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Does Oxycodone Have Tylenol in It?

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Although oxycodone is separate from Tylenol and does not contain it, some oxycodone formulations include Tylenol (acetaminophen) as an active ingredient that can provide an added level of pain relief. Various brands and their generic versions include these two medications. However, oxycodone products containing acetaminophen are much more dangerous than ingesting oxycodone alone. Acetaminophen is toxic in high doses and can result in severe liver damage or failure.

If you’ve been misusing drugs that contain oxycodone with or without acetaminophen, you are at a high risk of dependence, addiction, and overdose. Guardian Recovery is a specialized drug and alcohol treatment center that helps individuals overcome addiction and provides the tools and support they need to maintain long-term abstinence. If you want to learn more about our comprehensive programs and personalized treatment plans, contact us today.

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Why Is Acetaminophen Combined With Oxycodone for Pain Relief?

Acetaminophen and oxycodone are often combined for pain relief because their collective actions provide greater pain relief than either medication alone. Oxycodone is an opioid pain medication that binds to opioid receptors in the central nervous system (CNS), blocking pain signals and reducing pain perception. Acetaminophen works primarily by inhibiting the production of prostaglandins, chemicals contributing to inflammation and pain. (1) Their combined effects are compounded, providing a two-pronged approach to pain relief, as oxycodone acts on the CNS and acetaminophen acts on the peripheral nervous system.

Additionally, because acetaminophen is not an opioid, it can help reduce the amount of oxycodone needed to achieve sufficient pain relief, which can help reduce the risk of side effects associated with opioid use, such as sedation, constipation, and respiratory depression. Common brand-name drugs containing oxycodone and APAP in various strengths include Percocet, Endocet, Roxicet, Xartemis XR, and PrimLev.

Importantly, the combination of acetaminophen and oxycodone should only be used as directed by a licensed healthcare provider. It should never be taken in higher doses or for more extended periods than recommended, as this can increase the risk of side effects, addiction, and overdose.

Is Oxycodone Stronger When Combined With Acetaminophen?

Oxycodone is not necessarily stronger when combined with acetaminophen. Still, the combination can be more effective for certain types of pain than oxycodone alone. However, acetaminophen does not increase the potency of oxycodone and, instead, enhances its pain-relieving effects. This can result in improved pain control with lower doses of oxycodone.

This combination is commonly used to treat moderate to severe pain related to injuries, surgery, or chronic conditions like arthritis or cancer. Adding acetaminophen can help address pain from multiple angles, as it has a different mechanism of action than oxycodone. This can result in better pain relief and fewer side effects than if a higher dose of oxycodone were used alone.

Common Side Effects & Risks Associated With Oxycodone & Acetaminophen Use

The use of oxycodone and acetaminophen can be associated with several side effects and risks.

Common Side Effects of Oxycodone & Acetaminophen Include:

  • Drowsiness.
  • Dizziness.
  • Nausea and vomiting.
  • Constipation.
  • Headache.
  • Dry mouth.
  • Sweating.
  • Itching.
  • Loss of appetite.

In addition to these common side effects, several risks are associated with using oxycodone and acetaminophen, particularly if misused or for prolonged periods.

Short- & Long-Term Risks of Oxycodone & Acetaminophen Include:

  • Respiratory Depression—Oxycodone is a CNS depressant that slows down breathing, particularly in excessive doses or when combined with other CNS depressants.
  • Liver Damage—Acetaminophen can be toxic to the liver, particularly in high doses or when combined with alcohol.
  • Addiction and Dependence—The use of opioids like oxycodone can lead to addiction and dependence, primarily if used for prolonged periods or in higher doses than prescribed.
  • Withdrawal Symptoms—Abruptly stopping oxycodone once dependence has developed will lead to withdrawal symptoms, including anxiety, insomnia, muscle aches, nausea, and sweating.

If you experience any side effects or have any questions about the risks associated with these medications, speak with your healthcare provider.

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There Is a Limit to the Amount of Acetaminophen That Can Be Consumed Daily

The maximum recommended daily dose of acetaminophen for adults is 4,000 milligrams (mg) per day. Exceeding this amount increases the risk of liver damage. In addition, many other medications, such as sleep and cold remedies, also contain acetaminophen. This means that if you take multiple medications, you must avoid surpassing the recommended daily dose of acetaminophen.

If you have liver disease or other underlying medical conditions, you may need to take a lower dose of acetaminophen or avoid it altogether. Speak with your healthcare provider about the safe use of acetaminophen or any underlying medical conditions that may increase your risk of side effects.

Interactions & Medications to Avoid Combining With Acetaminophen

When combined with acetaminophen, several medications and substances, including alcohol, some anticonvulsants, and the antibiotic Isoniazid, can increase the risk of liver damage. (2) Also, the blood thinner warfarin and non-steroidal anti-inflammatory drugs (NSAIDs) can increase the risk of bleeding and ulcers.

Before using any new medications, speak with your doctor and read the labels on your over-the-counter medications to ensure they are acetaminophen-free to prevent accidental poisoning.

How Does Acetaminophen Increase Liver Damage Risk?

The liver is the primary metabolizer of acetaminophen, and ingesting an excessive amount can significantly undermine the liver’s ability to break it down. This can lead to the accumulation of a toxic byproduct known as N-acetyl-p-benzoquinone imine (NAPQI). (3) Typically, the liver uses an antioxidant called glutathione to detoxify NAPQI and prevent liver damage. (4) However, acetaminophen depletes glutathione levels, so if it becomes insufficient, NAPQI can damage liver cells, leading to liver failure.

Signs & Symptoms of Liver Toxicity (Hepatotoxicity) Include:

  • Jaundice, when skin and eyes appear yellow due to an accumulation of bilirubin. (5)(6)
  • Abdominal pain and swelling due to fluid buildup.
  • Fatigue and weakness.
  • Nausea, vomiting, and diarrhea.
  • Loss of appetite.
  • Dark urine and pale stools due to a bilirubin accumulation.
  • Itching due to bile salt buildup in the bloodstream.
  • Easy bruising and bleeding due to poor blood clotting.

It is critical to seek medical attention if you experience any of these signs and symptoms, especially if you have a history of liver disease.

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Oxycodone is a potentially dangerous drug, especially when taken in amounts greater than prescribed or misusing it without a prescription. Acetaminophen-containing products also come with considerable risks when used in excess due to the medication’s toxic effects on the liver. Despite this, this combination is commonly prescribed due to the analgesic effects of both substances, which work together to induce greater pain reduction than either would independently. Unfortunately, those who misuse them can experience severe effects, including respiratory depression, liver failure, and death.

If you’ve been misusing combination oxycodone-acetaminophen products, you are urged to seek professional treatment to prevent life-threatening complications. At Guardian Recovery, our addiction recovery programs feature a full continuum of care, including medically-assisted detox, inpatient and outpatient treatmentindividualized therapygroup support, aftercare planning, and more. Contact us today to speak to an experienced Treatment Advisor and receive a free, no-obligation health insurance benefits check, and learn more about our holistic approach to recovery.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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