aspirin and codeine

Generic Name: aspirin and codeine (AS pir in and KOE deen)
Brand Name: Empirin with Codeine

What is aspirin and codeine?

Aspirin is in a group of drugs called salicylates (sa-LIS-il-ates). It works by reducing substances in the body that cause pain, fever, and inflammation.

Codeine is an opioid pain medication. An opioid is sometimes called a narcotic.

The combination of aspirin and codeine is used to treat moderate to severe pain.

Aspirin and codeine may also be used for purposes not listed in this medication guide.

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

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

You should not take aspirin and codeine if you have a bleeding disorder, a recent history of stomach or intestinal bleeding, if you take a blood thinner, or if you are allergic to aspirin, codeine, or an NSAID (non-steroidal anti-inflammatory drug) such as Advil, Aleve, Motrin, Naprosyn, Orudis, Cataflam, Celecoxib, Feldene, Indocin, Lodine, Mobic, Relafen, Toradol, Voltaren, and others.

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Do not use aspirin and codeine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Codeine may be habit-forming and should be used only by the person for whom it was prescribed. Keep the medication in a secure place where others cannot get to it.

Ask a doctor or pharmacist before using any other over-the-counter cold, allergy, or pain medicine. Aspirin is contained in many combination medicines. Taking certain products together can cause you to get too much aspirin. Check the label to see if a medicine contains aspirin.

What should I tell my healthcare provider before taking aspirin and codeine?

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

You should not take this medication if you are allergic to aspirin or codeine, or if you have:

• a bleeding or blood clotting disorder such as hemophilia;

• an ulcer or bleeding in your stomach or intestines;

• an allergy to an NSAID (non-steroidal anti-inflammatory drug) such as Advil, Aleve, Motrin, Naprosyn, Orudis, Cataflam, Celecoxib, Feldene, Indocin, Lodine, Mobic, Relafen, Toradol, Voltaren, and others; or

• if you are taking a blood thinner such as warfarin (Coumadin, Jantoven).

Do not use aspirin and codeine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

To make sure you can safely take aspirin and codeine, tell your doctor if you have any of these other conditions:

• stomach or intestinal disorder, history of stomach ulcer or bleeding;

• severe constipation, a blockage in your stomach or intestines;

• liver or kidney disease;

• allergies, nasal polyps, asthma or other breathing disorders;

• a heart rhythm disorder, low blood pressure;

• enlarged prostate, urination problems;

• underactive thyroid;

• gallbladder disease;

• seizures, or a history of head injury or brain tumor;

• Addison's disease or other adrenal gland disorder;

• curvature of the spine;

• mental illness, a history of drug or alcohol addiction; or

• if you have been sick with diarrhea.

Codeine may be habit forming and should be used only by the person for whom it was prescribed. Never share this medication with another person, especially someone with a history of drug abuse or addiction.

FDA pregnancy category C. This medication can cause breathing problems or addiction/withdrawal symptoms in a newborn. Taking aspirin during late pregnancy may cause bleeding in the mother or the baby during delivery. Do not take aspirin and codeine during pregnancy unless your doctor has told you to. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.

Aspirin and codeine can pass into breast milk and may harm a nursing baby. The use of codeine by some nursing mothers may lead to life-threatening side effects in the baby. You should not breast-feed while you are using aspirin and codeine.

How should I take aspirin and codeine?

Take exactly as prescribed. Never take aspirin and codeine in larger amounts, or 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.

Aspirin and codeine may be taken with food if it upsets your stomach.

If you need surgery, tell the surgeon ahead of time that you are using aspirin and codeine.

Do not stop using aspirin and codeine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using aspirin and codeine.

Store at room temperature away from moisture, heat, and light. Keep track of the amount of medicine used from each new bottle. Codeine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

See also: Aspirin and codeine dosage (in more detail)

What happens if I miss a dose?

Since aspirin and codeine 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. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use 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 aspirin and codeine can be fatal.

Overdose symptoms may include extreme dizziness or spinning sensation, sweating, pinpoint pupils, double vision, vomiting, hallucinations, muscle weakness or limp feeling, cold and clammy skin, fainting, weak pulse, seizure (convulsions), blue lips, shallow breathing, or no breathing.

What should I avoid while taking aspirin and codeine?

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how aspirin and codeine will affect you.

Ask a doctor or pharmacist before using any other over-the-counter cold, allergy, or pain medicine. Aspirin is contained in many combination medicines. Taking certain products together can cause you to get too much aspirin. Check the label to see if a medicine contains aspirin.

Avoid taking acetaminophen (Tylenol) or an NSAID while you are taking aspirin and codeine, unless your doctor tells you to. NSAIDs include ibuprofen (Advil, Motrin), ketorolac (Toradol), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others.

Avoid drinking alcohol. It may increase your risk of stomach bleeding while taking aspirin.

Aspirin and codeine side effects

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

Seek emergency medical attention if a child taking this medication has any of the following life-threatening side effects: noisy breathing, sighing, slow breathing with long pauses between breaths; being unusually sleepy or hard to wake up; blue colored lips.

Call your doctor at once if you have a serious side effect such as:

• severe stomach pain or constipation, vomiting;

• bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

• shallow breathing, fast or slow heartbeat;

• confusion, hallucinations, unusual thoughts or behavior, feeling like you might pass out;

• easy bruising or bleeding;

• seizure (convulsions); or

• decreased hearing or ringing in the ears.

Less serious side effects may include:

• mild constipation, nausea;

• heartburn, upset stomach, bloating, gas, diarrhea;

• headache, dizziness, tired feeling; or

• mild itching or rash.

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: aspirin and codeine side effects (in more detail)

Aspirin and codeine Dosing Information

Usual Adult Dose for Pain:

Aspirin 325 mg - codeine 30 mg: 1 or 2 tablets orally every 4 hours as needed.
Aspirin 325 mg - codeine 60 mg: 1 tablet orally every 4 hours as needed.

What other drugs will affect aspirin and codeine?

Before using this medication, tell your doctor if you regularly use other medicines that make you sleepy or could slow your breathing (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by aspirin and codeine.

Many drugs can interact with aspirin and codeine. Below is just a partial list. Tell your doctor if you are using:

• deferasirox (Exjade);

• leflunomide (Arava);

• methotrexate (Rheumatrex, Trexall);

• sirolimus (Rapamune) or tacrolimus (Prograf);

• an antidepressant, such as bupropion (Wellbutrin, Zyban), citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and others;

• antiviral medicines such as adefovir (Hepsera), cidofovir (Vistide), or tenofovir (Viread, Atripla, Complera, Truvada);

• aspirin or other salicylates, including Kaopectate, Pamprin Cramp Formula, Pepto-Bismol, Tricosal, Trilisate, and others;

• bowel cleansing preparations (Half Lytely, Fleet Prep Kit, Evac-Q-Kwik, GoLytely, Supraprep, and others);

• glaucoma medication such as acetazolamide (Diamox) or methazolamide (Glauctabs, Neptazane); or

• medication used to prevent blood clots, such as dalteparin (Fragmin), enoxaparin (Lovenox), fondaparinux (Arixtra), tinzaparin (Innohep), and others.

This list is not complete and other drugs may interact with aspirin and codeine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about aspirin and codeine.