$Unique_ID{BRK03033} $Pretitle{} $Title{aspirin, caffeine, and dihydrocodeine combination} $Subject{Synalgos-DC Ives Analgesic combination aspirin caffeine dihydrocodeine mild moderate pain narcotic analgesic central nervous system brain spinal cord stimulant constricts blood vessels} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. aspirin, caffeine, and dihydrocodeine combination ------------------------------------------------------------------------------ BRAND NAME (Manufacturer) Synalgos-DC (Ives) TYPE OF DRUG Analgesic combination INGREDIENTS aspirin, caffeine, and dihydrocodeine DOSAGE FORM Capsules (356.4 mg aspirin, 30 mg caffeine, and 16 mg dihydrocodeine) STORAGE This medication should be stored at room temperature in a tightly closed container. Moisture causes the aspirin in this product to decompose. USES Aspirin, caffeine, and dihydrocodeine combination is used to relieve mild to moderate pain. Dihydrocodeine is a narcotic analgesic that acts on the central nervous system (brain and spinal cord) to relieve pain. Caffeine is a central nervous system stimulant. It constricts the blood vessels in the head, which may help to relieve headaches. TREATMENT In order to avoid stomach upset, you can take this medication with food or milk. This medication works most effectively if you take it at the onset of pain, rather than waiting until the pain becomes intense. If you are taking this drug on a schedule and you miss a dose, take the missed dose as soon as possible, unless it is almost time for your next dose. In that case, don't take the missed dose at all; just return to your regular dosing schedule. Do not double the next dose. SIDE EFFECTS Minor. Constipation, dizziness, drowsiness, dry mouth, false sense of well-being, headache, indigestion, loss of appetite, nausea, nervousness, restlessness, sleep disorders, sweating, or vomiting. These side effects should disappear as your body adjusts to the medication. If you are constipated, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads), drink more water, and exercise (unless your doctor directs you to do otherwise). Chew sugarless gum or suck on ice chips or a piece of hard candy to reduce mouth dryness. If you feel dizzy or light-headed, sit or lie down for a while; get up from a sitting or lying position slowly. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about black, tarry stools; blurred vision; chest tightness; difficult or painful urination; difficulty in breathing; fainting; itching; light-headedness; loss of coordination; palpitations; ringing in the ears; severe abdominal pain; skin rash; sore throat and fever; or unusual bleeding or bruising. INTERACTIONS This medication interacts with several other types of drugs: 1. Concurrent use of this medication with other central nervous system depressants (such as alcohol, antihistamines, barbiturates, benzodiazepine tranquilizers, muscle relaxants, and phenothiazine tranquilizers) or with tricyclic antidepressants can cause extreme drowsiness. 2. Concurrent use of this drug and monoamine oxidase (MAO) inhibitors should be avoided. At least 14 days should separate the use of aspirin, caffeine, and dihydrocodeine combination and the use of an MAO inhibitor. 3. Alcohol and anti-inflammatory medication can increase the gastrointestinal side effects of this medication. 4. The aspirin in this product may increase the side effects of anticoagulants (blood thinners, such as warfarin), oral antidiabetic agents, phenytoin, and methotrexate. 5. Large doses of antacids increase the elimination of the aspirin portion of this medication from the body and decrease its effectiveness. 6. The aspirin portion of this medication may decrease the antigout effects of probenecid and sulfinpyrazone. BE SURE TO TELL YOUR DOCTOR about any medications that you are currently taking, especially any of the medications that are listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to medications, especially to aspirin, methyl salicylate (oil of wintergreen), diclofenac, diflunisal, flurbiprofen, fenoprofen, ibuprofen, indomethacin, ketoprofen, meclofenamate, mefenamic acid, naproxen, piroxicam, sulindac, or tolmetin; to dihydrocodeine or other narcotic analgesics (such as codeine, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, and propoxyphene); or to caffeine. * Tell your doctor if you now have or if you have ever had abdominal disease, Addison's disease, bleeding or blood disorders, brain disease, colitis, epilepsy, gallstones or gallbladder disease, head injuries, heart disease, hemophilia, kidney disease, liver disease, lung disease, peptic ulcers, prostate disease, or thyroid disease. * If this drug makes you dizzy or drowsy, do not take part in any activity that requires alertness, such as driving a car or operating potentially dangerous equipment. * Before having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking this medication. Aspirin-containing medication is usually discontinued five to seven days before surgery, to prevent bleeding complications. * The use of aspirin in children (about 16 years of age or less) in an attempt to treat the symptoms of the flu or chicken pox has been associated with a rare, life-threatening condition called Reye's syndrome. Therefore, it is very important that aspirin-containing products should, not be given to children with the signs of these infections. * Because this drug contains dihydrocodeine, it has the potential for abuse and must be used with caution. Usually, it should not be taken on a regular schedule for longer than ten days at a time. Tolerance develops quickly; do not increase the dosage or stop taking the drug abruptly, unless you first consult your doctor. If you have been taking large amounts of this medication for long periods, you may experience a withdrawal reaction (muscle aches, diarrhea, gooseflesh, runny nose, nausea, vomiting, shivering, trembling, stomach cramps, sleep disorders, irritability, weakness, excessive yawning, or sweating). Your doctor may, therefore, want to reduce the dosage gradually. * Because this product contains aspirin, additional medications that contain aspirin should not be taken without your doctor's approval. Check the labels on over-the-counter (nonprescription) pain, sinus, allergy, asthma, cough, and cold products to see if they contain aspirin. * Diabetics should be aware that large doses of aspirin (more than eight 325-mg tablets of aspirin per day) may interfere with urine sugar testing and should, therefore, check with their doctor before changing their insulin dose. * Be sure to tell your doctor if you are pregnant. The effects of this medication during pregnancy have not been thoroughly studied in humans. Dihydrocodeine, used regularly in large doses during pregnancy, may result in addiction of the fetus, leading to withdrawal symptoms (irritability, excessive crying, tremors, fever, vomiting, diarrhea, sneezing, or excessive yawning) at birth. Large amounts of aspirin taken close to the end of pregnancy may prolong labor and cause bleeding problems in the mother and heart problems in the newborn infant. Also, tell your doctor if you are breast-feeding an infant. Small amounts of this medication may pass into breast milk and cause excessive drowsiness in the nursing infant. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.