acetaminophen/caffeine/dihydrocodeine

Pronunciation:	a seat a meen O fen/ CA feen/ di hi dro CO deen
Brand:	Panlor DC, Panlor SS

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

Avoid alcohol while taking acetaminophen/caffeine/dihydrocodeine. Alcohol can greatly increase drowsiness and dizziness caused by the medication which could be dangerous. Also, alcohol increases the risk of stomach bleeding when taking acetaminophen.

Do not take more of this medication than is prescribed. If the pain is not being adequately treated, talk to your doctor.

Do not take other over-the-counter and prescription products that contain acetaminophen. Too much acetaminophen could be dangerous. Talk to your doctor or pharmacist before taking any over-the-counter preparations.

Drowsiness or dizziness caused by acetaminophen/caffeine/dihydrocodeine may be increased by other drugs such as antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), other pain relievers, anxiety medicines, and muscle relaxants. Together, these medicines may cause dangerous sedation, possibly resulting in unconsciousness or death. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor.

Do not stop taking acetaminophen/caffeine/dihydrocodeine suddenly if you have been taking it continuously for more than 5 to 7 days. Stopping suddenly could cause withdrawal symptoms and make you very uncomfortable. Your doctor may want to gradually reduce the dose.

What is acetaminophen/caffeine/dihydrocodeine?

Dihydrocodeine (related to codeine) is in a class of drugs called narcotic analgesics. It relieves pain.

Acetaminophen is a less potent pain reliever and a fever reducer. Acetaminophen increases the effects of dihydrocodeine.

Caffeine is believed to constrict dilated blood vessels that may contribute to tension headaches.

Acetaminophen/caffeine/dihydrocodeine is used to treat moderate-to-severe pain.

Acetaminophen/caffeine/dihydrocodeine may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking acetaminophen/caffeine/dihydrocodeine?

Before taking this medication, tell your doctor if you have

kidney disease;
liver disease;
a stomach ulcer;
asthma;
urinary retention;
an enlarged prostate;
hypothyroidism;
seizures or epilepsy;
gallbladder disease;
a head injury;
Addison's disease; or
a history of drug or alcohol addiction.

You may not be able to take acetaminophen/caffeine/dihydrocodeine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

This drug combination is in the FDA pregnancy category C. This means that it is not known whether it will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant.

It is not known whether this drug combination passes into breast milk. Do not take acetaminophen/caffeine/dihydrocodeine without first talking to your doctor if you are breast-feeding a baby.

If you are older than 60 years of age, you may be more likely to experience side effects from this therapy. Your doctor may prescribe a lower dose of the medication.

How should I take acetaminophen/caffeine/dihydrocodeine?

Take acetaminophen/caffeine/dihydrocodeine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse or doctor to explain them to you.

Take each dose with a full glass of water.

Acetaminophen/caffeine/dihydrocodeine can be taken with food or milk if it causes stomach upset.

Do not take more of this medication than is prescribed. If the pain is not being adequately treated, talk to your doctor.

Do not stop taking acetaminophen/caffeine/dihydrocodeine suddenly if you have been taking it continuously for more than 5 to 7 days. Stopping suddenly could cause withdrawal symptoms and make you feel uncomfortable. Your doctor may want to gradually reduce the dose.

Constipation may be a side effect of treatment with acetaminophen/caffeine/dihydrocodeine. Increasing the amount of fiber and water (six to eight full glasses) in the diet may reduce constipation.

Do not share this medication with anyone else.

Store acetaminophen/caffeine/dihydrocodeine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Do not take a double dose of this medication. Wait the prescribed amount of time before taking the next dose.

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of an acetaminophen/caffeine/dihydrocodeine overdose include slow breathing, seizures, dizziness, weakness, loss of consciousness, coma, confusion, tiredness, cold and clammy skin, small pupils, nausea, vomiting, ringing in the ears, and sweating.

What should I avoid while taking acetaminophen/caffeine/dihydrocodeine?

Use caution when driving, operating machinery, or performing other hazardous activities. Dihydrocodeine may cause drowsiness. If you experience drowsiness, avoid these activities.

What are the possible side effects of acetaminophen/caffeine/dihydrocodeine?

If you experience any of the following serious side effects, stop taking acetaminophen/caffeine/dihydrocodeine and seek emergency medical attention or contact your doctor immediately:

an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
slow, weak breathing;
seizures;
cold, clammy skin;
severe weakness or dizziness;
unconsciousness; or
black, bloody, or tarry stools or blood in the urine or vomit.

Other, less serious side effects may be more likely to occur. Continue to take acetaminophen/caffeine/dihydrocodeine and talk to your doctor if you experience

constipation;
dry mouth, nausea, vomiting, or decreased appetite;
dizziness, tiredness, or lightheadedness;
muscle twitches;
sweating;
itching or rash;
decreased urination;
decreased sex drive; or
ringing in your ears.

Acetaminophen/caffeine/dihydrocodeine is habit forming. Do not stop taking it suddenly.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect acetaminophen/caffeine/dihydrocodeine?

Do not take acetaminophen/caffeine/dihydrocodeine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. Dangerous side effects could result.

Drugs other than those listed here may also interact with acetaminophen/caffeine/dihydrocodeine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines including vitamins, minerals, and herbal products.

Where can I get more information?

Your pharmacist has additional information about acetaminophen/caffeine/dihydrocodeine written for health professionals that you may read.

What does my medication look like?

Acetaminophen/caffeine/dihydrocodeine is available with a prescription under the brand name Panlor DC and Panlor SS. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

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.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 1.01. Revision date: 1/27/05.

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