sugar (glucose) frequently, and contact Dr. Starck if sugar is present. Your dose of diabetes medication and your diet may need to be changed.


Before you take this drug, tell Dr. Starck what prescription and non-prescription medications you are taking--especially aspirin, arthritis medication, anticoagulants ("blood thinners"), diuretics ("water pills"), estrogen (e.g., birth-control pills), phenytoin, rifampin, phenobarbital, macrolide antibiotics (such as erythromycin), ketoconazole, neostigmine, pyridostigimine, ambenomium, and drugs for diabetes.

The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is taken with other products that may also cause drowsiness or breathing problems. Tell your doctor or pharmacist if you are taking other products such as other opioid pain or cough relievers (such as morphine, hydrocodone), alcohol, marijuana, drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants, or antihistamines (such as cetirizine or diphenhydramine).

Drug interactions may change how your medications work or may increase your risk for serious side effects.


Store at room temperature between 59 and 86 degrees Fahrenheit (between 15 and 30 degrees Celsius) away from moisture, heat, and sunlight.

Do not store in bathroom

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Contact Dr. Starck

(817) 800-9634