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Tylenol 3 and Tylenol 4: Effects and Risks

Tylenol 3 and Tylenol 4 | Just Believe Recovery Center
In This Article

Tylenol 3 and Tylenol 4 are very similar medications that include the opiate alkaloid codeine and 300 mg of acetaminophen, a readily available over-the-counter pain reliever. The only distinction is the amount of codeine in each. Tylenol 3 has 30mg, whereas Tylenol 4 has 60mg.

Acetaminophen is an analgesic and fever reducer. Codeine is also indicated to treat moderate pain and is also effective as an anti-cough remedy. Both formulations are meant to treat short-term, acute pain such as following an injury or surgery. However, due to adverse effects and the potential for addiction, they are not recommended for long-term use or chronic conditions.

Tylenol 3 and 4 are sometimes misused for recreational purposes to induce euphoria and relaxation.

Side Effects of Tylenol 3 And 4

Common side effects include:

  • Dizziness/lightheadedness
  • Dry mouth
  • Constipation
  • Nausea and vomiting

Less common adverse effects, which may be the result of abuse, include the following:

  • Confusion
  • Agitation
  • Moodiness
  • Hallucinations
  • Labored or slowed breathing
  • Slowed heart rate
  • Seizures
  • Overdose


An overdose can be the result of extreme amounts of either codeine or acetaminophen. Overuse of codeine can cause life-threatening central nervous system (CNS) depression, and excessive doses of acetaminophen can cause permanent liver damage and even failure.

Overdose effects may also include the following:

  • Severe drowsiness or fainting
  • Unresponsiveness or unconsciousness
  • Cyanosis (bluish or purplish skin)
  • Cold, clammy skin

In addition, using Tylenol 3 or 4 with illicit drugs, alcohol, or other prescription medications that a licensed health provider has not approved increases the risk of overdose. An opioid overdose is a medical emergency. If you or a person you know is experiencing or exhibiting the above signs and symptoms, please call 911 immediately or visit the nearest emergency room.

Tylenol 3 and Tylenol 4 | Just Believe Recovery Center

Are Tylenol 3 and Tylenol 4 Addictive?

The short answer is yes. Codeine is a fairly weak opioid, and only about 10 percent is broken down into morphine, so it is not as potent as many opiate-based substances. That said, both drugs still have the potential for abuse, dependence, and addiction if used for recreational purposes. Moreover, misuse of codeine increases the risk of short- and long-term complications and, as noted above, overdose.

Codeine addiction can occur because of its effect on the brain’s reward center, affecting chemical neurochemicals responsible for feelings of pleasure and well-being, such as serotonin and dopamine.

When a person uses codeine for an extended period, they can develop a tolerance, which means they need to take increasing amounts to achieve the effect they are seeking. This effect occurs because when the brain is repeatedly exposed to psychoactive substances, the response tends to diminish.

Tylenol 3 and 4 Withdrawal Symptoms

Withdrawal symptoms onset when an individual has become chemically dependent on a substance and attempts to discontinue its use. Dependence results from the brain becoming adapted to repeated exposure to a psychoactive or intoxicating substance and becoming unable to function normally without it.

Symptoms of codeine withdrawal include the following:

  • Anxiety
  • Depression
  • Restlessness
  • Sweatiness or chills
  • Teariness and runny nose
  • Lack of appetite
  • Insomnia/sleep disturbances
  • Muscle aches and pains
  • Nausea and vomiting
  • Diarrhea

Risks of Acetaminophen

Due to its acceptable, widespread use outside the medical field, acetaminophen is not often perceived as a dangerous substance. However, it is definitely not without its risks, primarily if used in excess.

Studies have found that excessive amounts of acetaminophen are the most common cause of acute liver failure in the U.S. The maximum amount of acetaminophen considered to be safe is 4000 mg per day. Therefore, any amount above this recommendation is regarded as an overdose, and more than 7 grams can be toxic and potentially deadly in some cases.

Treatment for Codeine Addiction

Codeine abuse and dependence are severe conditions that require medical intervention and addiction treatment. Individuals dependent on either of these two drugs should seek professional help as soon as possible.

Because withdrawal symptoms from opiates are particularly unpleasant, a medically assisted detox is recommended in nearly all cases. During the detox process, individuals are supervised 24/7 and can be treated with medications to help relieve withdrawal symptoms.

Following detox, patients are urged to undergo inpatient treatment at an addiction treatment facility, such as Just Believe Recovery, which offers comprehensive, evidence-based approaches, such as psychotherapies and counseling.

Upon completing formal treatment, those in recovery can take advantage of our aftercare planning services and alumni activities that ensure the person in recovery has the best chance at sustaining long-term sobriety and wellness.

We Believe Recovery Is Possible For Everyone.
If you or a loved one need help with substance abuse and/or treatment, please contact Just Believe Recovery at (888) 380-0667. Our specialists can assess your individual needs and help you get the treatment that provides the best chance for long-term recovery.
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