Mixing Cocaine (coke) and Tylenol PM
Caution
Carries risk that is worth understanding before combining. Reduce doses and do not use alone.
Can you take Cocaine with Tylenol PM?
Tylenol PM contains acetaminophen and diphenhydramine. The most concerning part is Cocaine with Tylenol PM (Diphenhydramine): cocaine hides how sedated you are; if it wears off first, high doses of diphenhydramine can stop your breathing. Both strain the heart. Keep diphenhydramine to ordinary medical doses. MixSafe rates Cocaine with Tylenol PM as "Caution" — carries risk that is worth understanding before combining. Reduce doses and do not use alone. Sources: the Drug Facts labels on DailyMed, the TripSit combination chart and MixSafe research. Educational information, not medical advice.
What is in it
- Tylenol PM
- Acetaminophen + Diphenhydramine.
Ingredient by ingredient
Cocaine + Tylenol PM (Diphenhydramine)Caution
Cocaine hides how sedated you are; if it wears off first, high doses of diphenhydramine can stop your breathing. Both strain the heart. Keep diphenhydramine to ordinary medical doses.
Stimulants increase respiration rate allowing for a higher dose of sedatives than normal. If cocaine wears off first, recreational dosages of DPH may overcome the individual and cause respiratory arrest. Both substances at recreational dosages strain the heart and may lead to further dangerous heart complications. When taken together, both substances can potentially be more reinforcing and have greater risk of methemoglobinemia when higher dosages of DPH are combined with cocaine.
Source: TripSit drug combination chart
Cocaine + Tylenol PM (Acetaminophen)Low risk, no synergy
Neither substance is expected to meaningfully change the other. Both still carry their own individual risks.
No specific interaction is documented. Acetaminophen's main risk is dose-dependent liver injury, so the thing to watch in any combination is total daily intake across all products (roughly 4g/24h) and anything else straining the liver.
Sources: Prescott LF. Paracetamol, alcohol and the liver. Br J Clin Pharmacol. 2000 · Acetaminophen: A Liver Killer or Thriller
- Tylenol PM Extra Strength, Drug Facts label. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ce58105b-f010-47af-8f31-6dd4ce4e9cba
Ingredient lists checked 2026-09-27. Formulas change and store brands differ, so the Drug Facts box on your own packet is the final word.
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