Drug · FAERS side-effect profile with label screen
Acetaminophen and Codeine Phosphate side effects: what 1,889 FDA adverse event reports show
Drug class
Not stated in label
Label matched
Acetaminophen (Acetaminophen)
closest FDA label found for this product string; brand list suppressed because the label is a related product, not an exact match
Who reports
1,889 reports · 98% serious · 349 with death outcome · 58% female
openFDA FAERS counts, all years, deduplication not applied
Used for
temporarily relieves minor aches and pains due to: headache muscular aches backache minor pain of arthritis the common cold toothache premenstrual and menstrual cramps temporarily reduces fever
FDA label, Indications and Usage
Boxed warning
None in the current label
How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation.
Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)?
That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.
Causality screen of the 40 strongest signals
Labeled (related wording) 1Reporting / coding artifact 3Lab value / disease marker 6Outcome field, not a reaction 1Not in label — unassessed 29
What the badges mean
- Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Lab value / disease marker A laboratory result, investigation or disease-activity marker (antibody positive, CRP abnormal, swollen joint count) not described in the label. These usually mirror the monitored disease or testing protocol rather than a drug effect; not screened further.
- Outcome field, not a reaction Death is a report outcome, not a reaction term. It is dominated by the underlying illness; see the seriousness profile and the boxed warning instead.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 86 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
Show:
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Drug toxicity | 28 | 22.6 15.6–32.6ROR 22.9 · χ² 555 / p 6e-123 | 22.2 EB05 16.1 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | serious PRR 13.8 · 96% clinician | no trial data cached |
| Liver function test abnormal | 39 | 14.8 10.9–20.2ROR 15.1 · χ² 489 / p 1e-108 | 14.6 EB05 11.0 · IC025 +3.1 3/3 methods agree | Reporting / coding artifact | serious PRR 10.9 | no trial data cached |
| Completed suicide (death by suicide) | 100 | 13.2 10.9–16.0ROR 13.9 · χ² 1,120 / p 8e-246 | 13.1 EB05 11.0 · IC025 +3.3 3/3 methods agree | Outcome field, not a reaction | serious PRR 7.8 · 98% clinician | no trial data cached |
| Haematemesis (vomiting blood) | 29 | 12.7 8.8–18.2ROR 12.9 · χ² 301 / p 1e-67 | 12.2 EB05 8.6 · IC025 +2.8 3/3 methods agree | Not in label — unassessed | serious PRR 7.7 · ♀ 96% (drug 58%) · 100% clinician | no trial data cached |
| Poisoning | 14 | 12.3 7.3–20.8ROR 12.4 · χ² 135 / p 2e-31 | 11.0 EB05 6.3 · IC025 +2.2 3/3 methods agree | Not in label — unassessed | serious PRR 7.4 | no trial data cached |
| Renal failure acute | 43 | 11.1 8.3–14.9ROR 11.3 · χ² 386 / p 3e-86 | 10.7 EB05 8.1 · IC025 +2.8 3/3 methods agree | Not in label — unassessed | serious PRR 6.5 | no trial data cached |
| Pulmonary fibrosis | 17 | 9.9 6.2–15.9ROR 10.0 · χ² 127 / p 9e-30 | 8.7 EB05 5.4 · IC025 +2.2 3/3 methods agree | Not in label — unassessed | serious PRR 5.9 | no trial data cached |
| Acute hepatic failure | 12 | 9.8 5.6–17.2ROR 9.9 · χ² 86 / p 8e-21 | 8.1 EB05 4.6 · IC025 +1.9 3/3 methods agree | Not in label — unassessed | serious PRR 5.8 | no trial data cached |
| Circulatory collapse | 15 | 9.7 5.9–16.1ROR 9.8 · χ² 109 / p 8e-26 | 8.3 EB05 5.1 · IC025 +2.1 3/3 methods agree | Not in label — unassessed | serious PRR 5.8 | no trial data cached |
| International normalised ratio increased | 25 | 9.7 6.5–14.2ROR 9.8 · χ² 185 / p 2e-42 | 8.8 EB05 6.1 · IC025 +2.4 3/3 methods agree | Lab value / disease marker | serious PRR 6.3 · 92% clinician | no trial data cached |
| Glomerular filtration rate decreased | 10 | 9.2 4.9–17.0ROR 9.2 · χ² 65 / p 4e-16 | 7.2 EB05 3.9 · IC025 +1.6 3/3 methods agree | Lab value / disease marker | serious PRR 6.7 | no trial data cached |
| Melaena (black stool) | 18 | 9.1 5.7–14.4ROR 9.1 · χ² 121 / p 2e-28 | 7.9 EB05 5.1 · IC025 +2.1 3/3 methods agree | Not in label — unassessed | serious PRR 5.4 | no trial data cached |
| Toxic epidermal necrolysis (severe skin peeling reaction) | 12 | 8.8 5.0–15.5ROR 8.9 · χ² 76 / p 2e-18 | 7.2 EB05 4.2 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | serious PRR 5.2 | no trial data cached |
| Rhabdomyolysis (muscle breakdown) | 31 | 8.3 5.8–11.7ROR 8.4 · χ² 191 / p 8e-44 | 7.6 EB05 5.5 · IC025 +2.3 3/3 methods agree | Not in label — unassessed | serious PRR 4.9 · ♀ 33% (drug 58%) | no trial data cached |
| Gastric ulcer | 14 | 8.2 4.8–13.8ROR 8.2 · χ² 81 / p 1e-19 | 6.8 EB05 4.2 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | serious PRR 5.1 | no trial data cached |
| Gamma-glutamyltransferase increased | 16 | 8.0 4.9–13.1ROR 8.1 · χ² 91 / p 6e-22 | 6.8 EB05 4.3 · IC025 +1.9 3/3 methods agree | Lab value / disease marker | serious PRR 4.9 | no trial data cached |
| Intentional drug misuse | 15 | 7.9 4.7–13.0ROR 7.9 · χ² 83 / p 4e-20 | 6.6 EB05 4.2 · IC025 +1.8 3/3 methods agree | Reporting / coding artifact | serious PRR 8.3 | no trial data cached |
| Multi-organ failure | 12 | 7.6 4.3–13.4ROR 7.6 · χ² 62 / p 1e-15 | 6.2 EB05 3.7 · IC025 +1.6 3/3 methods agree | Not in label — unassessed | serious PRR 4.5 | no trial data cached |
| Blood alkaline phosphatase increased | 16 | 7.1 4.4–11.6ROR 7.2 · χ² 79 / p 4e-19 | 6.1 EB05 3.9 · IC025 +1.7 3/3 methods agree | Lab value / disease marker | serious PRR 4.6 | no trial data cached |
| Acute myocardial infarction | 19 | 7.1 4.6–11.2ROR 7.2 · χ² 94 / p 1e-22 | 6.2 EB05 4.2 · IC025 +1.9 3/3 methods agree | Not in label — unassessed | serious PRR 4.2 | no trial data cached |
| Jaundice (yellowing of skin/eyes) | 17 | 7.0 4.4–11.2ROR 7.1 · χ² 82 / p 8e-20 | 6.0 EB05 3.9 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | serious PRR 4.4 | no trial data cached |
| Blood creatine phosphokinase increased | 18 | 6.8 4.3–10.8ROR 6.9 · χ² 84 / p 2e-20 | 5.9 EB05 3.9 · IC025 +1.8 3/3 methods agree | Lab value / disease marker | serious PRR 4.5 | no trial data cached |
| Respiratory arrest | 17 | 6.8 4.2–10.9ROR 6.8 · χ² 78 / p 4e-19 | 5.9 EB05 3.8 · IC025 +1.7 3/3 methods agree | Not in label — unassessed | serious PRR 4.0 | no trial data cached |
| Cardio-respiratory arrest | 25 | 6.6 4.5–9.7ROR 6.7 · χ² 113 / p 9e-27 | 6.0 EB05 4.2 · IC025 +1.9 3/3 methods agree | Not in label — unassessed | serious PRR 3.9 · 96% clinician | no trial data cached |
| Upper gastrointestinal haemorrhage | 10 | 6.6 3.5–12.2ROR 6.6 · χ² 42 / p 5e-11 | 5.2 EB05 3.0 · IC025 +1.3 3/3 methods agree | Not in label — unassessed | serious PRR 3.9 | no trial data cached |
| Depressed level of consciousness | 22 | 6.2 4.1–9.4ROR 6.3 · χ² 91 / p 8e-22 | 5.5 EB05 3.8 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | serious PRR 3.7 | no trial data cached |
| Gastrointestinal haemorrhage | 46 | 6.1 4.6–8.1ROR 6.2 · χ² 191 / p 1e-43 | 5.8 EB05 4.5 · IC025 +2.0 3/3 methods agree | Not in label — unassessed | serious PRR 3.6 · 91% clinician | no trial data cached |
| Hyperkalaemia (high potassium) | 19 | 6.0 3.9–9.5ROR 6.1 · χ² 75 / p 2e-18 | 5.3 EB05 3.6 · IC025 +1.6 3/3 methods agree | Not in label — unassessed | serious PRR 3.6 | no trial data cached |
| Unresponsive to stimuli | 14 | 6.0 3.6–10.2ROR 6.1 · χ² 54 / p 1e-13 | 5.1 EB05 3.2 · IC025 +1.5 3/3 methods agree | Not in label — unassessed | serious PRR 3.6 | no trial data cached |
| Hepatic failure | 16 | 5.9 3.6–9.6ROR 5.9 · χ² 60 / p 5e-15 | 5.1 EB05 3.3 · IC025 +1.5 3/3 methods agree | Not in label — unassessed | serious PRR 3.5 | no trial data cached |
| Pallor | 14 | 5.7 3.4–9.6ROR 5.7 · χ² 50 / p 9e-13 | 4.9 EB05 3.1 · IC025 +1.4 3/3 methods agree | Not in label — unassessed | serious PRR 4.4 | no trial data cached |
| Swollen tongue | 16 | 5.7 3.5–9.3ROR 5.7 · χ² 57 / p 2e-14 | 4.9 EB05 3.2 · IC025 +1.5 3/3 methods agree | Not in label — unassessed | serious PRR 4.7 | no trial data cached |
| Metabolic acidosis | 16 | 5.6 3.4–9.1ROR 5.7 · χ² 56 / p 3e-14 | 4.9 EB05 3.2 · IC025 +1.5 3/3 methods agree | Not in label — unassessed | serious PRR 3.3 | no trial data cached |
| Coronary artery disease | 15 | 5.5 3.3–9.0ROR 5.5 · χ² 50 / p 6e-13 | 4.7 EB05 3.1 · IC025 +1.4 3/3 methods agree | Not in label — unassessed | serious PRR 3.3 | no trial data cached |
| Cerebral infarction | 12 | 5.5 3.1–9.6ROR 5.5 · χ² 39 / p 2e-10 | 4.6 EB05 2.8 · IC025 +1.2 3/3 methods agree | Not in label — unassessed | serious PRR 3.2 | no trial data cached |
| Lip swelling | 16 | 5.3 3.3–8.7ROR 5.4 · χ² 52 / p 2e-13 | 4.7 EB05 3.1 · IC025 +1.4 3/3 methods agree | Labeled (related wording) related wording | serious PRR 5.0 | no trial data cached |
| Mouth ulceration | 10 | 5.3 2.8–9.8ROR 5.3 · χ² 31 / p 2e-8 | 4.3 EB05 2.5 · IC025 +1.1 3/3 methods agree | Not in label — unassessed | serious PRR 4.1 | no trial data cached |
| Urinary incontinence | 14 | 5.3 3.1–8.9ROR 5.3 · χ² 44 / p 2e-11 | 4.5 EB05 2.9 · IC025 +1.3 3/3 methods agree | Not in label — unassessed | serious PRR 4.1 | no trial data cached |
| Medication error | 26 | 5.2 3.6–7.6ROR 5.3 · χ² 84 / p 2e-20 | 4.8 EB05 3.4 · IC025 +1.6 3/3 methods agree | Reporting / coding artifact | serious PRR 4.4 · 90% clinician | no trial data cached |
| Haemoglobin decreased | 48 | 5.2 3.9–6.9ROR 5.3 · χ² 159 / p 1e-36 | 4.9 EB05 3.9 · IC025 +1.8 3/3 methods agree | Lab value / disease marker | serious PRR 3.4 · 93% clinician | no trial data cached |
Trial evidence (ClinicalTrials.gov)
Trial cross-check not yet run for this drug (ClinicalTrials.gov pull covers the 800 most-reported drugs first).
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Completed suicide (death by suicide) | 100 | 13.2 10.9–16.0ROR 13.9 · χ² 1,120 / p 8e-246 | 13.1 EB05 11.0 · IC025 +3.3 3/3 methods agree | Outcome field, not a reaction | serious PRR 7.8 · 98% clinician | no trial data cached |
| Haemoglobin decreased | 48 | 5.2 3.9–6.9ROR 5.3 · χ² 159 / p 1e-36 | 4.9 EB05 3.9 · IC025 +1.8 3/3 methods agree | Lab value / disease marker | serious PRR 3.4 · 93% clinician | no trial data cached |
| Myocardial infarction (heart attack) | 46 | 2.9 2.2–3.9ROR 3.0 · χ² 56 / p 3e-14 | 2.8 EB05 2.2 · IC025 +1.0 3/3 methods agree | Not in label — unassessed | serious PRR 1.7 | no trial data cached |
| Gastrointestinal haemorrhage | 46 | 6.1 4.6–8.1ROR 6.2 · χ² 191 / p 1e-43 | 5.8 EB05 4.5 · IC025 +2.0 3/3 methods agree | Not in label — unassessed | serious PRR 3.6 · 91% clinician | no trial data cached |
| Renal failure acute | 43 | 11.1 8.3–14.9ROR 11.3 · χ² 386 / p 3e-86 | 10.7 EB05 8.1 · IC025 +2.8 3/3 methods agree | Not in label — unassessed | serious PRR 6.5 | no trial data cached |
| Liver function test abnormal | 39 | 14.8 10.9–20.2ROR 15.1 · χ² 489 / p 1e-108 | 14.6 EB05 11.0 · IC025 +3.1 3/3 methods agree | Reporting / coding artifact | serious PRR 10.9 | no trial data cached |
| Rhabdomyolysis (muscle breakdown) | 31 | 8.3 5.8–11.7ROR 8.4 · χ² 191 / p 8e-44 | 7.6 EB05 5.5 · IC025 +2.3 3/3 methods agree | Not in label — unassessed | serious PRR 4.9 · ♀ 33% (drug 58%) | no trial data cached |
| Haematemesis (vomiting blood) | 29 | 12.7 8.8–18.2ROR 12.9 · χ² 301 / p 1e-67 | 12.2 EB05 8.6 · IC025 +2.8 3/3 methods agree | Not in label — unassessed | serious PRR 7.7 · ♀ 96% (drug 58%) · 100% clinician | no trial data cached |
| Drug toxicity | 28 | 22.6 15.6–32.6ROR 22.9 · χ² 555 / p 6e-123 | 22.2 EB05 16.1 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | serious PRR 13.8 · 96% clinician | no trial data cached |
| Medication error | 26 | 5.2 3.6–7.6ROR 5.3 · χ² 84 / p 2e-20 | 4.8 EB05 3.4 · IC025 +1.6 3/3 methods agree | Reporting / coding artifact | serious PRR 4.4 · 90% clinician | no trial data cached |
| Cardio-respiratory arrest | 25 | 6.6 4.5–9.7ROR 6.7 · χ² 113 / p 9e-27 | 6.0 EB05 4.2 · IC025 +1.9 3/3 methods agree | Not in label — unassessed | serious PRR 3.9 · 96% clinician | no trial data cached |
| International normalised ratio increased | 25 | 9.7 6.5–14.2ROR 9.8 · χ² 185 / p 2e-42 | 8.8 EB05 6.1 · IC025 +2.4 3/3 methods agree | Lab value / disease marker | serious PRR 6.3 · 92% clinician | no trial data cached |
| Drug abuse | 22 | 2.9 1.9–4.4ROR 2.9 · χ² 26 / p 2e-7 | 2.8 EB05 2.0 · IC025 +0.8 | Reporting / coding artifact | serious PRR 1.7 · 100% clinician | no trial data cached |
| Anaphylactic reaction (severe allergic reaction) | 22 | 4.4 2.9–6.7ROR 4.5 · χ² 56 / p 5e-14 | 4.1 EB05 2.9 · IC025 +1.3 3/3 methods agree | Not in label — unassessed | serious PRR 2.6 · ♀ 91% (drug 58%) · 90% clinician | no trial data cached |
| Pancreatitis (pancreas inflammation) | 22 | 4.6 3.0–7.0ROR 4.7 · χ² 59 / p 8e-15 | 4.2 EB05 3.0 · IC025 +1.4 3/3 methods agree | Not in label — unassessed | serious PRR 2.8 | no trial data cached |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- Drug toxicity — n=28, PRR 22.6
- Haematemesis — n=29, PRR 12.7
- Renal failure acute — n=43, PRR 11.1
- Rhabdomyolysis — n=31, PRR 8.3
- Cardio-respiratory arrest — n=25, PRR 6.6
- Depressed level of consciousness — n=22, PRR 6.2
- Gastrointestinal haemorrhage — n=46, PRR 6.1
✓ A hand-written Bradford Hill causality assessment exists for this drug: Acetaminophen (paracetamol) ↔ Liver injury / hepatotoxicity.
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Acetaminophen and Codeine?
In FDA FAERS, the most frequently co-reported reaction terms for Acetaminophen and Codeine are haemoglobin decreased, myocardial infarction, gastrointestinal haemorrhage, renal failure acute, rhabdomyolysis, haematemesis. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Acetaminophen and Codeine have an FDA boxed warning?
No. The FDA label retrieved for Acetaminophen and Codeine has no boxed warning; see the label's Warnings and Precautions for the recognised risks.
Do FAERS signals prove that Acetaminophen and Codeine causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID 004c39cd-b4f4-1cae-e063-6394a90a0697, effective 20251003; matched on
openfda.generic_name.exact:"ACETAMINOPHEN") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 126 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath
Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.