Before Using

If you are taking this drug without a prescription, carefully read and follow any precautions on the label. For decongestant and analgesic combinations, the following must be considered

Allergic reaction

If this drug contains aspirin, salicylamide , or ibuprofen , before taking it check with your family doctor if you have any unusual or allergy to any of the following medication:

• Aspirin or other salicylates
• Diclofenac - Voltaren
• Diflunisal - Dolobid
• Etodolac - Lodine
• Fenoprofen - Nalfon
• Floctafenine - Idarac
• Flurbiprofen, by mouth - Ansaid
• Ibuprofen - Motrin
• Indomethacin - Indocin
• Ketoprofen - Orudis
• Ketorolac - Toradol
• Meclofenamate - Meclomen
• Mefenamic acid - Ponstel
• Methyl salicylate - oil of wintergreen
• Nabumetone - Relafen
• Naproxen - Naprosyn
• Oxaprozin - Daypro
• Oxyphenbutazone - Tandearil
• Phenylbutazone - Butazolidin
• Piroxicam - Feldene
• Sulindac - Clinoril
• Suprofen - Suprol
• Tenoxicam - Mobiflex
• Tiaprofenic acid - Surgam
• Tolmetin - Tolectin
• Zomepirac - Zomax

Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy care

• Alcohol Some of these combination medication contain large amounts of alcohol. Too much use of alcohol during pregnancy may cause birth defects.
• Caffeine Studies have not shown that caffeine causes birth defects. However, studies in pets have shown that caffeine causes birth defects when given in very large doses - amounts equal to the amount of caffeine contained in 12 to 24 cups of coffee a day.
• Ibuprofen Studies on birth defects have not been done. However, there is a risk that ibuprofen may cause unwanted effects on the heart or blood flow of the fetus or newborn baby if it is taken regularly during the last few months of pregnancy.
• Phenylephrine Studies on birth defects have not been done in either humans or pets with phenylephrine.
• Pseudoephedrine Studies on birth defects with pseudoephedrine have not been done. In animal studies pseudoephedrine did not cause birth defects. However, when given to pets in high doses, pseudoephedrine did cause a decrease in average weight, length, and rate of bone formation in the animal fetus.
• Salicylates - aspirin Studies on birth defects have been done with aspirin, but not with salicylamide. Although salicylates have been shown to cause birth defects in pets, they have not been shown to cause birth defects.
  Regular use of salicylates late in pregnancy may cause unwanted effects on the heart or blood flow in the fetus or newborn baby. Use of salicylates during the last 2 weeks of pregnancy may cause bleeding problems in the fetus before or during delivery, or in the newborn baby. Always too much use of salicylates during the last 3 months of pregnancy may increase the length of pregnancy, prolong labor and cause other problems during delivery, or cause severe bleeding in the mother before, during, or after delivery Do not take aspirin during the last 3 months of pregnancy unless it has been ordered by your family doctor .

Breast-feeding problem

• Acetaminophen Acetaminophen passes into the breast milk. However, it has not been reported to cause problems in nursing babies.
• Alcohol Alcohol passes into the breast milk. However, the amount of alcohol in recommended doses of this drug does not usually cause problems in nursing babies.
• Caffeine Small amounts of caffeine pass into the breast milk and may build up in the nursing baby. However, the amount of caffeine in recommended doses of this drug does not usually cause problems in nursing babies.
• Decongestants - phenylephrine, pseudoephedrine Decongestants may pass into the breast milk and may cause unwanted effects in nursing babies of mothers taking this drug.
• Salicylates - aspirin, salicylamide Salicylates pass into the breast milk. Although salicylates have not been reported to cause problems in nursing babies, it is possible that problems may occur if large amounts are taken regularly.

Use for Children

• Decongestants - phenylephrine, pseudoephedrine Increases in blood pressure may be more likely to occur in child taking decongestants.
• Salicylates - aspirin Do not give aspirin or other salicylates to a child with a fever or other symptoms of a virus infection, especially flu or chickenpox, without first discussing its use with your child's family doctor . This is very important because salicylates may cause a serious illness called Reye's syndrome in these children. Always children may be more sensitive to the aspirin or other salicylates contained in some of these medication, especially if they have a fever or have lost large amounts of body fluid because of vomiting, diarrhea, or sweating.

Adolescents Do not give aspirin or other salicylates to a teenager with a fever or other symptoms of a virus infection, especially flu or chickenpox, without first discussing its use with your child's family doctor . This is very important because salicylates may cause a serious illness called Reye's syndrome in these individuals.

Elderly care

Drug interactions

Other Information for using

• Alcohol abuse Acetaminophen-containing drug increases the risk of liver damage

• Anemia Taking aspirin-, salicylamide-, or ibuprofen-containing drug may make the anemia worse

• Asthma, allergies and nasal polyps, history of Taking salicylate- or ibuprofen-containing drug may cause an allergy in which breathing becomes difficult

• Diabetes mellitus - sugar diabetes The decongestant in this drug may put the patient with diabetes at a greater risk of having heart or blood vessel disease

• Gout Aspirin-containing drug may make the gout worse and reduce the benefit of the medication using for gout

• Hepatitis or other liver disease Liver disease increases the risk of side effects because the drug is not broken down and may build up in the body; also, if liver disease is severe there is a greater risk that aspirin-containing drug may cause bleeding and that ibuprofen-containing drug may cause serious kidney damage

• Heart or blood vessel disease
• High blood pressure The decongestant in this drug may cause the blood pressure to increase and may also speed up the heart rate; also, caffeine-containing drug if taken in large amounts may increase the heart rate; ibuprofen-containing drug may cause the blood pressure to increase

• Hemophilia or other bleeding problems Aspirin- or ibuprofen-containing drug increases the risk of bleeding

• Kidney disease The kidneys may be effected, especially if too much of this drug is taken for a long time

• Mental illness - history of The decongestant in this drug may increase the risk of mental side effects

• Overactive thyroid If an overactive thyroid has causing a fast heart rate, the decongestant in this drug may cause the heart rate to speed up further

• Stomach ulcer or other stomach problems Salicylate- or ibuprofen-containing drug may make the ulcer worse or cause bleeding of the stomach

• Systemic lupus erythematosus - SLE Ibuprofen-containing drug may put the patient with SLE at a greater risk of having unwanted effects on the central nervous system andkidneys

• Ulcers, sores, or white spots in the mouth This may be a sign of a serious side effect of ibuprofen-containing drug; if you already have ulcers or sores in the mouth you and your family doctor may not be able to tell when this side effect occurs