What should I watch for?
Tell your doctor or health care professional if your pain does not go away, if it gets worse, or if you have new or a different type of pain. You may develop tolerance to the medicine. Tolerance means that you will need a higher dose of the medicine for pain relief. Tolerance is normal and is expected if you take the medicine for a long time.
Do not suddenly stop taking your medicine because you may develop a severe reaction. Your body becomes used to the medicine. This does NOT mean you are addicted. Addiction is a behavior related to getting and using a drug for a non-medical reason. If you have pain, you have a medical reason to take pain medicine. Your doctor will tell you how much medicine to take. If your doctor wants you to stop the medicine, the dose will be slowly lowered over time to avoid any side effects.
There are different types of narcotic medicines (opiates). If you take more than one type at the same time or if you are taking another medicine that also causes drowsiness, you may have more side effects. Give your health care provider a list of all medicines you use. Your doctor will tell you how much medicine to take. Do not take more medicine than directed. Call emergency for help if you have problems breathing or unusual sleepiness.
Do not take other medicines that contain acetaminophen with this medicine. Always read labels carefully. If you have questions, ask your doctor or pharmacist.
If you take too much acetaminophen get medical help right away. Too much acetaminophen can be very dangerous and cause liver damage. Even if you do not have symptoms, it is important to get help right away.
You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.
The medicine will cause constipation. Try to have a bowel movement at least every 2 to 3 days. If you do not have a bowel movement for 3 days, call your doctor or health care professional.
Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.
Common and Rare Side Effects
Along with its needed effects, a medicine 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:
More common
Dizziness
lightheadedness
Incidence not known
Back, leg, or stomach pains
black, tarry stools
bleeding gums
blood in the urine or stools
blood in vomit
bluish lips or skin
chills
choking
cough or hoarseness
dark urine
decrease in the frequency of urination
decrease in urine volume
difficult or troubled breathing
difficulty in passing urine (dribbling)
difficulty with breathing
difficulty with swallowing
fast heartbeat
fever with or without chills
general body swelling
general feeling of tiredness or weakness
headache
irregular, fast or slow, or shallow breathing
light-colored stools
loss of appetite
lower back or side pain
nausea or vomiting
nosebleeds
not breathing
painful or difficult urination
pale or blue lips, fingernails, or skin
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
severe or continuing stomach pain
sore tongue
sores, ulcers, or white spots on the lips or in the mouth
tightness in the chest
unable to speak
unusual bleeding or bruising
unusual tiredness or weakness
upper right abdominal or stomach pain
yellow eyes and skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Bloody or cloudy urine
change in consciousness
chest pain or discomfort
cold and clammy skin
decreased awareness or responsiveness
extreme drowsiness
general feeling of discomfort or illness
increased sweating
irregular heartbeat
lightheadedness, dizziness, or fainting
loss of consciousness
no blood pressure or pulse
no muscle tone or movement
not breathing
severe sleepiness
slow or irregular heartbeat
stopping of heart
sudden decrease in the amount of urine
unconsciousness
unpleasant breath odor
Some side effects 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
Drowsiness
relaxed and calm
sleepiness
Incidence not known
Belching
changes in mood
difficulty having a bowel movement (stool)
fear or nervousness
feeling of indigestion
hearing loss
impaired hearing
pain in the chest below the breastbone
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
