APAP is medical shorthand for acetaminophen, generally known by the brand name Tylenol®. APAP with codeine is a generic version of this drug that also contains the narcotic codeine. This medicine is available by prescription only and must be used with care.

Acetaminophen and codeine both work to relieve mild to moderate pain. APAP with codeine is normally used for short-term relief such as after an accident or other injury, or post-surgery. Codeine acts as a central nervous system depressant and helps to prevent pain signals from being transmitted to the brain. Acetaminophen also works to block pain signals, but is not a narcotic and is available over-the-counter in a formulation without codeine.

APAP with codeine is available as capsules, tablets or liquid. Common tablet and capsule strengths are 300 milligrams (mg) of acetaminophen with 15 mg of codeine phosphate, 300 mg of acetaminophen with 30 mg of codeine phosphate and 300 mg of acetaminophen with 60 mg of codeine phosphate. The liquid form of this medication has 120 mg of acetaminophen with 12.5 mg codeine phosphate per teaspoonful and is typically prescribed for children.

When taking APAP with codeine, it is important to follow the prescribing doctor’s instructions carefully. Patients should check with a physician or pharmacist before making any changes in the amount of this medicine they are taking. Codeine is a narcotic and can be habit-forming if taken for an extended period of time. Acetaminophen is generally considered safe when taken according to directions, but can cause serious harm to the liver and even death if taken in too large of a dose. More than 4,000 mg per day is considered an overdose.

If the APAP with codeine is not providing adequate pain relief, patients can take additional over-the-counter pain medication. Never take additional acetaminophen when taking APAP with codeine. It is best to check with a doctor or pharmacist for specific information, but in general it is safe to take ibuprofen, naproxen or other drugs in the same category as those two in addition to APAP with codeine.

APAP with codeine can cause side effects, some serious and some that are troublesome but not harmful. Anaphylactic shock can occur if the patient is allergic to either of the drugs in this medicine. Reactions such as shortness of breath, shallow breathing and blue lips, fingernails or skin require immediate medical attention. Drowsiness, lightheadedness and constipation are some common side effects that do not need a trip to the doctor. This medicine is generally considered safe, and most patients will be able to take it for relief of pain without any serious side effects.