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Acetaminophen with codeine (brand name Tylenol with Codeine, Tylenol #3) is a combination drug used for pain management in humans. Acetaminophen is a pain reliever and fever reducer. It is not often used in animals and, when done so, must only be used in dogs. It is often combined with the drug codeine, which is a narcotic pain reliever. Codeine is also known as an anti-cough medication in humans, but in animals the effects of this drug are not well known.
There is no approved veterinary brand of acetaminophen/codeine. It is used off label to treat pain in dogs. Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the FDA or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as their directions may be significantly different from those on the label.
NEVER use in CATS or FERRETS. In these species, acetaminophen is toxic at any dose.
Acetaminophen/codeine comes as tablets, elixirs, and liquid solutions in many different formulations (e.g., 300 mg acetaminophen plus 15 mg, 30 mg, or 60 mg codeine).
This medication should take effect within 1 to 2 hours and improvement in clinical signs should follow. It is short-acting, meaning that effects should stop after 24 hours but may be prolonged in pets with kidney and/or liver disease.
If you miss a dose of acetaminophen, give it as soon as you remember, and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.
Acetaminophen/codeine may cause the following side effects:
The following reactions are rare; if they occur, contact your veterinarian immediately:
Drug sensitivities can develop over time, with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment.
Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately.
This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.
This medication SHOULD NOT BE USED in:
This medication SHOULD NOT BE USED in dogs who:
NEVER give to a dog without a veterinarian's advice. Although acetaminophen/codeine is not poisonous to dogs, it is not as safe to use in dogs as it is in humans.
This medication should be USED WITH CAUTION in dogs who:
Be sure to tell your veterinarian about any medications (including vitamins, supplements or herbal therapies) that your dog is taking before starting any treatment.
Certain medications SHOULD NOT BE USED with acetaminophen/codeine, including:
Certain medications should be used WITH CAUTION when given with acetaminophen/codeine, including:
At home, monitor for any side effects such as those noted above. If any side effects occur, discontinue the medication and contact your veterinarian.
Acetaminophen/codeine is a controlled substance, which means that it has been designated by the Drug Enforcement Administration (DEA) as having a potential for diversion to people other than the patient it was prescribed for. Use of a controlled substance in any person or animal other than that for which it is prescribed is illegal. Therefore, this medication should be stored in a locked cabinet or safe that cannot be easily moved, with access limited to only those that need to administer the medication. Monitor the amount of medication remaining to ensure the expected amount is present.
Ask your veterinarian for specific disposal instructions. Do not flush medicines down the sink or toilet unless instructed to do so.
If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms.
© Copyright 2025 LifeLearn Inc. Used and/or modified with permission under license. This content written by LifeLearn Animal Health (LifeLearn Inc.) is licensed to this practice for the personal use of our clients. Any copying, printing or further distribution is prohibited without the express written consent of LifeLearn. This content does not contain all available information for any referenced medications and has not been reviewed by the FDA Center for Veterinary Medicine, or Health Canada Veterinary Drugs Directorate. This content may help answer commonly asked questions, but is not a substitute for medical advice, or a proper consultation and/or clinical examination of your pet by a veterinarian. Please contact your veterinarian if you have any questions or concerns about your pet’s health. Created on Jun 18, 2024.
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