Acetaminophen (a-seet-a-MIN-oh-fen), Ibuprofen (eye-bue-PROE-fen)

Relieves pain.

Brand Name(s):

Combogesic

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• A nurse or other health provider will give you this medicine.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use any other NSAID medicine (including aspirin, diclofenac, diflunisal, or salsalate) unless your doctor tells you otherwise.
• Some medicines can affect how acetaminophen/ibuprofen works. Tell your doctor if you are using any of the following:
  • Cyclosporine, digoxin, lithium, methotrexate, pemetrexed
  • Blood pressure medicine (including ACE inhibitors, ARBs, beta blockers)
  • Blood thinner (including warfarin)
  • Diuretic (water pill)
  • Medicine to treat depression (including SNRIs, SSRIs)
  • Steroid medicine
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant. Do not use this medicine during the later part of a pregnancy, unless your doctor tells you to.
• Tell your doctor if you are breastfeeding, or if you have kidney disease, high blood pressure, anemia, heart disease, heart failure, a recent heart attack, bleeding disorder, lupus, or a history of stomach or bowel problems (including ulcers, bleeding) or stroke.
• This medicine may cause the following problems:
  • Liver problems
  • Increased risk of heart attack, heart failure, or stroke
  • Increased risk of stomach or bowel problems, including bleeding, ulcers, or perforation
  • High blood pressure
  • Kidney problems
  • Serious skin reactions, including Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, and acute generalized exanthematous pustulosis (AGEP)
  • Drug rash with eosinophilia and systemic symptoms (DRESS)
  • Aseptic meningitis
• Check with your doctor immediately if blurred vision or any other change in vision occurs while you are using this medicine. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).
• This medicine may cause a delay in ovulation for women and may affect the ability to have children. If you plan to have children, talk with your doctor before using this medicine.
• This medicine contains acetaminophen. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in one day.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Bloody or black, tarry stools, severe stomach pain, vomiting blood or material that looks like coffee grounds
• Change in how much or how often you urinate, bloody or cloudy urine
• Chest pain that may spread, trouble breathing, unusual sweating, fainting
• Confusion, weakness, uneven heartbeat, numbness or tingling in your hands, feet, or lips
• Dark urine or pale stools, nausea, vomiting, loss of appetite, yellow skin or eyes
• Numbness or weakness in your arm or leg, or on one side of your body, pain in your calf
• Rapid weight gain, swelling in your hands, ankles, or feet
• Sudden or severe headache, dizziness, or problems with vision, speech, or walking

If you notice these less serious side effects, talk with your doctor:

• Constipation
• Pain, redness, or swelling where the needle was placed
• Trouble sleeping

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088