Safety of Tylenol 4 (Acetaminophen/Codeine) with Reduced Renal Function

Assessment of Renal Function

• A GFR of 53 ml/min/1.73m² represents moderate renal impairment, requiring medication dose adjustments for renally excreted drugs 1
• Patients with reduced renal function may be more susceptible to nephrotoxic effects of medications and impaired drug metabolism 1
• Medication dosing should carefully consider risks, potential benefits, and potential harms in the context of reduced renal function 1

Monitoring and Precautions

• Monitor eGFR, electrolytes, and medication levels when indicated 1, 2
• Review and limit use of other over-the-counter medicines that may be harmful 2
• Establish collaborative relationships with pharmacists to ensure proper drug stewardship 1
• Temporarily discontinue potentially nephrotoxic medications during acute illness that increases risk of acute kidney injury 2
• Consider consulting with a clinical pharmacist for medication management 1
• Educate patients about expected benefits and possible risks so they can identify and report adverse events 1