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What should I discuss with my healthcare provider before taking aspirin, caffeine, and dihydrocodeine (Synalgos-DC)?

Aspirin should not be given to a child or teenager who has a fever, especially if the child also has flu symptoms or chicken pox. Aspirin can cause a serious and sometimes fatal condition called Reye's syndrome in children.

Do not use this medication if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take aspirin, caffeine, and dihydrocodeine before the MAO inhibitor has cleared from your body.

Do not use this medication if you are allergic to aspirin, caffeine, or dihydrocodeine, or if you have:

• porphyria;
• stomach ulcer;
• a bleeding or blood clotting disorder; or
• an allergy to an NSAID (non-steroidal anti-inflammatory drug) such as Advil, Motrin, Aleve, Orudis, Indocin, Lodine, Voltaren, Toradol, Mobic, Relafen, Feldene, and others.

Before taking aspirin, caffeine, and dihydrocodeine, tell your doctor if you have:

• kidney or liver disease;
• asthma;
• urination problems;
• an enlarged prostate;
• a thyroid disorder;
• a history of head injury or brain tumor;
• seizures or epilepsy;
• gallbladder disease;
• Addison's disease; or
• a history of drug or alcohol addiction.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

Dihydrocodeine may be habit-forming and should be used only by the person this medicine was prescribed for. This medication should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

FDA pregnancy category C. Aspirin may be harmful to an unborn baby's heart, and may also reduce birth weight or have other dangerous effects. Dihydrocodeine could cause addiction or withdrawal symptoms in a newborn if the mother takes the medicine during pregnancy. Do not take aspirin, caffeine, and dihydrocodeine without telling your doctor if you are pregnant or plan to become pregnant during treatment.

Dihydrocodeine may also cause addiction and withdrawal symptoms in a nursing infant. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more likely to have side effects from this medication.

How should I take aspirin, caffeine, and dihydrocodeine (Synalgos-DC)?

Take this medication exactly as it was prescribed for you. Do not take it in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Take with food or milk to ease stomach upset.

You may have withdrawal symptoms when you stop using aspirin, caffeine, and dihydrocodeine after using it over a long period of time. Do not stop using this medication suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using aspirin, caffeine, and dihydrocodeine. You may need to stop using the medicine for a short time.

Store this medication at room temperature away from moisture and heat.

Keep track of how many capsules have been used from each new bottle of this medicine. Dihydrocodeine is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

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