Snorting Tylenol PM: Dangers And Side Effects - Addiction Resource

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answered by Treatment X Evidence Based Snorting Tylenol PM: Dangers And Side Effects Written by Dr. Anjali Talcherkar, Ph.D. Medically Reviewed by Johnelle Smith, M.D.

Updated on August 26, 2025

Tylenol PM is an over-the-counter drug that some people may crush and snort for faster effects. It can also be crushed and mixed with heroin. Snorting Tylenol PM can be dangerous, and may have harmful side effects, including overdose and liver damage.

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  • Tylenol PM Vs. Tylenol
  • Effects Of Snorting Tylenol PM
  • Why Snort Tylenol PM?
  • Dangers
  • Find Treatment Today
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Tylenol PM is a drug that can be bought over-the-counter (OTC) and comes in the form of a tablet. Getting Tylenol PM does not require a prescription, making it easily available at most stores. The medication combines acetaminophen for pain and fever relief with diphenhydramine, an antihistamine that causes drowsiness. Uses for Tylenol PM include pain relief, allergy relief, reducing fever, and serving as a sleep aid for people with minor aches and pains.

This drug is intended to be swallowed by mouth. Taking it in any way other than directed, including snorting it, can have harmful side effects and may be a sign of drug abuse. Snorting Tylenol PM is particularly dangerous because the tablets contain fillers and binders not meant to be inhaled. The large amount of acetaminophen in each tablet can also cause severe nasal damage and potentially dangerous overdose levels when the body’s natural absorption process is bypassed.

Learn more about the dangers and effects of snorting drugs.

What Makes Tylenol PM Different Than Tylenol?

The main difference between regular Tylenol and Tylenol PM is that while regular Tylenol contains only acetaminophen for pain and fever relief, Tylenol PM contains the added ingredient diphenhydramine, an antihistamine that can relieve allergies and cause sleepiness. This addition of diphenhydramine is what gives Tylenol PM its nighttime formula properties, making it effective as both a pain reliever and a sleep aid, but also making it potentially more dangerous when misused since users are consuming two active drugs instead of one.

What Does Snorting Tylenol PM Do?

Snorting drugs, also known as insufflation, is a common sign of drug misuse. While often done to feel the effects of a drug more quickly, this can also lead to potentially serious side effects.

Side effects of snorting Tylenol PM can include:

  • irritated or runny nose
  • nosebleeds
  • intense drowsiness
  • dizziness
  • upset stomach
  • blurred vision
  • dry mouth
  • dry nose

Snorting a lot of Tylenol PM, or crushing it and mixing it with other drugs, can lead to additional side effects, including changes in mood, behavior, and vital signs.

Why Do People Snort Tylenol PM?

Snorting over-the-counter drugs like Tylenol PM is uncommon. However, sometimes people will snort Tylenol by itself or crush it and mix it with other drugs.

People may snort Tylenol PM to:

  • get high
  • get rapid pain relief
  • fall asleep
  • stave off withdrawal symptoms

Tylenol PM is sometimes crushed and mixed with heroin. This has been referred to as “cheese” heroin. It is tannish or brown in color.

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Snorting Tylenol PM mixed with heroin can be very dangerous, due to a high risk of drug dependence over time, addiction, and overdose.

Dangers Of Snorting Tylenol PM

Snorting Tylenol PM can lead to serious effects, in part because this is not how it is supposed to be used. It can also be dangerous depending on the dose taken, and if used with other drugs.

Short and long-term dangers include:

  • liver damage
  • confusion
  • severe skin reactions
  • vision problems
  • nasal damage
  • psychological dependence
  • mood swings
  • liver damage
  • risk of addiction

In September of 2020, the U.S. Food and Drug Administration issued a Drug Safety Communication regarding Benadryl, which contains an ingredient also in Tylenol PM. Within this safety alert, the FDA stated that taking high doses of diphenhydramine, an ingredient in Tylenol PM, may cause heart problems, seizures, coma, and even death.

Overdose After Snorting Tylenol PM

Drug overdose is a potentially life-threatening condition that can occur after taking too much Tylenol PM, or mixing it with other drugs, including alcohol.

Signs of an overdose might include:

  • nausea
  • vomiting
  • stomach pain
  • irregular heartbeat
  • loss of appetite
  • confusion
  • seizures
  • unconsciousness

If someone is experiencing severe symptoms after snorting Tylenol PM, such as difficulty breathing, stopped breathing, or unconsciousness, seek medical attention right away.

Cheese Heroin Overdose

Cheese heroin refers to Tylenol PM mixed with black tar heroin. Heroin is involved in thousands of drug overdose deaths each year.

Symptoms of a cheese heroin overdose include:

  • difficulty breathing
  • very slow or stopped breathing
  • bluish lips or fingers
  • cold, clammy skin
  • tiny pupils
  • weak pulse
  • low blood pressure
  • gurgling noises
  • unresponsiveness
  • unconsciousness

Heroin overdose can be life-threatening. Call 911 right away if someone has stopped breathing, is unresponsive, or has fallen unconscious after snorting heroin and Tylenol PM.

Tylenol PM Abuse And Addiction

National survey data shows that an estimated 3.1 million Americans misuse over-the-counter medications at some point in their lives. Antihistamines and pain-relievers like Tylenol PM are some of the most commonly misused OTC drugs.

Snorting Tylenol PM repeatedly can lead to psychological addiction, physical health problems, and may increase the risk of abusing other drugs, including illicit drugs like heroin.

Treatment For Tylenol PM Abuse

Treatment may include medical detox if the person has developed a physical dependence on the diphenhydramine, as stopping suddenly can cause uncomfortable withdrawal symptoms like anxiety, insomnia, and nausea. Healthcare providers can also check for liver damage from acetaminophen abuse and provide medications to help manage withdrawal symptoms safely.

Professional addiction treatment programs offer the best chance for long-term recovery from Tylenol PM abuse. These programs typically include counseling to address the underlying reasons for drug abuse, behavioral therapy to develop healthy coping skills, and support groups where people can connect with others facing similar challenges. Since Tylenol PM abuse often happens alongside other substance abuse problems, treatment centers can address multiple addictions at once. Outpatient programs allow people to get treatment while maintaining work or school responsibilities, while inpatient programs provide 24-hour support for those with more severe abuse patterns or multiple health complications.

Written by the Addiction Resource Editorial Staff

This page does not provide medical advice. See more Article resources

Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.

These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.

  • Dallas Police Department—Cheese Heroinhttps://dallaspolice.net/division/narcotics/cheese-heroin
  • U.S. Food and Drug Administration (FDA)—FDA warns about serious problems with high doses of the allergy medicine diphenhydramine (Benadryl)https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-serious-problems-high-doses-allergy-medicine-diphenhydramine-benadryl
  • U.S. National Library of Medicine: DailyMed—TYLENOL PMhttps://www.tylenol.com/products/sleep-pain/tylenol-pm-extra-strength-caplet
  • U.S. National Library of Medicine: MedlinePlus—Heroin overdosehttps://medlineplus.gov/ency/article/002861.htm
  • U.S. National Library of Medicine—Abuse of over-the-counter medicines: a pharmacist’s perspectivehttps://pmc.ncbi.nlm.nih.gov/articles/PMC5774309/
  • U.S. National Library of Medicine—Prescription and over-the-counter drug treatment admissions to the California pubic treatment systemhttps://pubmed.ncbi.nlm.nih.gov/21193282/
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