Narcotic Analgesics and Acetaminophen (Systemic)
Before Using This MedicineIn 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 narcotic analgesic
and acetaminophen combinations, the following should be considered:
Allergies - Tell your doctor if you have ever had any unusual or
allergic reaction to acetaminophen or to a narcotic analgesic. Also tell your
health care professional if you are allergic to any other substances, such
as foods, preservatives, or dyes.
Pregnancy -
-
For acetaminophen
: Although studies on
birth defects with acetaminophen have not been done in pregnant women, it
has not been reported to cause birth defects or other problems.
-
For narcotic analgesics
: Although studies
on birth defects with narcotic analgesics have not been done in pregnant women,
they have not been reported to cause birth defects. However, hydrocodone caused
birth defects in animal studies when very large doses were used. Codeine did
not cause birth defects in animals, but it caused slower development of bones
and other toxic or harmful effects in the fetus. Pentazocine and propoxyphene
did not cause birth defects in animals. There is no information about whether
dihydrocodeine or oxycodone causes birth defects in animals.
Too much use of a narcotic during pregnancy may cause the fetus to become
dependent on the medicine. This may lead to withdrawal side effects in the
newborn baby. Also, some of these medicines may cause breathing problems in
the newborn baby if taken just before or during delivery.
-
For caffeine
: Studies in humans have not
shown that caffeine (contained in some of these combination medicines) causes
birth defects. However, studies in animals have shown that caffeine causes
birth defects when given in very large doses (amounts equal to those present
in 12 to 24 cups of coffee a day).
Breast-feeding - Acetaminophen, codeine, and propoxyphene pass into
the breast milk. It is not known whether other narcotic analgesics pass into
the breast milk. However, these medicines have not been reported to cause
problems in nursing babies.
Children - Breathing problems may be especially likely to occur
when narcotic analgesics are given to children younger than 2 years of age.
These children are usually more sensitive than adults to the effects of narcotic
analgesics. Also, unusual excitement or restlessness may be more likely to
occur in children receiving these medicines. Acetaminophen has been tested in children and has not been shown to cause
different side effects or problems in children than it does in adults.
Older adults - Elderly people are especially sensitive to the effects
of narcotic analgesics. This may increase the chance of side effects, especially
breathing problems, during treatment. Acetaminophen has been tested and has not been shown to cause different
side effects or problems in older people than it does in younger adults.
Other medicines - 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
a narcotic analgesic and acetaminophen combination, it is especially important
that your health care professional know if you are taking any of the following:
-
Carbamazepine (e.g., Tegretol) - Propoxyphene may increase the
blood levels of carbamazepine, which increases the chance of serious side
effects
-
Central nervous system (CNS) depressants or
-
Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g.,
Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline
[e.g., Eldepryl], tranylcypromine [e.g., Parnate]) (taken currently
or within the past 2 weeks) or
-
Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine
[e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane],
doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g.,
Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) - Taking
these medicines together with a narcotic analgesic may increase the chance
of serious side effects
-
Naltrexone (e.g., Trexan) - Naltrexone keeps narcotic analgesics
from working to relieve pain; people taking naltrexone should take pain relievers
that do not contain a narcotic
-
Zidovudine (e.g., AZT, Retrovir) - Acetaminophen may increase
the blood levels of zidovudine, which increases the chance of serious side
effects
Other medical problems - The presence of other medical
problems may affect the use of narcotic analgesic and acetaminophen combinations.
Make sure you tell your doctor if you have any other medical problems, especially:
-
Alcohol and/or other drug abuse, or history of, or
-
Brain disease or head injury or
-
Colitis or
-
Convulsions (seizures), history of, or
-
Emotional problems or mental illness or
-
Emphysema, asthma, or other chronic lung disease or
-
Hepatitis or other liver disease or
-
Kidney disease or
-
Underactive thyroid - The chance of serious side effects may
be increased
-
Enlarged prostate or problems with urination or
-
Gallbladder disease or gallstones - Some of the effects of narcotic
analgesics may be especially serious in people with these medical problems
-
Heart disease - Caffeine (present in some of these combination
medicines) can make some kinds of heart disease worse
|