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acetaminophen, caffeine, and dihydrocodeine

Pronunciation: a SEET a MIN oh fen, KAF een, dye HYE droe KOE deen

Brand: Panlor SS, Trezix, Zerlor

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

Multum emt

Tell your doctor if you have ever had alcoholic liver disease (cirrhosis) or if you drink more than 3 alcoholic beverages per day. You may not be able to take medicine that contains acetaminophen.

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Do not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death.

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Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.

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

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This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how acetaminophen, caffeine, and dihydrocodeine will affect you.

Tell your doctor if the medicine seems to stop working as well in relieving your pain.

What is acetaminophen, caffeine, and dihydrocodeine?

Dihydrocodeine is an opioid pain medication. An opioid is sometimes called a narcotic.

Acetaminophen is a less potent pain reliever that increases the effects of dihydrocodeine.

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

The combination of acetaminophen, caffeine, and dihydrocodeine is used to relieve moderate to severe pain.

Acetaminophen, 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 acetaminophen, caffeine, and dihydrocodeine?

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Do not use this medication if you are allergic to acetaminophen (Tylenol) or dihydrocodeine, or if you have a stomach condition called paralytic ileus, or severe or uncontrolled asthma.

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Tell your doctor if you have ever had alcoholic liver disease (cirrhosis) or if you drink more than 3 alcoholic beverages per day. You may not be able to take medicine that contains acetaminophen.

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Dihydrocodeine may be habit forming and should be used only by the person it was prescribed for. Never share acetaminophen, caffeine, and dihydrocodeine 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.

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

  • sleep apnea or other breathing disorders;
  • liver or kidney disease;
  • a history of head injury or brain tumor;
  • epilepsy or other seizure disorder;
  • low blood pressure;
  • a stomach or intestinal disorder;
  • underactive thyroid;
  • a pancreas disorder;
  • Addison's disease or other adrenal gland disorder;
  • enlarged prostate, urination problems;
  • curvature of the spine;
  • mental illness; or
  • a history of drug or alcohol addiction.
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FDA pregnancy category C. It is not known whether this medication is harmful to an unborn baby, but it could cause breathing problems or addiction/withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant while using acetaminophen, caffeine, and dihydrocodeine.

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Dihydrocodeine can pass into breast milk and may harm a nursing baby. The use of this medication by some nursing mothers may lead to life-threatening side effects in the baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take acetaminophen, caffeine, and dihydrocodeine?

Take exactly as prescribed. Never take acetaminophen, caffeine, and dihydrocodeine 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.

Multum donot

Do not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death.

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Do not stop using acetaminophen, 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 acetaminophen, caffeine, and dihydrocodeine.

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This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using acetaminophen, caffeine, and dihydrocodeine.

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If you need surgery, tell the surgeon ahead of time that you are using acetaminophen, caffeine, and dihydrocodeine. You may need to stop using the medicine for a short time.

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Store at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Acetaminophen, caffeine, and 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 acetaminophen, caffeine, and dihydrocodeine 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?

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

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.

Overdose symptoms may also include extreme drowsiness or insomnia, restless feeling, tremors, fast heart rate, pinpoint pupils, fainting, weak pulse, seizure (convulsions), coma, blue lips, shallow breathing, or no breathing.

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

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Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.

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This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how acetaminophen, caffeine, and dihydrocodeine will affect you.

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Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.

While you are taking this medication, avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice.

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

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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.

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Stop using acetaminophen, caffeine, and dihydrocodeine and call your doctor at once if you have a serious side effect such as:

  • shallow breathing, slow heartbeat;
  • fast or pounding heart rate, feeling light-headed, fainting;
  • confusion, hallucinations, unusual thoughts or behavior;
  • muscle twitching;
  • problems with urination;
  • easy bruising or bleeding; or
  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects include:

  • feeling dizzy or drowsy, shaky or agitated;
  • mild nausea, vomiting, upset stomach; constipation, diarrhea;
  • mood changes, sleep problems (insomnia);
  • sweating, urinating more than usual;
  • ringing in your ears, blurred vision; or
  • dry mouth.

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 acetaminophen, caffeine, and dihydrocodeine?

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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:

  • ciprofloxacin (Cipro);
  • atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), glycopyrrolate (Robinul), isoniazid, mepenzolate (Cantil), methscopolamine (Pamine), or scopolamine (Transderm-Scop);
  • bladder or urinary medications such as oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);
  • a blood thinner such as warfarin (Coumadin, Jantoven);
  • a bronchodilator such as ipratropium (Atrovent) or tiotropium (Spiriva);
  • irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Levsin, and others), or propantheline (Pro-Banthine);
  • seizure medicine such as carbamazepine (Carbatrol, Equetro, Tegretol) or phenytoin (Dilantin); or
  • an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate).

This list is not complete and other drugs may interact with acetaminophen, 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 acetaminophen, caffeine, and dihydrocodeine.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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