Have you ever had a severe ache, backache, or post-surgery pain that no other painkiller could relieve? Today we are going to talk about a special, powerful painkiller that doctors prescribe for such cases. It contains three ingredients. They are acetaminophen , caffeine , and dihydrocodeine.
What really happens with this medicine?
Simply put, this is a medication that is given to control severe pain. A doctor will prescribe this medication, especially if the pain has not been relieved by other common painkillers, or if those medications do not suit your body.
The dihydrocodeine component in this belongs to a group of powerful painkillers called opioids . It works by blocking pain signals to the brain. Acetaminophen is also a painkiller. Caffeine is added to enhance the effectiveness of these painkillers. When all three are combined, they provide good relief from severe pain.
Things to inform your doctor before using the medicine
Because this is a powerful medication, it is very important to give your doctor a complete account of your health. If you have any of the conditions listed below, be sure to tell them before taking this medication.
| Information to inform the doctor | |
|---|---|
| 🧠 A brain tumor or head injury | 🍺 If you drink alcohol regularly |
| 🫁 Lung or breathing diseases (such as asthma, COPD) | ❤️ Heart disease |
| 🩺 Liver or kidney disease | 😵💫 Epilepsy (Seizures) |
| 💊 If you have a substance use disorder | 🤰 If you are pregnant or trying to get pregnant |
| 🤱 If you are a mother who is breastfeeding your child | Allergies (to this medicine, to other medicines, to foods) |
| 💊 Especially: If you have taken an MAOI antidepressant (e.g. Marplan, Nardil) within the past 14 days. | |
How exactly do you use this medicine?
Take this medicine with a glass of water. Take only the amount prescribed by your doctor. Do not take more than that or take it more often than prescribed. If you feel an upset stomach, take the medicine with some food.
This medicine should be used with caution in children. It is not suitable for children under 12 years of age. It should also not be given to children under 18 years of age after surgery to remove the tonsils or adenoids .
What if I miss a dose of medication?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose.
What to do if you take too much medicine?
This is a very serious matter. If you think you have taken too much medicine, immediately contact the National Poisons Information Centre at the Colombo National Hospital. Or go to the Emergency Department (ETU) of the nearest hospital. Do not wait until symptoms appear.
Things to keep in mind when taking this medicine
1. Pain, Addiction, and Tolerance
When you take this medicine for a long time, you may need to take a slightly higher dose to get the same relief you had before. We call this tolerance . This is normal, so don't worry. If your pain doesn't go away, talk to your doctor. He or she will adjust the dose as needed.
Remember, taking this medicine for pain on the advice of a doctor is different from using a medicine for pleasure without any medical reason (addiction). It is normal for your body to get used to the medicine (dependence). Therefore, do not stop taking the medicine suddenly without the advice of your doctor. Doing so may cause severe withdrawal symptoms . If you stop taking the medicine, you should do so by gradually reducing the dose as directed by your doctor.
2. Special warning about Acetaminophen!
This is very important. This medicine already contains acetaminophen (a medicine in the same group as paracetamol). Therefore, do not take any other medicine that contains paracetamol (e.g. Panadol, Calpol) while taking this medicine. Some cold medicines that you can buy from the pharmacy may also contain acetaminophen. Therefore, read the label of all medicines carefully.
Taking too much acetaminophen can cause severe liver damage, so be very careful with this.
3. Drowsiness and alcohol
You may feel drowsy or dizzy after taking this medicine. Therefore, do not drive or operate machinery until you know how this medicine affects you. Avoid drinking alcohol. Taking this medicine with alcohol can make the side effects worse.
4. Constipation
Constipation is common when taking opioid painkillers like these. Drink plenty of water, eat fiber-rich foods (fruits, vegetables). If you don't have a bowel movement within 3 days, tell your doctor.
Possible side effects of the medicine
Like any medicine, this can cause side effects in some people.
| Serious side effects that should be reported to the doctor immediately | |
|---|---|
| Allergic reactions: skin rash, itching, swelling of the face, lips, tongue. | |
| Breathing difficulties: slow breathing, shallow breathing, excessive sleepiness, loss of consciousness. (CNS depression) | |
| Symptoms of liver damage: pain in the upper right side of the stomach, loss of appetite, nausea, dark yellow/brown urine, yellowing of the skin or eyes. | |
| Low blood pressure: dizziness, blurred vision, fainting. | |
| Skin blisters: Redness of the skin, blistering, peeling of the skin (even inside the mouth). | |
| Common (if it persists, tell your doctor ) | |
|---|---|
| Constipation | Dry mouth |
| Dizziness | Nausea and vomiting |
| Drowsiness | Headache |
Safe storage and disposal of medicine
Because this is a strong medicine, keep it locked up in a safe place out of the reach of children and pets. Do not share it with others. It is against the law and very dangerous to give someone else a medicine that was prescribed for you.
Properly dispose of expired or unwanted medications. Some pharmacies have programs that accept old medications. Alternatively, mix the medication with something like coffee grounds, soil, or cat litter, put it in a tightly sealed bag, and throw it in the trash. Never flush medications down the toilet without your doctor's advice.
Take-Home Message
- This is a powerful medicine prescribed by a doctor only for severe pain.
- Always take the medicine at the dose and time prescribed by your doctor . Never take more than the recommended dose.
- Do not take any other medicine containing acetaminophen (paracetamol) while taking this medicine.
- Avoid driving as the medicine may cause drowsiness. Avoid drinking alcohol completely.
- Be sure to tell your doctor about any other illnesses you have and any other medications you are taking.
- Do not share the medicine with others. It is very dangerous. Keep it safe out of the reach of children.
- If you experience any problems, severe side effects, or overdose, seek medical advice immediately.
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