Yes

Analgesic, Combination (Narcotic)

Dental: Treatment of postoperative pain

Medical: Relief of moderate to moderately severe pain

C-III

D

Use with caution in patients with impaired renal function, erosive gastritis, or peptic ulcer disease; children and teenagers should not use for chickenpox or flu symptoms before a physician is consulted about Reye's syndrome; tolerance or drug dependence may result from extended use

>10%:

Cardiovascular: Hypotension

Central nervous system: Lightheadedness, dizziness, sedation, drowsiness, fatigue

Gastrointestinal: Nausea, heartburn, stomach pains, dyspepsia, epigastric discomfort

Neuromuscular & skeletal: Weakness

1% to 10%:

Cardiovascular: Bradycardia

Central nervous system: Confusion

Dermatologic: Rash

Gastrointestinal: Vomiting, gastrointestinal ulceration

Genitourinary: Decreased urination

Hematologic: Hemolytic anemia

Respiratory: Shortness of breath, dyspnea

Miscellaneous: Anaphylactic shock

<1%: Hypertension, hallucinations, insomnia, nervousness, jitters, xerostomia, anorexia, biliary tract spasm, urinary tract spasm, occult bleeding, prolongated bleeding time, leukopenia, thrombocytopenia, iron deficiency anemia, hepatotoxicity, diplopia, miosis, impaired renal function, bronchospasm, histamine release, physical and psychological dependence with prolonged use

Antidote is naloxone for codeine. Naloxone 2 mg I.V. (0.01 mg/kg for children) with repeat administration as necessary up to a total of 10 mg. The "Done" nomogram is very helpful for estimating the severity of aspirin poisoning and directing treatment using serum salicylate levels. Treatment can also be based upon symptomatology; see Aspirin.

Increased toxicity with CNS depressants, warfarin (bleeding)

Refer to individual agents

Onset of effect: Onset of narcotic analgesia: Within 10-20 minutes

Duration of effect: 3-6 hours

Serum half-life: 3.8 hours

Adults: Oral: 1-2 tablets every 4-6 hours as needed for pain

Alcohol: Additive CNS effect, avoid use

Observe patient for excessive sedation, respiratory depression

Urine glucose, urinary 5-HIAA, serum uric acid

No information available to require special precautions

<1% of patients experience dry mouth; use with caution in patients with platelet and bleeding disorders, renal dysfunction, erosive gastritis, or peptic ulcer disease, previous nonreaction does not guarantee future safe taking of medication; use with caution in impaired hepatic function; do not use aspirin in children <16 years of age for chickenpox or flu symptoms due to the association with Reye's syndrome

Elderly are a high-risk population for adverse effects from nonsteroidal anti-inflammatory agents. As much as 60% of elderly with GI complications to NSAIDs can develop peptic ulceration and/or hemorrhage asymptomatically. Also, concomitant disease and drug use contribute to the risk for GI adverse effects. Use lowest effective dose for shortest period possible. Consider renal function decline with age. Use with caution in patients with history of asthma.

If self-administered, use exactly as directed (do not increase dose or frequency); may cause physical and/or psychological dependence. Take with food or milk. While using this medication, do not use alcohol, excessive amounts of vitamin C, or salicylate-containing foods (curry powder, prunes, raisins, tea, or licorice), other aspirin- or salicylate-containing medications, and other prescription or OTC medications (especially sedatives, tranquilizers, antihistamines, or pain medications) without consulting prescriber. Maintain adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid intake). May cause hypotension, dizziness, drowsiness, impaired coordination, or blurred vision (use caution when driving, climbing stairs, or changing position - rising from sitting or lying to standing, or when engaging in tasks requiring alertness until response to drug is known); nausea, vomiting, or dry mouth (frequent mouth care, small frequent meals, chewing gum, or sucking lozenges may help); constipation (increased exercise, fluids, or dietary fruit and fiber may help - if constipation remains an unresolved problem, consult prescriber about use of stool softeners). Report ringing in ears; persistent pain in stomach; unresolved nausea or vomiting; difficulty breathing or shortness of breath; yellowing of skin or eyes; changes in color of stool or urine; or unusual bruising or bleeding. Pregnancy/breast-feeding precautions: Use appropriate contraceptive measures; do not get pregnant while taking this drug. Do not breast-feed.

May cause drowsiness; avoid alcohol; watch for bleeding gums or any signs of GI bleeding; notify physician if ringing in ears or persistent GI pain occurs

Tablet: Hydrocodone bitartrate 5 mg and aspirin 500 mg

Dionne RA, "New Approaches to Preventing and Treating Postoperative Pain," J Am Dent Assoc, 1992, 123(6):26-34.

Gobetti JP, "Controlling Dental Pain," J Am Dent Assoc, 1992, 123(6):47-52.