Medication Guide    

• A strong prescription pain medicine that contains an opioid (narcotic) that is used to manage mild to moderate pain when other pain treatments such as non-opioid pain medicines do not treat your pain well enough or you cannot tolerate them.
• An opioid pain medicine that can put you at risk for overdose and death. Even if you take your dose correctly as prescribed you are at risk for opioid addiction, abuse, and misuse that can lead to death.

• Get emergency help right away if you take too much acetaminophen and codeine phosphate oral solution (overdose). When you first start taking acetaminophen and codeine phosphate oral solution, when your dose is changed, or if you take too much (overdose), serious or life-threatening breathing problems that can lead to death may occur.
• Taking acetaminophen and codeine phosphate oral solution with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death.
• Never give anyone else your acetaminophen and codeine phosphate oral solution. They could die from taking it. Selling or giving away acetaminophen and codeine phosphate oral solution is against the law.
• Store acetaminophen and codeine phosphate oral solution securely, out of sight and reach of children, and in a location not accessible by others, including visitors to the home.

• Do not give acetaminophen and codeine phosphate oral solution to a child younger than 12 years of age.
• Do not give acetaminophen and codeine phosphate oral solution to a child younger than 18 years of age after surgery to remove the tonsils and/or adenoids.
• Avoid giving acetaminophen and codeine phosphate oral solution to children between 12 to 18 years of age who have risk factors for breathing problems such as obstructive sleep apnea, obesity, or underlying lung problems.

• severe asthma, trouble breathing, or other lung problems.
• a bowel blockage or have narrowing of the stomach or intestines.
• previously had an allergic reaction to codeine or acetaminophen.

• abuse of street or prescription drugs, alcohol addiction, opioid overdose, or mental health problems.
• Have been told by your healthcare provider that you are a "rapid metabolizer" of certain medicines.

• noticing your pain getting worse. If your pain gets worse after you take acetaminophen and codeine phosphate oral solution, do not take more of acetaminophen and codeine phosphate oral solution without first talking to your healthcare provider. Talk to your healthcare provider if the pain that you have increases, if you feel more sensitive to pain, or if you have new pain after taking acetaminophen and codeine phosphate oral solution.
• pregnant or planning to become pregnant. Use of acetaminophen and codeine phosphate oral solution for an extended period of time during pregnancy can cause withdrawal symptoms in your newborn baby that could be life-threatening if not recognized and treated. 
• breastfeeding. Not recommended; may harm your baby.
• living in a household where there are small children or someone who has abused street or prescription drugs.
• taking prescription or over-the-counter medicines, vitamins, or herbal supplements. Taking acetaminophen and codeine phosphate oral solution with certain other medicines can cause serious side effects that could lead to death.

• Do not change your dose. Take acetaminophen and codeine phosphate oral solution exactly as prescribed by your healthcare provider. Use the lowest dose possible for the shortest time needed.
  
  
• For acute (short-term) pain, you may only need to take acetaminophen and codeine phosphate oral solution for a few days. You may have some acetaminophen and codeine phosphate oral solution left over that you did not use. See disposal information at the bottom of this section for directions on how to safely throw away (dispose of) your unused acetaminophen and codeine phosphate oral solution.

• Always use a calibrated measuring device to correctly measure your dose. A household teaspoon or tablespoon is not an adequate measuring device. Given the inexactitude of the household spoon measure and the possibility of using a tablespoon instead of a teaspoon, which could lead to overdosage, it is strongly recommended that caregivers obtain and use a calibrated measuring device.

• Take your prescribed dose at the same time every day.  Do not take more than your prescribed dose. If you miss a dose, take your next dose at your usual time.

• Call your healthcare provider if the dose you are taking does not control your pain.

• If you have been taking acetaminophen and codeine phosphate oral solution regularly, do not stop taking acetaminophen and codeine phosphate oral solution without talking to your healthcare provider.

• Dispose of expired, unwanted, or unused acetaminophen and codeine phosphate oral solution by taking your drug to an authorized DEA-registered collector or drug take-back program. If one is not available, you can dispose of acetaminophen and codeine phosphate oral solution by mixing the product with dirt, cat litter, or coffee grounds; placing the mixture in a sealed plastic bag, and throwing the bag in your trash.

• Drive or operate heavy machinery, until you know how acetaminophen and codeine phosphate oral solution affects you. Acetaminophen and codeine phosphate oral solution can make you sleepy, dizzy, or lightheaded.
• Drink alcohol or use prescription or over-the-counter medicines that contain alcohol. Using products containing alcohol during treatment with acetaminophen and codeine phosphate oral solution may cause you to overdose and die.

• constipation, nausea, sleepiness, vomiting, tiredness, headache, dizziness, abdominal pain. Call your healthcare provider if you have any of these symptoms and they are severe.

Get emergency medical help or call 911 if you have:

      •  trouble breathing, shortness of breath, fast heartbeat, chest pain, swelling of your face, tongue, throat, or hands, hives, itching, rash, extreme drowsiness, light-             headedness when changing positions, feeling faint, agitation, high body temperature, trouble walking, stiff muscles, or mental changes such as confusion

 These are not all the possible side effects of acetaminophen and codeine phosphate oral solution. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. For more information go to dailymed.nlm.nih.gov.

Manufactured and Distributed By: PAI Pharma., Greenville, SC 29605, www.paipharma.com.

This Medication Guide has been approved by the U.S. Food and Drug Administration.
Revised: November 2023