ACETAMINOPHEN & SALICYLATES

Brand & Generic Names

ACETAMINOPHEN & ASPIRIN	Goody's Extra Strength
ACETAMINOPHEN &	Tablets
SALICYLAMIDE	Goody's Headache Powders
ACETAMINOPHEN & SODIUM	Presalin
SALICYLATE	Rid-A-Pain Compound
ACETAMINOPHEN, ASPIRIN &	S-A-C
SALICYLAMIDE	Salatin
Arthralgin	Saleto
Buffets II	Salocol
Duoprin	Salphenyl
Duradyne	Supac
Excedrin Extra Strength	Tenol Plus
Caplets	Tri-Pain
Excedrin Extra Strength	Trigesic
Tablets	Vanquish
Gelpirin
Gemnisyn

Basic Information

• Habit forming? No
• Prescription needed? High strength: Yes Low strength: No Yes, for some combinations
• Available as generic? No
• Drug class: Analgesic, fever-reducer, anti-inflammatory (non- steroidal)

Uses

• Treatment of mild pain and fever.
• Salicylates are useful in the treatment of inflammatory conditions such as stiffness, swelling, joint pain of arthritis or rheumatism. For long term use for inflammatory problems, separate drugs instead of this combination may be safer and more effective.

Dosage & Usage Information

How to take:
Tablet or capsule--swallow with liquid.
Effervescent granules--dissolve granules in 4 oz. of cool water.

When to take:
As needed, no more often than every 3 hours or as prescribed by your doctor.

If you forget a dose:
Take as soon as you remember. Wait 3 hours for next dose.

What drug does:
May affect hypothalamus, the part of the brain that helps regulate body heat and receives body's pain messages.
May affect production of prostaglandins to reduce inflammation.

Time lapse before drug works:
15 to 30 minutes. May last 4 hours.

Don't take with:
Other drugs with acetaminophen or aspirin or other salicylates. Too much can cause damage to liver, kidneys and peripheral nerves.
Any laxative containing cellulose.
If medicine you take has a buffering agent added, don't take with tetracyclines.
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Ringing in ears; nausea; vomiting; diarrhea; dizziness; fever; deep, rapid breathing; hallucinations; coma; unusual sweating; blood in urine; thirst; vision problems; nervousness.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

• Jaundice, vomiting blood, black stools, cloudy urine, nausea and vomiting, unexplained tiredness, discomfort on urinating.
• Indigestion or heartburn.

Infrequent:

Shortness of breath; wheezing (for medicines containing aspirin); decreased urine volume; feet swelling; black or tarry stools; pain on urinating; nausea and vomiting; skin rash, hives; sore throat, fever; easy bruising.

Rare:

• While taking medicine: Sudden decrease in urine volume.
• After discontinuing medicine: Swelling of feet; rapid weight gain; bloating or puffiness; any urinary problems, such as painful, cloudy or bloody urine.

Warnings & Precautions

Don't take if:

• You are allergic to acetaminophen or any salicylates*.
• Your symptoms don't improve after 3 days' use.
• You take a buffered form and need to restrict sodium in your diet.
• You have a peptic ulcer.
• You have a bleeding disorder.

Before you start, consult your doctor:

• If you have ever had peptic ulcers.
• If you have had gout.
• If you have asthma or nasal polyps.
• If you have kidney disease or liver damage.

Over age 60:
Don't exceed recommended dose. More likely to be harmful to kidney and liver or cause hidden bleeding in stomach or intestines. Watch for black stools or decreased urine output.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor on maintaining milk supply.

Infants & children:
Overdose frequent and severe. Keep bottles out of children's reach. Consult doctor before giving to persons under age 18 who have fever and discomfort of viral illness, especially chicken pox and influenza. Probably increases risk of Reye's syndrome*.

Prolonged use:

• High doses for severe inflammatory conditions taken for long periods may increase likelihood of kidney damage.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check liver function, kidney function.

Skin & sunlight:
Aspirin combined with sunscreen may decrease sunburn.

Driving, piloting or hazardous work:
No problems expected unless you feel drowsy.

Discontinuing:
No problems expected.

Others:

• Children up to 12 years--Don't take more than 5 doses per day for more than 5 consecutive days.
• Adults--Don't take for more than 10 consecutive days.
• Urine test for sugar may be inaccurate.
• Don't take if container has a strong vinegar-like odor.
• May interfere with the accuracy of some medical tests.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Antacids*	Decreased acetaminophen and
	salicylates effect.
Anticoagulants*	Increased anticoagulant effect.
	Abnormal bleeding.
Antidiabetics, oral*	Low blood sugar.
Aspirin and other	Likely toxicity.
Barbiturates*	Increased liver toxicity.
Carbamazepine	Increased liver toxicity.
Carteolol	Decreased antihypertensive effect
	of carteolol.
Cortisone drugs*	Increased cortisone effect. Risk of
	ulcers and stomach bleeding.
Furosemide	Possible salicylate toxicity,
	decreased furosemide effect.
Hepatotoxic drugs*	Increased liver toxicity.
Indomethacin	Risk of stomach bleeding and
	ulcers.
Lisinopril	Decreased lisinopril effect.
Methotrexate	Increased methotrexate effect.
Non-steroidal	Risk of stomach
anti-inflammatory	bleeding and ulcers.
Para-aminosalicylic	Possible salicylate
acid (PAS)	toxicity.
Phenobarbital	Decreased effect of acetaminophen
	and salicylates because of quicker
	elimination.
Phenytoin	Increased phenytoin effect.
Primidone	Increased liver toxicity.
Probenecid	Decreased probenecid effect.
Propranolol	Decreased aspirin effect.
Rauwolfia alkaloids*	Decreased aspirin effect.
Rifampin	Increased liver toxicity.
Sotalol	Decreased antihypertensive effect
	of sotalol.
Spironolactone	Decreased spironolactone effect.
Sulfinpyrazone	Decreased sulfinpyrazone effect.
Terazosin	Decreases effectiveness of
	terazosin. Causes sodium and fluid
	retention.
Tetracyclines*	May slow tetracycline
(effervescent	absorption. Space
granules or tablets)	doses 2 hours apart.
Vancomycin	Hearing loss.
Verapamil	Increased risk of toxicity.
Vitamin C	Possible aspirin
(large doses)	toxicity.
Urinary alkalizers*	Increased risk of toxicity.
Zidovudine	Increased toxicity of both.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Increased chance of stomach
	irritation and bleeding.
Beverages:	None expected.
Cocaine:	None expected.
	However, cocaine may deter body's
	recovery. Avoid.
Foods:	None expected.
Marijuana:	Possible increased pain relief, but
	marijuana may deter body's
	recovery. Avoid.
Tobacco:	None expected.