$Unique_ID{BRK03030} $Pretitle{} $Title{aspirin and codeine combination} $Subject{ Empirin Burroughs Wellcome Analgesic combination aspirin codeine tension headaches pain narcotic analgesic central nervous system} $Volume{} $Log{ Empirin with Codeine #2*0303001.scf} Copyright (C) 1993 Publications International, Ltd. aspirin and codeine combination ------------------------------------------------------------------------------ BRAND NAME (Manufacturer) aspirin with codeine (various manufacturers) Empirin with Codeine (Burroughs Wellcome) TYPE OF DRUG Analgesic combination INGREDIENTS aspirin and codeine DOSAGE FORM Tablets (325 mg aspirin with 15 mg, 30 mg, or 60 mg of codeine) Note that on the label of the vial of tablets, the name of this drug is followed by a number. This number refers to the amount of codeine: #2 contains 1/4 grain (15 mg) codeine, #3 has 1/2 grain (30 mg) codeine, and #4 contains 1 grain (60 mg) codeine. STORAGE Aspirin and codeine combination tablets should be stored at room temperature in a tightly closed container. Care should be taken to prevent moisture from entering the container, as it will cause the aspirin in this product to decompose. Discard the medicine if it has a vinegary odor. USES This medication is used to relieve tension headaches and mild to severe pain. Codeine is a narcotic analgesic that acts on the central nervous system to relieve pain. TREATMENT In order to avoid stomach upset, you can take this medication with food or milk. This medication works best if you take it at the onset of pain, rather than when the pain becomes intense. If you are taking this medication on a regular 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, flushing, indigestion, light-headedness, loss of appetite, nausea, sweating, and 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, and be careful on stairs. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about severe abdominal pain; bloody or black, tarry stools; chest tightness; difficult or painful urination; difficulty in breathing; fatigue; itching; palpitations; rash; ringing in the ears; tremors; or yellowing of the eyes or skin. INTERACTIONS This medication interacts with several other types of drugs: 1. Concurrent use of it 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. The concurrent use of aspirin and codeine combination and monoamine oxidase (MAO) inhibitors should be avoided. At least 14 days should separate the use of aspirin and codeine 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 side effects of anticoagulants (blood thinners, such as warfarin), oral antidiabetic agents, phenytoin, and methotrexate may be increased by the aspirin in this product. 5. Large doses of antacids increase the elimination of the aspirin portion of this medication from the body and decrease its effectiveness. 6. Aspirin may decrease the antigout effects of probenecid and sulfinpyrazone. BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any 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, and tolmetin or to codeine or other narcotic analgesics (such as hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, and propoxyphene). * 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, porphyria, enlarged prostate gland, 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 flu or chicken pox has been associated with a rare, life-threatening condition called Reye's syndrome. Aspirin-containing products should, therefore, not be given to children with signs of infection. * Because this drug contains codeine, 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. * Diabetic patients should be aware that large doses of aspirin (more than eight 325-mg tablets per day) may interfere with urine sugar testing. Diabetics 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. Codeine, 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.