ORPHENADRINE, ASPIRIN & CAFFEINE

Brand & Generic Names

Norgesic	N3 Gesic
Norgesic Forte	N3 Gesic Forte
Norphadrine	Orphenagesic
Norphadrine Forte	Orphenagesic Forte

Basic Information

• Habit forming? Yes
• Prescription needed? Yes
• Available as generic? No
• Drug class: Stimulant, vasoconstrictor, muscle relaxant, analgesic, anti-inflammatory (non-steroidal)

Uses

• Reduces muscle-strain discomfort.
• Reduces pain, fever, inflammation.
• Relieves swelling, stiffness, joint pain.
• Treatment for drowsiness and fatigue.

Dosage & Usage Information

How to take:
Tablet--Swallow with liquid. If you can't swallow whole, crumble tablet and take with liquid or food.

When to take:
At the same times each day.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Sedative and analgesic effects reduce spasm and pain in skeletal muscles.
Affects hypothalamus, the part of the brain which regulates temperature by dilating small blood vessels in skin.
Prevents clumping of platelets (small blood cells) so blood vessels remain open.
Decreases prostaglandin effect.
Suppresses body's pain messages.
Constricts blood vessel walls.
Stimulates central nervous system.

Time lapse before drug works:
1 hour.

Don't take with:
Tetracyclines. Space doses 1 hour apart.
Non-prescription drugs without consulting doctor.
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Fainting, confusion, widely dilated pupils, rapid pulse, ringing in ears, nausea, vomiting, dizziness, fever, deep and rapid breathing, excitement, rapid heartbeat, hallucinations, coma.

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:

Hives, rash, intense Seek emergency itching, wheezing, faint- treatment immediately. ness, soon after a dose (anaphylaxis), convulsions, fever.

Common:

• Nausea, vomiting, abdominal cramps, nervousness, urgent urination, low blood sugar (hunger, anxiety, cold sweats, rapid pulse).
• Ringing in ears, indigestion, heart- burn, insomnia.

Infrequent:

• Weakness, headache, dizziness, drowsiness, agitation, tremor, confusion, irregular heartbeat, hearing loss, diarrhea, hallucinations.
• Dry mouth, constipation.

Rare:

• Black or bloody vomit.
• Change in vision; blurred vision; black, bloody or tarry stool; bloody urine; dilated pupils; uncontrolled movement of hands; sore throat; fever.

Warnings & Precautions

Don't take if:

• You need to restrict sodium in your diet. Buffered effervescent tablets and sodium salicylate are high in sodium.
• Aspirin has a strong vinegar-like odor, which means it has decomposed.
• You have a peptic ulcer of stomach or duodenum, a bleeding disorder, heart disease.
• You are allergic to any stimulant or orphenadrine.

Before you start, consult your doctor:

• If you have had stomach or duodenal ulcers, gout, heart disease or heart rhythm disturbance, peptic ulcer.
• If you have asthma, nasal polyps, irregular heartbeat, hypoglycemia (low blood sugar), epilepsy, glaucoma, myasthenia gravis, difficulty emptying bladder, prostate enlargement.

Over age 60:

• More likely to cause hidden bleeding in stomach or intestines. Watch for dark stools.
• Adverse reactions and side effects may be more frequent and severe than in younger persons.

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 for advice 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.
• Not recommended for children younger than 12.

Prolonged use:

• Kidney damage. Periodic kidney function test recommended.
• Stomach ulcers more likely.
• Increased internal eye pressure.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check liver function, complete blood counts (white blood cell count, platelet count, red blood cell count, hemoglobin, hematocrit).

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

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.

Discontinuing:

• For chronic illness--Don't discontinue without doctor's advice until you complete prescribed dose, even though symptoms diminish or disappear.
• May be unnecessary to finish medicine if you take it for a short-term illness. Follow doctor's instructions.

Others:

• Aspirin can complicate surgery; illness; pregnancy, labor and delivery.
• For arthritis, don't change dose without consulting doctor.
• Urine tests for blood sugar may be inaccurate.
• May produce or aggravate fibrocystic breast disease in women.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Acebutolol	Decreased antihypertensive effect
	of acebutolol.
Allopurinol	Decreased allopurinol effect.
Antacids*	Decreased aspirin effect.
Anticholinergics*	Increased anticholinergic effect.
Anticoagulants*	Increased anticoagulant effect.
	Abnormal bleeding.
Antidepressants,	Increased sedation.
Antidiabetics*, oral	Low blood sugar.
Aspirin, other	Likely aspirin toxicity.
Chlorpromazine	Hypoglycemia (low blood sugar).
Contraceptives*,	Increased caffeine
oral	effect.
Cortisone drugs*	Increased cortisone effect. Risk of
	ulcers and stomach bleeding.
Furosemide	Possible aspirin toxicity.
Gold compounds*	Increased likelihood of kidney
	damage.
Griseofulvin	Decreased griseofulvin effect.
Indomethacin	Risk of stomach bleeding and
	ulcers.
Isoniazid	Increased caffeine effect.
Levodopa	Increased effect of levodopa.
	(Improves effectiveness in treating
	Parkinson's disease.)
MAO inhibitors*	Dangerous blood pressure rise.
Methotrexate	Increased methotrexate effect.
Minoxidil	Decreased minoxidil effect.
Nitrates*	Increased internal eye pressure.
Non-steroidal	Risk of stomach
anti-inflammatory	bleeding and ulcers.
Para-aminosalicylic	Possible aspirin
acid (PAS)	toxicity.
Penicillins*	Increased effect of drugs.
Phenobarbital	Decreased aspirin effect.
Potassium	Increased possibility
supplements*	of intestinal ulcers with oral
	potassium tablets.
Probenecid	Decreased probenecid effect.
Propoxyphene	Possible confusion, nervousness,
	tremors.
Propranolol	Decreased aspirin effect.
Rauwolfia alkaloids*	Decreased aspirin effect.
Salicylates*, other	Likely aspirin toxicity.
Sedatives*	Decreased sedative effect.
Sleep inducers*	Decreased sedative effect.
Spironolactone	Decreased spironolactone effect.
Sulfinpyrazone	Decreased sulfinpyrazone effect.
Sympathomimetics*	Overstimulation.
Terfenadine	May conceal symptoms of aspirin
	overdose, such as ringing in ears.
Thyroid hormones*	Increased thyroid effect.
Tranquilizers*	Decreased tranquilizer effect.
Valproic acid	May increase valproic acid effect.
Vitamin C	Possible aspirin
(large doses)	toxicity.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Possible stomach irritation and
	bleeding, increased drowsiness.
	Avoid.
Caffeine drinks.	Increased caffeine effect.
Cocaine:	Decreased orphenadrine effect.
	Overstimulation. Avoid.
Foods:	No proven problems.
Marijuana:	Increased effect of drugs. May lead
	to dangerous, rapid heartbeat.
	Increased dry mouth. Avoid.
Tobacco:	Increased heartbeat. Avoid.