Health Guide
Drug Guide

Analgesic combination, acetaminophen/salicylate (Oral route)

Brand Names:

Dosage Forms:

Uses of This Medicine:

Acetaminophen and salicylate combination medicines relieve pain and reduce fever. They may be used to relieve occasional pain caused by mild inflammation or arthritis (rheumatism). The acetaminophen, aspirin, and caffeine combination also may be used to relieve pain associated with migraine headaches.

Neither acetaminophen nor salicylamide is as effective as aspirin for treating chronic or severe pain, or other symptoms, caused by inflammation or arthritis. Some of these combination medicines do not contain any aspirin. Even those that do contain aspirin may not contain enough to be effective in treating these conditions.

A few reports have suggested that acetaminophen and salicylates used together may cause kidney damage or cancer of the kidney or urinary bladder. This may occur if large amounts of both medicines are taken together for a very long time. However, taking usual amounts of these combination medicines for a short time has not been shown to cause these unwanted effects. Also, these effects are not likely to occur with either acetaminophen or a salicylate used alone, even if large amounts have been taken for a long time. Therefore, for long-term use, it may be best to use either acetaminophen or a salicylate, but not both, unless you are under a doctor's care.

Before giving any of these combination medicines to a child, check the package label very carefully. Some of these medicines are too strong for use in children. If you are not certain whether a specific product can be given to a child, or if you have any questions about the amount to give, check with your health care professional.

These medicines are available without a prescription. However, your doctor may have special instructions on the proper dose of these medicines for your medical condition.

Before Using This Medicine:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children

Older adults

Elderly people may be more likely than younger adults to develop serious kidney problems if they take large amounts of these combination medicines for a long time. Therefore, it is best that elderly people not take this medicine for more than 5 days in a row unless they are under a doctor's care.

Pregnancy

Breast-feeding

Other medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Other interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Using medicines in this class with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use your medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

Proper Use of This Medicine:

Take this medicine with food or a full glass (8 ounces) of water to lessen the chance of stomach upset.

Unless otherwise directed by your doctor:

Dosing

The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Storage

Keep out of the reach of children.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using This Medicine:

If you will be taking this medicine for a long time, or in high doses, your doctor should check your progress at regular visits. This is especially important for elderly people, who may be more likely than younger adults to develop serious kidney problems if they take large amounts of this medicine for a long time.

Check with your doctor:

Do not take any of the combination medicines containing aspirin for 5 days before any surgery, including dental surgery, unless otherwise directed by your medical doctor or dentist. Taking aspirin during this time may cause bleeding problems.

Check the label of all over-the-counter (OTC), nonprescription, and prescription medicines you now take. If any of them contain acetaminophen, aspirin, other salicylates such as bismuth subsalicylate (e.g., Pepto Bismol) or magnesium salicylate (e.g., Nuprin Backache Caplets), or salicylic acid (present in some shampoos and skin products), check with your health care professional. Using any of them together with this medicine may cause an overdose.

Stomach problems may be more likely to occur if you drink three or more alcoholic beverages while you are taking aspirin. Also, liver damage may be more likely to occur if you drink three or more alcoholic beverages while you are taking acetaminophen.

Taking certain other medicines together with acetaminophen and salicylates may increase the chance of unwanted effects. The risk will depend on how much of each medicine you take every day, and on how long you take the medicines together. If your medical doctor or dentist directs you to take these medicines together on a regular basis, follow his or her directions carefully. However, do not take any of the following medicines together with any of these combination medicines for more than a few days unless your doctor has directed you to do so and is following your progress:

The antacid present in buffered forms of these combination medicines can keep other medicines from working properly. If you need to take a buffered form of this medicine, and you are also taking one of the following medicines, be sure to take the buffered acetaminophen and salicylate combination medicine:

If you are taking a laxative containing cellulose, do not take it within 2 hours of taking this medicine. Taking the laxative and this medicine close together may make this medicine less effective by preventing the salicylate in it from being absorbed by your body.

Acetaminophen and salicylate combinations may interfere with the results of some medical tests. Before you have any medical tests, tell the person in charge if you have taken any of these combination medicines within the past 3 or 4 days. If possible, it is best to call the laboratory where the test will be done about 4 days ahead of time to find out whether the medicine may be taken during the 3 or 4 days before the test.

For patients with diabetes:

For patients taking one of the products that contain caffeine:

If you think that you or anyone else may have taken an overdose of this medicine, get emergency help at once. Taking an overdose of a salicylate may cause unconsciousness or death. The first symptom of an aspirin overdose may be ringing or buzzing in the ears. Other signs include convulsions (seizures), hearing loss, confusion, severe drowsiness or tiredness, severe excitement or nervousness, and unusually fast or deep breathing. Signs of severe acetaminophen overdose may not appear until 2 to 4 days after the overdose is taken, but treatment to prevent liver damage or death must be started within 24 hours or less after the overdose is taken.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common or rare
Coughing
difficulty in swallowing
dizziness, lightheadedness, or feeling faint (severe)
flushing, redness, or other change in skin color
shortness of breath, troubled breathing, tightness in chest, or wheezing
sudden decrease in amount of urine
swelling of eyelids, face, or lips

Get emergency help immediately if any of the following symptoms of overdose occur:

Signs and symptoms of overdose
Agitation, anxiety, excitement, irritability, nervousness, or restlessness
any loss of hearing
bloody urine
confusion or delirium
convulsions (seizures)
diarrhea (severe or continuing)
dizziness or lightheadedness
drowsiness (severe)
fast or deep breathing
fast or irregular heartbeat (for medicines containing caffeine
frequent urination (for medicines containing caffeine)
hallucinations (seeing, hearing, or feeling things that are not there)
increased sensitivity to touch or pain (for medicines containing caffeine)
increased sweating
loss of appetite
muscle trembling or twitching (for medicines containing caffeine)
nausea or vomiting (continuing, sometimes with blood)
ringing or buzzing in ears (continuing)
seeing flashes of lights (for medicines containing caffeine)
stomach cramps or pain (severe or continuing)
swelling, pain, or tenderness in the upper abdomen or stomach area
trouble in sleeping (for medicines containing caffeine)
uncontrollable flapping movements of the hands, especially in elderly patients
unexplained fever
unexplained fever
Signs of overdose in children
Changes in behavior
drowsiness or tiredness
fast or deep breathing

Check with your doctor as soon as possible if any of the following side effects occur:

Less common or rare
Bloody or black, tarry stools
bloody or cloudy urine
fever with or without chills (not present before treatment and not caused by the condition being treated)
pain in lower back and/or side (severe and/or sharp)
pinpoint red spots on skin
skin rash, hives, or itching
sores, ulcers, or white spots on lips or in mouth
sore throat (not present before treatment and not caused by the condition being treated)
stuffy nose
swelling of face, fingers, feet, or lower legs
unusual bleeding or bruising
unusual tiredness or weakness
vomiting of blood or material that looks like coffee grounds
weight gain
yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Heartburn or indigestion (for medicines containing aspirin)
nausea, vomiting, or stomach pain (for medicines containing aspirin)
Less common
Drowsiness (for medicines containing salicylamide)
trouble in sleeping, nervousness, or jitters (for medicines containing caffeine)

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Rare
Bloody or cloudy urine
decreased urination
swelling of face, fingers, feet, or lower legs
weight gain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 10/12/2016

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