$Unique_ID{BRK01834}
$Pretitle{}
$Title{ASPIRIN, CAFFEINE, AND DIHYDROCODEINE COMBINATION}
$Subject{Synalgos-DC (Ives)}
$Volume{}
$Log{}

Copyright (C) 1991 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 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, 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, 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
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) with 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 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.
