aspirin, caffeine, and dihydrocodeine

What is the most important information I should know about aspirin, caffeine, and dihydrocodeine?

You should not use this medication if you are allergic to aspirin, caffeine, or dihydrocodeine.

This medication should not be given to a child younger than 12 years old. Aspirin should not be given to a child or teenager who has a fever, especially if the child also has flu symptoms or chicken pox. Aspirin can cause a serious and sometimes fatal condition called Reye's syndrome in children.

Stop using this medication and call your doctor at once if you have any symptoms of bleeding in your stomach or intestines. Symptoms include black, bloody, or tarry stools, and coughing up blood or vomit that looks like coffee grounds.

Dihydrocodeine may be habit-forming and should be used only by the person this medicine was prescribed for. Keep the medication in a secure place where others cannot get to it.

What is aspirin, caffeine, and dihydrocodeine?

Aspirin is a salicylate (sa-LIS-il-ate). It works by reducing substances in the body that cause pain, fever, and inflammation.

Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow.

Dihydrocodeine is related to codeine. It is an opioid pain medication. An opioid is sometimes called a narcotic.

The combination of aspirin, caffeine, and dihydrocodeine is used to treat moderate to severe pain.

Aspirin, caffeine, and dihydrocodeine may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking aspirin, caffeine, and dihydrocodeine?

You should not use this medication if you are allergic to aspirin, caffeine, or dihydrocodeine.

To make sure you can safely take this medication, tell your doctor if you have any of these other conditions:

• a bleeding or blood clotting disorder;
• stomach ulder or bleeding;
• severe constipation, blockage in your stomach or intestines;
• liver or kidney disease;
• asthma or other breathing disorder;
• a history of head injury or brain tumor; or
• or a history of drug or alcohol addiction.

Dihydrocodeine may be habit forming and this medication should be used only by the person it was prescribed for. Never share the medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

Dihydrocodeine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

FDA pregnancy category C. Dihydrocodeine may cause addiction or withdrawal symptoms in a newborn if the mother takes the medication during pregnancy. Taking aspirin during late pregnancy may cause bleeding in the mother or the baby during delivery. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Older adults may be more likely to have side effects from this medication.

This medication should not be given to a child younger than 12 years old. Aspirin should not be given to a child or teenager who has a fever, especially if the child also has flu symptoms or chicken pox. Aspirin can cause a serious and sometimes fatal condition called Reye's syndrome in children.

How should I take aspirin, caffeine, and dihydrocodeine?

Take exactly as prescribed. Never take this medication in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Take this medicine with food or milk if it upsets your stomach.

Do not stop using aspirin, caffeine, and dihydrocodeine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using aspirin, caffeine, and dihydrocodeine.

If you need surgery, tell the surgeon ahead of time that you are using this medication. You may need to stop using the medicine for a short time.

Store at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Dihydrocodeine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Since this medication is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of dihydrocodeine can be fatal.

Overdose symptoms may include extreme drowsiness or insomnia, restless feeling, tremors, fast heart rate, pinpoint pupils, nausea, vomiting, dark urine, confusion, ringing in your ears, fainting, weak pulse, seizure (convulsions), blue lips, shallow breathing, or no breathing.

What should I avoid while taking aspirin, caffeine, and dihydrocodeine?

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how the medicine will affect you.

Ask a doctor or pharmacist before using any cough, cold, allergy, or pain medication. Aspirin and caffeine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains aspirin or caffeine.

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Talk with your doctor about taking aspirin, caffeine, and dihydrocodeine if you also take diet pills, caffeine pills, or other stimulants (such as ADHD medications).

What are the possible side effects of aspirin, caffeine, and dihydrocodeine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using this medication and call your doctor at once if you have a serious side effect such as:

• shallow breathing, slow heart rate;
• fast or pounding heart rate, muscle twitching;
• confusion, unusual thoughts or behavior;
• black, bloody, or tarry stools; or
• coughing up blood or vomit that looks like coffee grounds.

Less serious side effects may include:

• feeling dizzy, drowsy, shaky, anxious, or agitated;
• nausea, vomiting, constipation;
• itching or mild rash;
• sleep problems (insomnia); or
• ringing in your ears.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect aspirin, caffeine, and dihydrocodeine?

Before using this medication, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by dihydrocodeine.

Tell your doctor about all other medicines you use, especially:

• bupropion (Wellbutrin, Zyban);
• droperidol (Inapsine);
• naloxone (Narcan, Suboxone);
• probenecid (Benemid);
• a blood thinner such as rivaroxaban (Xarelto) or warfarin (Coumadin, Jantoven);
• bowel cleansing preparations (Half Lytely, Fleet Prep Kit, Evac-Q-Kwik, GoLytely, Supraprep, and others);
• heparin medications such as dalteparin (Fragmin), enoxaparin (Lovenox), fondaparinux (Arixtra), or tinzaparin (Innohep);
• an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate);
• another NSAID such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others; or
• other salicylate such as aspirin, Nuprin Backache Caplet, Kaopectate, KneeRelief, Pamprin Cramp Formula, Pepto-Bismol, Tricosal, Trilisate, and others.

This list is not complete and other drugs may interact with aspirin, caffeine, and dihydrocodeine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about aspirin, caffeine, and dihydrocodeine.