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 medication for pain relief. Tolerance is normal and is expected if you take this 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:
Abdominal or stomach pain
black, tarry stools
loss of appetite
unpleasant breath odor
unusual tiredness or weakness
vomiting of blood
yellow eyes or skin
Cough or hoarseness
fever with or without chills
general feeling of tiredness or weakness
lower back or side pain
painful or difficult urination
sores, ulcers, or white spots on the lips or in the mouth
unusual bleeding or bruising
Incidence not known
Back, leg, or stomach pains
blood in the urine or stools
blue lips and fingernails
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chest pain or discomfort
coughing that sometimes produces a pink frothy sputum
decreased awareness or responsiveness
decreased frequency or amount of urine
difficult or labored breathing
difficult or painful urination
difficult, fast, noisy breathing, sometimes with wheezing
difficulty in passing urine (dribbling)
difficulty with swallowing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
extremely shallow or slow breathing
fast or deep breathing
fast, slow, irregular, pounding, or racing heartbeat
feeling of warmth
general body swelling
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
numbness or tingling in the hands, feet, or lips
pains in the stomach, side, or abdomen, possibly radiating to the back
pinpoint red spots on the skin
pounding in the ears
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rapid, deep or shallow breathing
redness of the face, neck, arms, and occasionally, upper chest
skin rash, hives, or welts
swelling of the face, fingers, lower legs, or ankles
tightness in the chest
weakness or heaviness of the legs
Get emergency help immediately if any of the following symptoms of overdose occur:
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:
Relaxed and calm feeling
Incidence not known
Acid or sour stomach
bad, unusual or unpleasant (after) taste
change in taste
constricted, pinpoint, or small pupils (black part of the eye)
continuing ringing or buzzing or other unexplained noise in the ears
cool, pale skin
difficulty with moving
disturbed color perception
excess air or gas in the stomach or intestines
false or unusual sense of well-being
flushed, dry skin
fruit-like breath odor
general feeling of discomfort or illness
halos around lights
lack or loss of strength
muscle cramps or spasms
muscle pain or stiffness
overbright appearance of lights
seeing, hearing, or feeling things that are not there
sleepiness or unusual drowsiness
stomach discomfort, upset, or pain
unexplained weight loss
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.