Aspirin, Caffeine, and Dihydrocodeine

Aspirin, caffeine, and dihydrocodeine is a combination medication used to relieve moderate to moderately severe pain. It is only available with a doctor's prescription, an comes in capsule form.

Overview

Aspirin is a salicylate medication, which reduces inflammation by interacting with the immune system. It is used to reduce fever and remove pain. Caffeine is a stimulant, which interacts with pain relievers to increase the analgesic effect, and can reduce migraine headaches. Dihydrocodeine is a narcotic analgesic that acts on the central nervous system to relieve pain.

Conditions treated:

  • Moderate pain
  • Moderately severe pain
  • Fever
  • Swelling

Type of Medicine:

  • Analgesic
  • Anti-inflammatory
  • Salicylate
  • CNS stimulant
  • Narcotic

Side Effects

Aspirin, caffeine, and dihydrocodeine, like any substance in the body, can cause some unwanted effects as well as the desired therapeutic effects. Not all of these side effects will occur in all patients. If any of these side effects occur, be sure to inform your doctor.

Mild Side Effects

Aspirin, caffeine, and dihydrocodeine can cause some mild side effects in some patients. These side effects are usually a result of your body adjusting to the medication and may subside or go away over the course of your treatment. They do not usually require medical treatment. Let your doctor know if you are experiencing any of these side effects. Your doctor may be able to suggest courses of treatment that can help you relieve or treat these side effects if they become too bothersome. If these side effects become worse or do not subside, inform your physician.

While taking aspirin, caffeine, and dihydrocodeine, you may experience some itchy skin, nausea with some vomiting, drowsiness, sleepiness, or dizziness and difficulty in having a bowel movement.

Serious Side Effects

Some side effects of aspirin, caffeine, and dihydrocodeine may be more serious. These side effects may cause serious health problems or be symptoms of more serious health problems that may be triggered by your ingestion of this medication. In the case of aspirin, caffeine, and dihydrocodeine, these symptoms may be caused by an overdose of this medication, and require emergency medical help. If you experience these symptoms, get medical assistance immediately.

While taking aspirin, caffeine, and dihydrocodeine, you may experience unusual lightheadedness or confusion, or extreme sleepiness. You may experience irregular or shallow breathing, unusually fast or slow breathing, or difficult or troubled breathing. This may be accompanied by pale or blue lips, pale or blue fingernails, or pale or blue skin. These are symptoms of an overdose. If you experience these symptoms, get medical help immediately.

Side Effects of Aspirin

Medications with aspirin may cause some unwanted side effects in addition to its therapeutic effects. Some of these side effects may be a result of your body adjusting to the medication and may subside over the course of your treatment. These side effects may not need additional medical treatment as long as they remain mild. If your side effects increase in severity, do not subside, or become bothersome, let your doctor know. Your healthcare provider may be able to help you find treatments that will reduce your symptoms and discomfort. Mild side effects may include gastrointestinal effects such as stomach upset, discomfort or pain, acid or sour stomach, dry mouth, or unusual belching. You may experience some anxiety, hyperventilation, irritability, or shaking, as well as trouble sleeping. You may also experience unusual dullness, tiredness, weakness, or a feeling of drowsiness or sluggishness.

Medications with aspirin can cause unwanted side effects that may require medical attention, as they can lead to health problems or be symptoms or signs of serious health problems. If you experience these side effects, contact your doctor immediately and seek medical assistance. You may experience gastrointestinal symptoms such as severe abdominal or stomach cramping, pain, or burning, especially in the upper right abdomen or stomach, indigestion or heartburn, nausea or vomiting, or loss of appetite. Other gastrointestinal symptoms may include black or tarry stools, light-colored stools, constipation, diarrhea, or vomiting of blood or material that looks like coffee grounds. You may experience a decreased frequency or amount of urine, a bloody or cloudy urine, increased thirst, or yellow eyes and skin. You may experience a change in consciousness, confusion, drowsiness, fainting, general tiredness and weakness, loss of consciousness, unusual tiredness or weakness, or weakness and heaviness of the legs. You may feel chest pain or discomfort, difficulty in breathing, rapid or deep breathing, numbness or tingling in the extremities such as hands, feet or lips. You may experience convulsions, fever, irregular heartbeat, lower back or side pain, muscle cramping or weakness, muscle tremors, restlessness, or seizures. You may experience yellow skin or eyes, weight gain, unusual bleeding or bruising, or swelling of the extremities such as the face, fingers, or lower legs. You may also experience panic, nervousness, or a feeling of impending doom. If you experience any of these symptoms, contact your medical care professional immediately.

Side Effects of Caffeine

Caffeine can have effects on the body beyond its therapeutic use in aspirin, caffeine, and dihydrocodeine. Most of these side effects are mild and will subside over time, and do not require medical assistance. If these side effects become bothersome, contact your healthcare physician. Your doctor may be able to help you find treatments that can reduce these side effects. When taking medications with caffeine, you may experience nervousness, restlessness, increased heart rate and respiration, or insomnia. You may also experience stomach irritation, nausea, or vomiting. Higher doses of caffeine can cause headaches, agitation, chest pain, and ringing in the ears.

Side Effects of Dihydrocodeine

Dihydrocodeine can have unwanted effects on the body in addition to its desired therapeutic effects. Some of these side effects can have serious health implications on the body or may be symptoms of serious health conditions triggered within the body by the medication. If you experience any of these side effects, contact your doctor immediately. Your doctor may be able to suggest a course of treatment to reduce your side effects. You may experience gastrointestinal effects such as nausea, vomiting, lack of appetite, indigestion, dry mouth, constipation, a spasm of the biliary tract, or abdominal pain. You may experience sweating, itching, a rash, or other skin reactions. You may experience cardiac palpitations or a decrease in blood pressure, especially when getting up from a lying or prone position. You may experience blurred vision, or an inability to cough. You may experience side effects such as dizziness, drowsiness, headache, fatigue, confusion, hallucinations or vivid dreams, lassitude, giddiness, increased inability, or excitement. If any of these side effects occur, contact your doctor immediately.

Dosage

Aspirin, caffeine, and dihydrocodeine is normally sold in capsules, each of which contains 16 mg of dihydrocodeine bitartrate, 356.4 mg of aspirin, and 30 mg of caffeine. The capsules are usually blue and grey, and are supplied in bottles of 100 capsules.

The dosage of aspirin, caffeine, and dihydrocodeine and the schedule of administration are supplied as an average suggestion by the manufacturer. Your doctor's directions about your dosage and schedule may vary. When in doubt, refer to your doctor's directions. Do not take more of this medication than directed, do not take it more often than directed, and do not take it for a longer time than your doctor has directed.

Aspirin, caffeine, and dihydrocodeine is normally taken every four hours, or as needed, in doses of two capsules each. Your dosage may depend on the level and severity of your pain, your prior experiences with analgesic treatment, and any risk factors for addiction, abuse, or misuse.

This medication is only taken when directed, so there are no instructions for a missed dose.

Major Drug Interactions

Aspirin, caffeine, and dihydrocodeine can interact with other medications, drugs, or supplements you are taking. These interactions can increase your risk for unwanted or serious side effects, change the way your medications work or the effectiveness of your medications, or cause other problems. Any substance may interact with aspirin, caffeine, and dihydrocodeine, even if not listed here. Keep a list of the medications, drugs, and supplements you take consistently, whether they are prescribed to you or taken over the counter. Your doctor or pharmacist can help identify potential drug interactions with aspirin, caffeine, and dihydrocodeine.

Aspirin, caffeine, and dihydrocodeine may increase the risk of bleeding when taken with other medications that also have a risk of causing bleeding, such as anti-platelet drugs like clopidogrel, or blood thinners like warfarin, dabigatran, or enoxaparin.

When taking aspirin, caffeine, and dihydrocodeine with drugs that may cause breathing problems, your risk of respiratory side effects may increase. Take aspirin, caffeine, and dihydrocodeine with caution if you are taking cough medications or pain relievers with opioids such as codeine or hydrocodone. Take with caution if you are taking drugs for sleep or anxiety such as alprazolam, lorazepam, or zolpidem, or muscle relaxants such as carisoprodol or cyclobenzaprine. Take antihistamines such as cetirizine or diphenhydramine with caution. Consume alcohol or marijuana with caution.

Some medications can affect the way aspirin, caffeine, and dihydrocodeine is removed from the body, which may affect the therapeutic effects of your medication. Medications that can have this effect includes bupropion, fluexetine, azole antifungals such as ketoconazole, macrolide antibiotics such as erythromycin, HIV medications such as ritonavir, drugs used to treat seizures such as carbamazepine or phenytoin, paroxetine, quinidine, and rifamycins such as rifabutin or rifampin.

Other painkillers may increase your risk of side effects if taken together with aspirin, caffeine, and dihydrocodeine. Take caution when consuming pain relievers or fever medications, including NSAIDs such as ibuprofen, ketorolac, naproxen, or aspirin.

Some allergy medications, cough and cold medications, or headache medications may contain aspirin, caffeine, or other ingredients that may cause drowsiness. Check with your doctor or pharmacist for guidelines about using these products safely while taking aspirin, caffeine, and dihydrocodeine.

Aspirin, caffeine, and dihydrocodeine may interact with other drugs such as:

  • Acetazolamide
  • Antacids such as
  • Anticholinergic drugs such as scopolamine
  • Antibiotics such as penicillin sulfonamides, i.e. sulfamethoxazole
  • Anti-seizure medications such as valproic acid
  • Gout treatments or uricosuric drugs such as probenecid or sulfinpyrazone
  • Cimetidine
  • Corticosteroids such as prednisone
  • Disulfiram
  • Lithium and medications containing lithium
  • MAO inhibitors such as isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, or tranylcypromine
  • 6-mercaptopurine
  • Methotrexate
  • Mifepristone
  • Naltrexone
  • Pain medications such as pentazocine, nalbuphine, or morphine
  • Vemurafenib
  • Zidovudine
  • Warnings
  • Check-Ups

Your doctor will need to check the progress of your treatment while you're taking aspirin, caffeine, and dihydrocodeine in order to ensure that the medication is working properly. Regular check-ups with your doctor will make sure that you're getting the proper therapeutic effects from your aspirin, caffeine, and dihydrocodeine and help determine whether you should continue to take it.

Drowsiness

Aspirin, caffeine, and dihydrocodeine can cause drowsiness. Make sure that you know how you react to aspirin, caffeine, and dihydrocodeine before you drive, use machines, or perform any other actions that could be dangerous if you are not sufficiently alert. Aspirin, caffeine, and dihydrocodeine can add to the effects of drugs or other substances that can make you drowsy. Take caution when taking aspirin, caffeine, and dihydrocodeine with antihistamines for allergy medication, sedatives or tranquilizers, sleeping medication, medication for seizures, muscle relaxants, or anesthetics. Check with your doctor before you take any of these medications for proper dosage, use, and precautions.

Constipation

This medication can cause severe constipation when used over a long period of time. Be sure to follow your doctor's directions carefully when using this medication, or more severe constipation may ensure. Your doctor may prescribe laxatives, direct you to drink more fluids, or choose to increase the amount of fiber in your diet. Consistent constipation can lead to more serious health problems.

Ultra-Metabolizers and Morphine Overdose

Codeine is metabolized into morphine when taken in the body. Some people's bodies make this change more quickly than others. People who are ultra-metabolizers of codeine may have too much morphine in their bodies when taking this medication, leading to the possibility of more side effects of morphine than usual, or even a morphine overdose. Contact a doctor if you experience symptoms of a morphine overdose such as extreme sleepiness, extreme confusion, or shallow breathing. You may also experience dark urine, difficult or troubled breathing, breathing that is unusually fast, slow, or irregular, nausea or vomiting along with pain in your upper stomach, pinpoint pupils of the eye, lips and fingernails that are unusually pale or blue, yellow eyes, and pale, blue, or yellow skin. If you experience any of these overdose symptoms, get medical help immediately.

Addiction

Aspirin, caffeine, and dihydrocodeine can be habit-forming. Misuse of aspirin, caffeine, and dihydrocodeine can cause addiction. If your prescribed dose of aspirin, caffeine, and dihydrocodeine is not working as well as necessary, do not use more than the prescribed dosage. Call your doctor for instructions.

Pregnancy Warnings

Patients who use aspirin, caffeine, and dihydrocodeine while pregnant may have babies which are chemically dependent on the dihydrocodeine at the time of birth. This can cause withdrawal symptoms in the baby after it is born, which can be life-threatening. Babies who are born with a chemical dependency on habit-forming medication such as dihydrocodeine may need medical treatment for several weeks after birth.

Patients who take medications containing aspirin during late pregnancy should take care, as this can cause bleeding in the baby or in the patient carrying the baby during the delivery.

Patients who breast-feed a child should not take aspirin, caffeine, and dihydrocodeine This medicine can pass into breast milk, which can cause problems such as drowsiness, bleeding, breathing issues, or death in a nursing baby.

Pre-Existing Conditions

Aspirin, caffeine, and dihydrocodeine may cause health problems or aggravate existing problems in patients with some health conditions. When discussing the possibility of using aspirin, caffeine, and dihydrocodeine with your doctor, tell your doctor if you have or have ever had any of the following health conditions:

  • Liver disease or kidney disease
  • Respiratory disorders or breathing disorders such as asthma
  • Seizures
  • A stomach disorder, especially internal bleeding or ulcers
  • Any bleeding disorder or blood clotting disorder
  • Any head injury or brain tumor
  • Drug addition or alcohol addiction

Storage

Aspirin, caffeine, and dihydrocodeine should be stored at room temperature, around 77 degrees Fahrenheit or 25 degrees Centigrade. Aspirin, caffeine, and dihydrocodeine should be tightly closed and kept in its original container when not in use. When you no longer need your aspirin, caffeine, and dihydrocodeine, it is permissible to flush the unused capsules down the toilet.

Summary

Aspirin, caffeine, and dihydrocodeine is a compound medication used to relieve moderate to moderately severe pain. It's often sold as Synalgos-DC, and comes in blue and grey capsules with 16 mg of dihydrocodeine bitartrate, 356.4 mg of aspirin, and 30 mg of caffeine. Aspirin, caffeine, and dihydrocodeine is normally taken in doses of 2 capsules every 4 hours, or as directed by your doctor. Do not take more aspirin, caffeine, and dihydrocodeine than prescribed, more frequently than prescribed, or for a longer period than prescribed.

Your doctor will need to check the progress of your treatment regularly. Aspirin, caffeine, and dihydrocodeine can cause severe constipation when taken over a long period of time. Aspirin, caffeine, and dihydrocodeine can be habit-forming when misused. Patients who are pregnant should not take aspirin, caffeine, and dihydrocodeine, as ingredients in it can cause withdrawal symptoms in babies or bleeding at birth, or leach into breast milk and cause health problems in breast-feeding babies.

Aspirin, caffeine, and dihydrocodeine can aggravate health problems in patients who have had ulcers, liver disease or kidney disease, breathing disorders such as asthma, seizures, any bleeding disorder or blood clotting disorder, any head injury or brain tumor, or drug or alcohol addiction.

Some patients may be ultra-metabolizers of codeine, which can cause a morphine overdose in the body. When taking aspirin, caffeine, and dihydrocodeine, you should call a doctor immediately if you exhibit signs of morphine overdose such as extreme sleepiness, extreme confusion, or shallow breathing.

Aspirin, caffeine, and dihydrocodeine can cause some unwanted side effects. Mild side effects can include gastrointestinal distress like stomach distress or acid stomach, nervous reactions such as anxiety, irritability, hyperventilation, shaking, or insomnia, or neurological reactions like weakness or a feeling of drowsiness. You may also experience itchy skin or difficulty in having a bowel movement.

Aspirin, caffeine, and dihydrocodeine can cause some serious side effects. Get medical assistance and tell your doctor if you experience extreme confusion or sleepiness, breathing that is difficult, irregular, shallow, or unusually fast or slow, or pale or blue lips, fingernails, or skin.

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Last Reviewed:
December 24, 2017
Last Updated:
December 22, 2017
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