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acetaminophen and aspirin

Generic Name: acetaminophen and aspirin (a seet oh MIN oh fen and AS prin)
Brand Name: Excedrin Back & Body, Excedrin Back & Body

What is acetaminophen and aspirin?

Acetaminophen is a pain reliever and fever reducer.

Aspirin is a salicylate (sa-LIS-il-ate). It works by reducing substances in the body that cause pain, fever, and inflammation.

Acetaminophen and aspirin is a combination medicine used to treat minor arthritis pain, back pain, and muscle aches.

Acetaminophen and aspirin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about acetaminophen and aspirin?

This medicine 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 take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death. Call your doctor at once if you have nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of your skin or eyes).

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Aspirin may cause stomach or intestinal bleeding, which can be fatal. Call your doctor at once if you have symptoms such as bloody or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

In rare cases, acetaminophen may cause a severe skin reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

What should I discuss with my health care provider before taking acetaminophen and aspirin?

You should not use this medication if you are allergic to acetaminophen (Tylenol) or aspirin.

Do not give this medication to a child or teenager with a fever, flu symptoms, or chicken pox. Salicylates can cause Reye's syndrome, a serious and sometimes fatal condition in children.

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:

  • liver disease, cirrhosis, a history of alcoholism, or if you drink more than 3 alcoholic beverages per day;

  • high blood pressure, heart disease;

  • a bleeding or blood clotting disorder;

  • kidney disease;

  • asthma;

  • gout;

  • diabetes;

  • a history of stomach or intestinal bleeding; or

  • stomach ulcer or history of heartburn or ongoing indigestion or stomach pain.

Aspirin may cause stomach or intestinal bleeding, which can be fatal. Older adults have a higher risk of stomach bleeding.

Do not use this medication without telling your doctor if you are pregnant. Aspirin can cause harm to an unborn baby or problems with delivery if you take the medicine during the last 3 months of pregnancy. Use effective birth control, and tell your doctor if you become pregnant during treatment.

Acetaminophen and aspirin can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give this medicine to a child younger than 12 years old without the advice of a doctor.

How should I take acetaminophen and aspirin?

Use exactly as directed on the label, or as prescribed by your doctor. You should not take more than 8 caplets in 24 hours. Do not take this medicine for longer than recommended.

Take this medicine with a full glass of water.

Do not take more of this medication than is recommended. An overdose of this medicine can damage your liver, kidneys, lungs, and other organs, or cause death.

Call your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever lasting longer than 3 days, or any swelling or pain lasting longer than 10 days.

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

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since acetaminophen and aspirin is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of this medication can cause serious harm.

Aspirin overdose can cause ringing in your ears, dizziness, vomiting, diarrhea, increased sweating, confusion, hallucinations, rapid breathing, seizure (convulsions), or coma.

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.

What should I avoid while taking acetaminophen and aspirin?

Avoid drinking alcohol. It may increase your risk of stomach bleeding or liver damage while you are taking acetaminophen and aspirin. Ask a doctor before taking acetaminophen if you drink more than 3 alcoholic beverages per day.

Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as "APAP") and aspirin are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug, which can lead to a fatal overdose. Check the label to see if a medicine contains aspirin, acetaminophen, or APAP.

Acetaminophen and aspirin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. This could occur even if you have taken acetaminophen in the past and had no reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling. If you have this type of reaction, you should never again take any medicine that contains acetaminophen.

Stop using acetaminophen and aspirin and call your doctor at once if you have:

  • hearing loss;

  • symptoms of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds, feeling like you might pass out;

  • liver problems--nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

  • heart problems--chest pain, fast or pounding heartbeats, shortness of breath, swelling, rapid weight gain.

Common side effects may include:

  • upset stomach;

  • drowsiness; or

  • ringing in your ears.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Acetaminophen and aspirin dosing information

Usual Adult Dose for Pain:

Oral (acetaminophen 250 mg- aspirin 250 mg):
Initial dose: 2 caplets orally every 6 hours, not to exceed 8 caplets in 24 hours.

Usual Adult Dose for Rheumatoid Arthritis:

Oral (acetaminophen 250 mg- aspirin 250 mg):
Initial dose: 2 caplets orally every 6 hours, not to exceed 8 caplets in 24 hours.

Usual Adult Dose for Backache:

Oral (acetaminophen 250 mg- aspirin 250 mg):
Initial dose: 2 caplets orally every 6 hours, not to exceed 8 caplets in 24 hours.

Usual Pediatric Dose for Pain:

Oral (acetaminophen 250 mg- aspirin 250 mg):
12 years or older:
Initial dose: 2 caplets orally every 6 hours, not to exceed 8 caplets in 24 hours.

Usual Pediatric Dose for Rheumatoid Arthritis:

Oral (acetaminophen 250 mg- aspirin 250 mg):
12 years or older:
Initial dose: 2 caplets orally every 6 hours, not to exceed 8 caplets in 24 hours.

Usual Pediatric Dose for Backache:

Oral (acetaminophen 250 mg- aspirin 250 mg):
12 years or older:
Initial dose: 2 caplets orally every 6 hours, not to exceed 8 caplets in 24 hours.

What other drugs will affect acetaminophen and aspirin?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with acetaminophen and aspirin, especially:

  • acetazolamide, methotrexate, a blood thinner (warfarin, Coumadin), a diuretic or "water pill," or a steroid;

  • medicine used to prevent blood clots--dalteparin, desirudin, enoxaparin, fondaparinux, tinzaparin, and others; or

  • NSAIDs (non-steroidal anti-inflammatory drugs)--ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, ketorolac, and others.

This list is not complete. Other drugs may interact with acetaminophen and aspirin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist has information about acetaminophen and aspirin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 5.01. Revision Date: 2013-08-07, 4:02:40 PM.

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