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.
This 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:
Burning, itching, and redness of the skin
difficulty with swallowing
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
tightness in the chest
unusual tiredness or weakness
Incidence not known
Blistering, peeling, or loosening of the skin
irregular or slow heart rate
joint or muscle pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
red skin lesions, often with a purple center
red, irritated eyes
sores, ulcers, or white spots in the mouth or on the lips
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Black, tarry stools
difficulty with sleeping
drowsiness to profound coma
irregular, fast or slow, or shallow breathing
loss of appetite
mood or other mental changes
pale or blue lips, fingernails, or skin
seeing, hearing, or feeling things that are not there
unpleasant breath odor
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
vomiting of blood
yellow eyes or skin
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:
bloated or feeling of fullness
excess air or gas in the stomach or intestines
false or unusual sense of well-being
feeling of warmth
increase in bowel movements
loss of strength or energy
muscle pain or weakness
numbness or tingling of the hands, legs, and feet
painful or difficult urination
redness of the face, neck, arms, and occasionally the upper chest
sleepiness or unusual drowsiness
change in vision
clumsiness, unsteadiness, trembling, or problems with muscle control or coordination
continuing ringing, buzzing, or unexplained noise in the ears
decrease in the frequency or amount of urination
decreased awareness or responsiveness
decreased interest in sexual intercourse
difficulty in passing urine (dribbling)
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
feeling of constant movement of self or surroundings
feeling unusually cold
headache, severe or continuing
increased muscle tone
involuntary muscle contractions
loss of memory
loss of sense of reality
loss of sexual ability, desire, drive, or performance
pounding in the ears
problems with memory
quick to react or overreact emotionally
rapidly changing moods
sensation of spinning
severe stomach pain
shakiness and unsteady walk
swelling of the tongue
vomiting of blood or material that looks like coffee grounds
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.