Acetaminophen Combinations

For moderately severe pain, a doctor may prescribe a combination pill with acetaminophen and a narcotic.

• Acetaminophen with codeine (Tylenol with Codeine, Capital and Codeine, Phenaphen with Codeine)
  
  
• Acetaminophen with hydrocodone (Vicodin, Anexsia, Anodynos-DHC, Bancap HC, Co-Gesic, Dolacet, Lortab, Margesic H, Medipain 5, Norcet, Stagesic, T-Gesic, Zydone)
  
  
• Acetaminophen with oxycodone (Percocet, Roxicet, Endocet, Roxilox, Tylox)

It is difficult to evaluate the relative strength of different medications because all medications affect different people differently.

• Tylenol with codeine is no stronger than an adequate dose of ibuprofen. It also has several unpleasant side effects such as nausea, vomiting, constipation, and feeling disoriented. Codeine must be converted by the body to morphine to be effective. Some people lack the enzyme necessary to do the conversion. In these people, codeine is not effective.
  
  
• Vicodin is probably twice as strong as acetaminophen or any NSAID and has few side effects. It is a safe and effective medication. Long-term use can lead to dependency, so its use should be limited (less than a week), except under the management of your doctor or a pain management specialist. Narcotics are not usually addictive, but the potential for addiction exists in certain people.
  
  
• Percocet is probably stronger than Vicodin and is very similar in its safety and side effects. The main side effect of both is constipation.

An effective way to take these medications for short-term pain resulting from something such as an injury or kidney stone is to take a regular dose of an NSAID such as ibuprofen and then take a Percocet or Vicodin as needed.