This poisoning is from taking an excessive amount of acetaminophen (Tylenol) with codeine.

Acetaminophen combined with codeine

Acetaminophen with codeine is a prescription painkiller. It is commonly called Tylenol #3. The drug may be habit forming, which means it is a narcotic.

• Respiratory
  • Breathing slow and labored
  • Breathing shallow  
  • Respiratory arrest
• Eyes, ears, nose, and throat
  • Pinpoint pupils
• Skin
  • Bluish skin (fingernails and lips)
  • Heavy sweating
  • Cold, clammy skin
• Gastrointestinal
  • Spasms of the stomach and intestines
  • Vomiting
  • Kidney and liver failure
• Heart and blood vessels
  • Low blood pressure
  • Heart attack
• Nervous system
  • Drowsiness
  • Coma due to low blood sugar
  • Convulsions
  • Stupor (lack of alertness)

Seek immediate emergency medical help. This type of overdose can cause death.

DO NOT MAKE THE PERSON THROW UP.

Determine the following information:

• Patient's age, weight, and condition
• Name of the product (as well as the ingredients and strength, if known)
• Time it was swallowed
• Amount swallowed
• If the medication was prescribed for the patient

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the U.S. use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the emergency room.

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure.

The patient may be admitted to the hospital, and may receive:

• Fluids
• Medicines to treat symptoms
• Activated charcoal
• A nasogastric (NG) tube thru the nose into the stomach to empty the stomach (gastric lavage)   
• Artificial respiration
• A counteracting drug called naloxone (multiple doses may be needed)

If there is a high level of acetaminophen in the blood, the patient will be given N-Acetyl cysteine. Without this counteracting drug, called an antidote, deadly liver failure will occur.

If medicine to reverse the poisoning (an antidote) can be given, recovery from an acute overdose often occurs within 24-48 hours.