Tylenol 3 Side Effects

Tylenol 3 is known generically as acetaminophen with codeine phosphate. It delivers 300 mg of Tylenol and 30 mg of codeine in a tablet form. Tylenol 3 is indicated for the relief of mild to moderate pain and is a C-II controlled substance. This drug must be kept out of the reach of children and not given to anyone to whom it is not prescribed. It must be taken only as ordered. Tylenol 3 users should be aware of possible side effects.

Man holding pills in hand with water. Credit: Wavebreakmedia Ltd/Wavebreak Media/Getty Images

Nervous System Side Effects

Common nervous system side effects include sedation, confusion, dizziness, sweating, clamminess, light-headedness, tiredness, headache and a feeling you are floating or about to fall. Less common side effects include agitation, insomnia, nervousness, anxiety, fear, delirium, coma, tremor, seizures, euphoria, vivid dreams, hallucinations, double vision, blurry vision, mood changes and impaired physical and mental performance.

Cardiovascular Side Effects

Cardiovascular side effects of Tylenol 3 are uncommon and include cardiac arrest, myocardial damage, chest pain, difficulty breathing, heart palpitations, circulatory depression, fast heart rate, slow heart rate, high blood pressure, low blood pressure, shock and irregular heartbeat.

Gastrointestinal Side Effects

Common gastrointestinal side effects include nausea, vomiting and constipation. Uncommon side effects include liver toxicity, liver failure, jaundice, poor appetite, abdominal pain, spasms of the biliary tract and dry mouth.

Hematological Side Effects

Hematological side effects of acetaminophen with codeine are uncommon. One side effect is hemolytic anemia, which manifests as blood in the urine and a lack of urine. Another side effect is methemoglobinemia, which occurs when the body cannot recycle hemoglobin. It can lead to a bluish color to the skin. Other uncommon side effects are leukopenia, granulocytosis and neutropenia (low levels of certain white blood cells), thrombocytopenia (low blood platelets) and pancytopenia (low levels of red blood cells, white blood cells and blood platelets).

Genitourinary Side Effects

Genitourinary side effects are uncommon and include renal tubular necrosis, difficulty voiding, voiding less urine than normal, low sex drive, voiding more than normal, spasms of the ureters and kidney failure.


Physical and psychological dependence can occur as a side effect of taking codeine. Tolerance can also occur. These symptoms must be discussed with the physician, and medication changes may be appropriate. If dependence and tolerance lead to the patient ingesting more medication than prescribed, serious life-threatening adverse effects can occur, including permanent liver damage due to the acetaminophen in the Tylenol 3 product.

Other Side Effects

Other side effects include rash, low blood sugar, a feeling of warmth with facial redness, spasms of the bronchi or larynx, slow breathing, rash, unusual sensitivity to cold, shallow breathing, hives, suppressed cough reflex, itching and fever. These side effects are uncommon.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.
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