acetaminophen / caffeine / dihydrocodeine

Even at recommended doses, Trezix can cause addiction, abuse, or misuse. Using Trezix for reasons other than prescribed (misuse) or at higher doses than prescribed can lead to overdose and death. To lower this risk, your healthcare provider will prescribe the lowest amount of Trezix that's necessary for you for the shortest period of time possible.

Trezix can cause irregular or slowed breathing, especially when first starting the medication or after your dose is raised. Respiratory depression can happen at any time, even at recommended doses. If you have shortness of breath, slow or shallow breathing, or bluish-colored lips, fingers, or toes, get medical help right away. Respiratory depression can cause you to stop breathing and lead to death, so it's important to recognize breathing problems and treat them as soon as possible.

Overdose can happen at recommended doses of Trezix, if your prescriber incorrectly converts your Trezix dose from a different opioid medication, or if it's accidentally taken by a child or a loved one. It can also happen if you take higher doses than prescribed or take the medication more often than prescribed. Overdoses can be life-threatening and lead to death if it's not recognized or treated in time.

Children can be more sensitive to codeine (and dihydrocodeine) and have a higher risk of life-threatening respiratory depression or overdose. Accidental ingestion of even one capsule in a child can cause overdose and death. Some children who took codeine for pain management after tonsil or adenoid surgery have died because of respiratory depression. Because of this risk, Trezix shouldn't be given to children younger than 12 years of age or to those younger than 18 years of age if they recently had tonsil or adenoid surgery. Keep this medication out of reach from children. If you suspect your child has taken Trezix or if you notice signs of extreme tiredness, sleepiness, and slowed breathing, call 911 right away.

Trezix contains acetaminophen. The maximum amount of acetaminophen you can take in a day is 3 to 4 grams, depending on your provider's instructions. Ask your healthcare provider what your daily acetaminophen maximum is.

Certain medications can interfere with how your body gets rid of Trezix or how quickly dihydrocodeine works. This can affect the amount of Trezix in your body, how well it works, and the risk of side effects.

During pregnancy, opioids can be passed from you to your unborn baby. Long-term use during pregnancy can cause your unborn baby to become dependent on opioids the same way that you can. Once your baby is born, they can experience withdrawal symptoms just like if you were to stop the medication suddenly. Withdrawal symptoms in your newborn can include high-pitched crying, poor feeding and sucking behavior, trembling, irritability, abnormal sleep patterns, and seizures. This condition is called neonatal opioid withdrawal syndrome and can be life-threatening if not recognized and treated in time. Providers who are experts in this area will know how to treat your newborn. Let your healthcare provider know if you've used Trezix during pregnancy or if you notice these symptoms in your baby.

Dihydrocodeine can be found in breast milk. At least one breast-fed baby died after being exposed to high levels of opioids in breast milk. Mothers with certain genetic factors that activate dihydrocodeine quickly can have higher concentrations of the medication in their breast milk, which can then be passed to their breast-fed baby. This can cause life-threatening respiratory depression and death in the baby. Because of this risk, Trezix is not recommended for people who are breastfeeding. Ask your provider for alternative pain medications that can be used while breastfeeding.

Dihydrocodeine can cause extreme sleepiness and lower your ability to think, react, and focus. Alcohol and other medications, like benzodiazepines, sedatives, anxiety medications, and certain muscle relaxants, can make you feel even worse. It's best to avoid drinking alcohol or taking these medications while taking Trezix. Make sure you know how this medication affects you before driving a car or doing activities that require your concentration. Talk to your healthcare provider right away if you feel too sleepy from taking Trezix.

If taken regularly for a long time, Trezix can cause physical dependence. This means your body relies on the medication to function. You might experience withdrawal if you stop taking the medication suddenly. Withdrawal symptoms include suicidal thoughts, the return of your pain, anxiety, restlessness, runny nose, yawning, sweating, chills, wide pupils, and irritability. Don't lower your dose or stop taking the medication suddenly without talking to your healthcare provider first. Your provider will slowly lower your dose to prevent withdrawal symptoms. If you have concerns about taking the medication because of these risks, talk to your healthcare provider about alternative pain medications.

Taking Trezix with medications that raise serotonin levels in your body can lead to a potentially life-threatening condition called serotonin syndrome. Serotonin is a natural chemical in your body that your brain and nerves use to communicate, but at very high levels, serotonin can cause hallucinations, coma, seizures, confusion, high fevers, racing heart, sweating, and muscle stiffness or twitching. Watch for signs of serotonin syndrome if you need to take Trezix with certain medications, including sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), and duloxetine (Cymbalta). If you experience any of these symptoms, stop taking Trezix and get medical help right away.

Opioids can cause your hormone levels to drop. This is more likely to happen if you take the medication for longer than a month. Symptoms of very low hormone levels include nausea, vomiting, loss of appetite, tiredness, dizziness, and weakness. Let your healthcare provider know right away if you experience these symptoms.