Skip to Content

DHC Plus Side Effects

Generic Name: acetaminophen / caffeine / dihydrocodeine

Note: This document contains side effect information about acetaminophen / caffeine / dihydrocodeine. Some of the dosage forms listed on this page may not apply to the brand name DHC Plus.

For the Consumer

Applies to acetaminophen / caffeine / dihydrocodeine: oral capsule, oral tablet

Along with its needed effects, acetaminophen/caffeine/dihydrocodeine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking acetaminophen/caffeine/dihydrocodeine:

More Common

  • Bleeding gums
  • blood in the urine or stools
  • bloody, black, or tarry stools
  • chest pain
  • chills
  • clay colored stools
  • cough
  • dark urine
  • decreased appetite
  • dizziness
  • drowsiness
  • fever
  • headache
  • high fever
  • itching or skin rash
  • lightheadedness
  • loss of appetite
  • nausea
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach pain or tenderness
  • swelling of the feet or lower legs
  • swollen glands
  • unexplained or unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting
  • yellow eyes or skin

Rare

  • Agitation
  • confusion
  • decreased urine output
  • difficulty with swallowing
  • fast heartbeat
  • hives
  • hostility
  • irritability
  • loss of consciousness
  • muscle twitching
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • rapid weight gain
  • seeing, hearing, or feeling things that are not there
  • seizures
  • stupor
  • swelling of the face, ankles, or hands
  • tightness in the chest
  • unusual drowsiness, dullness, or feeling of sluggishness

Incidence Not Known

  • Cold sweats
  • darkening of the skin
  • decrease in the frequency of urination
  • decrease in the urine volume
  • difficult or troubled breathing
  • difficulty in passing urine (dribbling)
  • dizziness, faintness, or lightheadedness when getting up from lying or sitting position
  • fainting
  • irregular, fast or slow, or shallow breathing
  • overactive reflexes
  • pale or blue lips, fingernails, or skin
  • poor coordination
  • shivering
  • talking or acting with excitement you cannot control
  • trembling or shaking

Some side effects of acetaminophen / caffeine / dihydrocodeine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More Common

  • Difficulty having a bowel movement
  • relaxed and calm feeling
  • sleepiness

Incidence Not Known

  • Constricted, pinpoint, or small pupils (black part of the eye)
  • diarrhea
  • dry mouth
  • gas in the stomach
  • heartburn

For Healthcare Professionals

Applies to acetaminophen / caffeine / dihydrocodeine: oral capsule, oral tablet

General

The most frequently expected adverse reactions based on the individual components may include lightheadedness, dizziness, drowsiness, sedation, nausea, vomiting, constipation, pruritus and skin reactions.[Ref]

Hepatic

Acetaminophen:

Frequency not reported: Hepatotoxicity[Ref]

Respiratory

Dihydrocodeine:

Frequency not reported: Respiratory depression, cough suppression[Ref]

Psychiatric

Dihydrocodeine:

Frequency not reported: Confusion, physical and psychological dependence, hallucinations vivid dreams

Caffeine:

Frequency not reported: Anxiety, anxiety neurosis, excitement, insomnia, irritability, restlessness, tenseness[Ref]

Dermatologic

Dihydrocodeine:

Frequency not reported: Sweating, pruritus, skin reactions

Acetaminophen:

Rare (less than 0.1%): Serious skin reactions such as acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN)

Caffeine:

Frequency not reported: Urticaria[Ref]

Hypersensitivity

Dihydrocodeine:

Frequency not reported: Anaphylactoid reactions, hypersensitivity reactions

Acetaminophen:

Rare (less than 0.1%): Anaphylactoid reactions

Frequency not reported: Hypersensitivity reactions including urticarial or erythematous skin reactions, laryngeal edema, angioedema[Ref]

Nervous system

Postmarketing reports: Serotonin syndrome

Dihydrocodeine:

Rare (less than 0.1%): Narcosis

Frequency not reported: Lightheadedness, dizziness, drowsiness, sedation, headache

Caffeine:

Frequency not reported: Headaches, lightheadedness, tremor[Ref]

Renal

Dihydrocodeine:

Rare (less than 0.1%): Acute renal failure

Frequency not reported: Granulomatous interstitial nephritis

Caffeine:

Frequency not reported: Diuresis[Ref]

Cardiovascular

Dihydrocodeine:

Frequency not reported: Orthostatic hypotension

Caffeine:

Frequency not reported: Extrasystoles, palpitations, tachycardia[Ref]

Endocrine

Postmarketing reports: Adrenal insufficiency

Opioids:

Frequency not reported: Androgen deficiency[Ref]

Chronic opioid use may influence the hypothalamic-pituitary-gonadal axis and lead to androgen deficiency; however, the causal role of opioids is unknown due to the lack of studies into the many medical, physical, lifestyle, and psychological stressors that influence gonadal hormone levels.[Ref]

Gastrointestinal

Dihydrocodeine:

Frequency not reported: Nausea, vomiting, constipation, abdominal pain, diarrhea, dry mouth, indigestion, spasm of biliary tract

Caffeine:

Frequency not reported: Diarrhea, nausea, stomach pain, vomiting[Ref]

Genitourinary

Dihydrocodeine:

Frequency not reported: Urinary retention[Ref]

Hematologic

Acetaminophen:

Frequency not reported: Thrombocytopenia, leukopenia, pancytopenia, neutropenia, thrombocytopenic purpura, agranulocytosis[Ref]

Metabolic

Dihydrocodeine:

Frequency not reported: Anorexia[Ref]

Ocular

Dihydrocodeine:

Frequency not reported: Miosis

Caffeine:

Frequency not reported: Scintillating scotoma[Ref]

Other

Dihydrocodeine:

Frequency not reported: Fatigue

Caffeine:

Frequency not reported: Tinnitus[Ref]

References

1. "Product Information. APAP/Caffeine/Dihydrocodeine Bitartrate (acetaminophen / caffeine / dihydrocodeine)." Xspire Pharma, Ridgeland, MS.

2. "Product Information. Trezix (acetaminophen / caffeine / dihydrocodeine)." WraSer Pharmaceuticals, Madison, MS.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

More about DHC Plus (acetaminophen / caffeine / dihydrocodeine)

Consumer resources

Other brands: Trezix, Panlor, Panlor DC, Panlor SS, Zerlor

Professional resources

Related treatment guides

Hide