Before Using

Drug information provided by: IBM Micromedex

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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.

Pediatric

Use of aspirin, caffeine, and dihydrocodeine combination is not recommended in children 12 years of age or younger.

Synalgos®-DC should not be used to relieve pain after surgery removal of tonsils or adenoids in children. Severe breathing problems and deaths have been reported in some children who received codeine after tonsil or adenoid surgery.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of aspirin, caffeine, and dihydrocodeine combination in the elderly. However, elderly patients are more likely to have age-related lung, liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving aspirin, caffeine, and dihydrocodeine combination in order to avoid potentially serious side effects.

Breastfeeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Drug Interactions

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

  • Defibrotide
  • Dichlorphenamide
  • Influenza Virus Vaccine, Live
  • Ketorolac
  • Nalmefene
  • Naltrexone
  • Riociguat
  • Safinamide

Using this medicine 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.

  • Abiraterone Acetate
  • Acarbose
  • Aceclofenac
  • Acemetacin
  • Acepromazine
  • Alfentanil
  • Alipogene Tiparvovec
  • Almotriptan
  • Alteplase, Recombinant
  • Amifampridine
  • Amiloride
  • Amineptine
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Amitriptylinoxide
  • Amobarbital
  • Amoxapine
  • Amphetamine
  • Amprenavir
  • Amtolmetin Guacil
  • Anagrelide
  • Anileridine
  • Anisindione
  • Apixaban
  • Aprepitant
  • Argatroban
  • Aripiprazole
  • Armodafinil
  • Asenapine
  • Atazanavir
  • Baclofen
  • Bendroflumethiazide
  • Benperidol
  • Benzhydrocodone
  • Benzphetamine
  • Benzthiazide
  • Betrixaban
  • Bivalirudin
  • Boceprevir
  • Bosentan
  • Bromazepam
  • Bromfenac
  • Bromopride
  • Brompheniramine
  • Bufexamac
  • Bumetanide
  • Bupropion
  • Buspirone
  • Butabarbital
  • Caplacizumab-yhdp
  • Carbamazepine
  • Carbinoxamine
  • Carisoprodol
  • Carphenazine
  • Celecoxib
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorothiazide
  • Chlorpheniramine
  • Chlorpromazine
  • Chlorpropamide
  • Chlorthalidone
  • Chlorzoxazone
  • Choline Salicylate
  • Cilostazol
  • Cimetidine
  • Cinacalcet
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clobazam
  • Clomipramine
  • Clonazepam
  • Clonixin
  • Clopamide
  • Clopidogrel
  • Clorazepate
  • Clozapine
  • Cobicistat
  • Cocaine
  • Codeine
  • Conivaptan
  • Crizotinib
  • Cyclobenzaprine
  • Cyclopenthiazide
  • Cyclosporine
  • Dabigatran Etexilate
  • Danaparoid
  • Darunavir
  • Delavirdine
  • Desipramine
  • Desirudin
  • Desmopressin
  • Desvenlafaxine
  • Dexamethasone
  • Dexibuprofen
  • Dexketoprofen
  • Dexmedetomidine
  • Dextroamphetamine
  • Dextromethorphan
  • Diazepam
  • Diazoxide
  • Dibenzepin
  • Dichloralphenazone
  • Diclofenac
  • Dicumarol
  • Difenoxin
  • Diflunisal
  • Digoxin
  • Diltiazem
  • Diphenhydramine
  • Diphenoxylate
  • Dipyrone
  • Dolasetron
  • Donepezil
  • Dothiepin
  • Doxepin
  • Doxylamine
  • Dronedarone
  • Droperidol
  • Droxicam
  • Duloxetine
  • Edoxaban
  • Efavirenz
  • Eletriptan
  • Enflurane
  • Enzalutamide
  • Eplerenone
  • Eptifibatide
  • Erythromycin
  • Escitalopram
  • Esketamine
  • Eslicarbazepine Acetate
  • Estazolam
  • Eszopiclone
  • Ethacrynic Acid
  • Ethchlorvynol
  • Ethopropazine
  • Ethylmorphine
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Etravirine
  • Felbinac
  • Fenoprofen
  • Fentanyl
  • Fepradinol
  • Feprazone
  • Feverfew
  • Flibanserin
  • Floctafenine
  • Fluconazole
  • Flufenamic Acid
  • Fluoxetine
  • Fluphenazine
  • Flurazepam
  • Flurbiprofen
  • Fluspirilene
  • Fluvoxamine
  • Fondaparinux
  • Fosamprenavir
  • Fosaprepitant
  • Fosphenytoin
  • Fospropofol
  • Frovatriptan
  • Furazolidone
  • Furosemide
  • Ginkgo
  • Glimepiride
  • Glipizide
  • Glyburide
  • Gossypol
  • Granisetron
  • Halazepam
  • Haloperidol
  • Halothane
  • Heparin
  • Hexobarbital
  • Hydrochlorothiazide
  • Hydrocodone
  • Hydroflumethiazide
  • Hydromorphone
  • Hydroxytryptophan
  • Hydroxyzine
  • Ibrutinib
  • Ibuprofen
  • Idelalisib
  • Imatinib
  • Imipramine
  • Indapamide
  • Indinavir
  • Indomethacin
  • Inotersen
  • Iobenguane I 131
  • Iproniazid
  • Isocarboxazid
  • Isoflurane
  • Itraconazole
  • Ivacaftor
  • Ketamine
  • Ketazolam
  • Ketobemidone
  • Ketoconazole
  • Ketoprofen
  • Lepirudin
  • Levomilnacipran
  • Levorphanol
  • Linezolid
  • Lisdexamfetamine
  • Lithium
  • Lofepramine
  • Lofexidine
  • Lomitapide
  • Lopinavir
  • Lorazepam
  • Lorcaserin
  • Lornoxicam
  • Loxapine
  • Loxoprofen
  • Lumacaftor
  • Lumiracoxib
  • Macimorelin
  • Meclizine
  • Meclofenamate
  • Mefenamic Acid
  • Melitracen
  • Meloxicam
  • Melperone
  • Meperidine
  • Mephobarbital
  • Meprobamate
  • Mesoridazine
  • Metaxalone
  • Metformin
  • Methadone
  • Methamphetamine
  • Methdilazine
  • Methocarbamol
  • Methohexital
  • Methotrexate
  • Methotrimeprazine
  • Methyclothiazide
  • Methylene Blue
  • Metoclopramide
  • Metolazone
  • Mibefradil
  • Midazolam
  • Mifepristone
  • Milnacipran
  • Mirabegron
  • Mirtazapine
  • Mitotane
  • Moclobemide
  • Modafinil
  • Molindone
  • Moricizine
  • Morniflumate
  • Morphine
  • Morphine Sulfate Liposome
  • Nabumetone
  • Nafcillin
  • Naproxen
  • Naratriptan
  • Nateglinide
  • Nefazodone
  • Nelfinavir
  • Nepafenac
  • Nevirapine
  • Nialamide
  • Nicomorphine
  • Nicorandil
  • Niflumic Acid
  • Nilotinib
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Nitrazepam
  • Nitrous Oxide
  • Nortriptyline
  • Olanzapine
  • Ondansetron
  • Opipramol
  • Opium
  • Opium Alkaloids
  • Orphenadrine
  • Oxaprozin
  • Oxazepam
  • Oxcarbazepine
  • Oxycodone
  • Oxymorphone
  • Oxyphenbutazone
  • Palbociclib
  • Palonosetron
  • Papaveretum
  • Parecoxib
  • Paregoric
  • Paroxetine
  • Peginterferon Alfa-2b
  • Pemetrexed
  • Pentobarbital
  • Pentosan Polysulfate Sodium
  • Pentoxifylline
  • Perampanel
  • Perazine
  • Periciazine
  • Perphenazine
  • Phenelzine
  • Phenindione
  • Phenobarbital
  • Phenprocoumon
  • Phenylbutazone
  • Phenytoin
  • Piketoprofen
  • Pimozide
  • Piperacetazine
  • Pipotiazine
  • Piracetam
  • Piritramide
  • Piroxicam
  • Pixantrone
  • Polythiazide
  • Posaconazole
  • Pralatrexate
  • Pranoprofen
  • Prasugrel
  • Prazepam
  • Prednisone
  • Primidone
  • Procarbazine
  • Prochlorperazine
  • Proglumetacin
  • Promazine
  • Promethazine
  • Propofol
  • Propyphenazone
  • Proquazone
  • Protein C
  • Protriptyline
  • Quazepam
  • Quetiapine
  • Quinidine
  • Quinine
  • Ramelteon
  • Ranitidine
  • Ranolazine
  • Rasagiline
  • Remifentanil
  • Remoxipride
  • Repaglinide
  • Reteplase, Recombinant
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Ritonavir
  • Rivaroxaban
  • Rizatriptan
  • Rofecoxib
  • Rolapitant
  • Salicylic Acid
  • Salsalate
  • Saquinavir
  • Scopolamine
  • Secobarbital
  • Selegiline
  • Sertindole
  • Sertraline
  • Sibutramine
  • Sildenafil
  • Sodium Oxybate
  • Sodium Salicylate
  • Spironolactone
  • St John's Wort
  • Sufentanil
  • Sulindac
  • Sulpiride
  • Sumatriptan
  • Suvorexant
  • Tacrolimus
  • Tapentadol
  • Telaprevir
  • Telithromycin
  • Temazepam
  • Tenofovir Disoproxil Fumarate
  • Tenoxicam
  • Terbinafine
  • Thiethylperazine
  • Thiopental
  • Thiopropazate
  • Thioridazine
  • Thiothixene
  • Tianeptine
  • Tiaprofenic Acid
  • Ticagrelor
  • Ticlopidine
  • Tilidine
  • Tirofiban
  • Tizanidine
  • Tolazamide
  • Tolbutamide
  • Tolfenamic Acid
  • Tolmetin
  • Tolonium Chloride
  • Topiramate
  • Torsemide
  • Tramadol
  • Tranylcypromine
  • Trazodone
  • Treprostinil
  • Triamterene
  • Triazolam
  • Trichlormethiazide
  • Trifluoperazine
  • Trifluperidol
  • Triflupromazine
  • Trimeprazine
  • Trimipramine
  • Tryptophan
  • Valdecoxib
  • Varicella Virus Vaccine, Live
  • Venlafaxine
  • Verapamil
  • Vilazodone
  • Voriconazole
  • Vortioxetine
  • Warfarin
  • Xipamide
  • Zaleplon
  • Ziprasidone
  • Zolmitriptan
  • Zolpidem
  • Zopiclone
  • Zotepine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acebutolol
  • Atenolol
  • Betamethasone
  • Betaxolol
  • Bisoprolol
  • Captopril
  • Carteolol
  • Carvedilol
  • Celiprolol
  • Cortisone
  • Delapril
  • Dexamethasone
  • Enalaprilat
  • Enalapril Maleate
  • Esmolol
  • Imidapril
  • Labetalol
  • Levobunolol
  • Lisinopril
  • Methylprednisolone
  • Metipranolol
  • Metoprolol
  • Nadolol
  • Nebivolol
  • Nitroglycerin
  • Oxprenolol
  • Paramethasone
  • Penbutolol
  • Pindolol
  • Practolol
  • Prednisolone
  • Prednisone
  • Probenecid
  • Propranolol
  • Sotalol
  • Streptokinase
  • Tamarind
  • Temocapril
  • Tenecteplase
  • Timolol
  • Triamcinolone
  • Valproic Acid

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. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine 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 this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol
  • Grapefruit Juice
  • Tobacco

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol

Other Medical Problems

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

  • Alcohol abuse, or history of or
  • Brain problems (eg, tumor, increased intracranial pressure), history of or
  • Breathing or lung problems (eg, COPD, sleep apnea, respiratory depression) or
  • Cor pulmonale (serious heart condition) or
  • Depression, history of or
  • Drug dependence, especially with narcotic abuse or dependence, or history of or
  • Head injuries, history of or
  • Hyperkalemia (high potassium levels in the blood) or
  • Hypovolemia (low blood volume) or
  • Mental health problems, history of or
  • Obesity (overweight) or
  • Weakened physical condition—Use with caution. May increase risk for more serious side effects.
  • Bleeding problems or
  • Hypotension (low blood pressure) or
  • Pancreatitis swelling of the pancreas) or
  • Peptic ulcer disease, active or history of or
  • Seizures, history of—Use with caution. May make these conditions worse.
  • Hemophilia (bleeding problem) or
  • Reye's syndrome or
  • Severe asthma, asthma with nasal polyps and runny nose, trouble breathing, or other lung problems or
  • Stomach or bowel blockage (including paralytic ileus) or
  • Surgery (eg, nasopharyngeal tonsils, tonsils)—Should not be used in patients with these conditions.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.