Can consuming caffeine while taking acetaminophen cause liver damage. How does caffeine affect the metabolism of acetaminophen. What groups are more vulnerable to the potentially toxic interaction between acetaminophen and caffeine. Why should people monitor their intake of acetaminophen and caffeine more carefully when taking them together.

The Unexpected Interaction Between Acetaminophen and Caffeine

Acetaminophen, one of the most widely used painkillers in the United States, has long been known to potentially cause liver damage when consumed in excess or combined with alcohol. However, recent research has uncovered a surprising interaction between acetaminophen and another common substance: caffeine.

A preliminary laboratory study published in the journal Chemical Research in Toxicology has revealed that consuming large amounts of caffeine while taking acetaminophen could potentially lead to liver damage. This finding has significant implications for millions of people who regularly use both substances, either separately or in combination products.

The Science Behind the Interaction

To understand the potential dangers of combining acetaminophen and caffeine, we need to delve into the science behind their interaction:

• Researchers used E. coli bacteria genetically engineered to express a key human liver enzyme responsible for detoxifying many drugs.
• They found that caffeine triples the amount of a toxic byproduct called N-acetyl-p-benzoquinone imine (NAPQI) produced when breaking down acetaminophen.
• NAPQI is the same toxin responsible for liver damage and failure in toxic alcohol-acetaminophen interactions.

These findings were supported by previous studies showing that high doses of caffeine can increase the severity of liver damage in rats with acetaminophen-induced liver damage.

Understanding the Risks: Who Is Most Vulnerable?

While the study’s results are concerning, it’s important to note that the bacteria were exposed to “megadoses” of both acetaminophen and caffeine, far higher than most individuals would normally consume daily. However, certain groups may be more vulnerable to this potentially toxic interaction:

1. People taking anti-epileptic medications such as carbamazepine and phenobarbital
2. Those who use St. John’s Wort, a popular herbal supplement
3. Individuals who consume large amounts of alcohol
4. People who take medications that combine acetaminophen and caffeine for conditions like migraines or arthritis

These groups may be at increased risk due to higher levels of the enzyme that produces NAPQI or other factors that can exacerbate the toxic effects.

The Role of Caffeine in Acetaminophen Metabolism

How does caffeine affect the metabolism of acetaminophen in the body? The study suggests that caffeine interferes with the normal breakdown of acetaminophen, leading to increased production of the toxic byproduct NAPQI. This interaction occurs in the liver, where both substances are metabolized.

When consumed together in large amounts, caffeine appears to enhance the activity of the enzyme responsible for producing NAPQI. This increased production of the toxic metabolite can overwhelm the liver’s natural detoxification processes, potentially leading to liver damage.

Balancing Safety and Effectiveness: Recommendations for Consumers

In light of these findings, what should consumers do to protect their health while still benefiting from the pain-relieving properties of acetaminophen? Here are some recommendations:

• Monitor your intake of both acetaminophen and caffeine, especially when consuming them together
• Be cautious with energy drinks and strong coffee while taking acetaminophen
• Pay attention to combination medications that include both acetaminophen and caffeine
• Consult with a healthcare professional if you regularly use both substances, particularly if you fall into one of the high-risk groups

It’s important to note that you don’t necessarily need to stop taking acetaminophen or caffeine products entirely. The key is to be aware of the potential interaction and to use these substances responsibly.

The Impact on Common Medications and Supplements

Many people may be unaware that they are consuming both acetaminophen and caffeine in combination products. Some common medications and supplements that could be affected by this interaction include:

• Over-the-counter migraine medications
• Menstrual pain relievers
• Certain cold and flu remedies
• Pre-workout supplements containing caffeine

Always read the labels of your medications and supplements carefully, and be aware of their caffeine content. If you’re unsure, consult with a pharmacist or healthcare provider.

Future Research and Implications for Public Health

What are the next steps in understanding and addressing this potential health risk? Researchers are currently studying the mechanism by which the toxic interaction between acetaminophen and caffeine occurs. They are also considering human studies in the future to further explore the implications of their findings.

This research could have significant implications for public health, potentially leading to:

• Updated guidelines for acetaminophen and caffeine consumption
• Changes in the labeling of combination medications
• Increased awareness among healthcare providers and the general public
• Development of safer pain relief options

As more research is conducted, it will be crucial for health authorities to stay informed and provide updated recommendations to ensure public safety.

Alternatives and Safer Pain Management Strategies

Given the potential risks associated with combining acetaminophen and caffeine, what are some alternative pain management strategies that consumers can consider? Here are some options:

• Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen
• Topical pain relievers
• Physical therapy and exercise
• Relaxation techniques such as meditation or yoga
• Acupuncture or acupressure
• Heat or cold therapy

It’s important to consult with a healthcare professional to determine the most appropriate pain management strategy for your individual needs and health status.

The Importance of Moderation

While the potential risks of combining acetaminophen and caffeine are concerning, it’s crucial to remember that moderation is key. Most people who consume average amounts of these substances are unlikely to experience severe liver damage. However, being aware of the potential interaction can help individuals make informed decisions about their health and medication use.

Understanding Liver Health and Toxicity

To fully grasp the implications of the acetaminophen-caffeine interaction, it’s essential to understand how the liver processes these substances and why liver toxicity can be so dangerous.

The liver is responsible for metabolizing a wide range of substances, including medications, alcohol, and caffeine. It uses various enzymes to break down these compounds into forms that can be safely eliminated from the body. However, when the liver is overwhelmed by toxic substances or their byproducts, it can lead to cellular damage and, in severe cases, liver failure.

Signs of Liver Toxicity

What are the signs that someone might be experiencing liver toxicity from acetaminophen or other substances? Some common symptoms include:

• Nausea and vomiting
• Abdominal pain, especially in the upper right quadrant
• Fatigue and weakness
• Yellowing of the skin and eyes (jaundice)
• Dark urine
• Loss of appetite

If you experience these symptoms, especially after taking acetaminophen or consuming large amounts of caffeine, it’s crucial to seek medical attention immediately.

The Global Impact of Acetaminophen and Caffeine Use

The potential interaction between acetaminophen and caffeine has global implications, given the widespread use of both substances worldwide. Acetaminophen, also known as paracetamol in many countries, is one of the most commonly used pain relievers globally. Similarly, caffeine consumption is ubiquitous, with coffee, tea, and energy drinks being popular in cultures around the world.

This research highlights the need for international cooperation in studying and addressing potential drug interactions. It also underscores the importance of harmonizing medication guidelines and labeling across different countries to ensure consistent safety information for consumers worldwide.

Cultural Differences in Medication and Caffeine Use

How do cultural differences impact the potential risks associated with acetaminophen and caffeine interaction? Different cultures have varying patterns of medication use and caffeine consumption, which could influence the prevalence of this interaction. For example:

• In some European countries, acetaminophen is available only by prescription, potentially reducing the risk of overuse.
• Coffee consumption varies greatly between countries, with some nations having significantly higher per capita intake than others.
• The popularity of energy drinks and caffeine supplements differs across regions and age groups.

These cultural factors may need to be taken into account when developing public health strategies to address the potential risks of combining acetaminophen and caffeine.

The Role of Education in Preventing Adverse Drug Interactions

Education plays a crucial role in preventing adverse drug interactions, including the potential risks associated with combining acetaminophen and caffeine. Both healthcare professionals and the general public need to be informed about these risks to make safe and responsible decisions about medication use.

Educating Healthcare Providers

How can healthcare providers be better equipped to advise patients about the potential risks of combining acetaminophen and caffeine? Some strategies include:

• Incorporating the latest research on drug interactions into medical and pharmacy school curricula
• Providing continuing education opportunities for practicing healthcare professionals
• Developing and disseminating clinical guidelines that address the acetaminophen-caffeine interaction
• Encouraging healthcare providers to ask patients about their caffeine consumption when prescribing or recommending acetaminophen

Public Awareness Campaigns

What can be done to increase public awareness of the potential risks associated with combining acetaminophen and caffeine? Some effective approaches might include:

• Creating easy-to-understand infographics and educational materials for distribution in pharmacies and healthcare settings
• Utilizing social media platforms to share information about safe medication use
• Partnering with consumer health organizations to reach a wider audience
• Incorporating medication safety information into school health education programs

By improving education and awareness at all levels, we can help reduce the risk of adverse drug interactions and promote safer medication use practices.

The Future of Pain Management: Balancing Efficacy and Safety

As our understanding of drug interactions and their potential risks grows, what does the future hold for pain management? The acetaminophen-caffeine interaction study highlights the need for continued research and innovation in developing safer and more effective pain relief options.

Personalized Medicine Approaches

One promising avenue for improving pain management is the field of personalized medicine. This approach takes into account an individual’s genetic makeup, lifestyle factors, and other personal characteristics to tailor treatment plans. In the context of pain management, this could involve:

• Genetic testing to identify individuals who may be more susceptible to certain drug interactions
• Developing algorithms that consider a patient’s caffeine intake and other relevant factors when recommending pain relief options
• Creating personalized dosing regimens that maximize efficacy while minimizing the risk of adverse effects

Novel Pain Relief Compounds

Researchers are also working on developing new pain relief compounds that may offer improved safety profiles compared to existing options. Some areas of investigation include:

• Targeted pain relievers that act on specific pain pathways, potentially reducing systemic side effects
• Natural compounds with analgesic properties that may have fewer interactions with other substances
• Drug delivery systems that allow for more precise control of medication release and absorption

As these new approaches are developed and refined, they may provide safer alternatives for pain management, particularly for individuals who are at higher risk for adverse drug interactions.

Regulatory Considerations and Policy Implications

The discovery of the potential interaction between acetaminophen and caffeine raises important questions about regulatory oversight and policy implications. How might this new information impact the regulation of over-the-counter medications and dietary supplements?

Potential Changes in Labeling Requirements

Regulatory agencies may need to consider updating labeling requirements for acetaminophen-containing products to include warnings about potential interactions with caffeine. This could involve:

• Adding cautionary statements about caffeine consumption on acetaminophen packaging
• Requiring combination products containing both acetaminophen and caffeine to carry special warnings
• Implementing more stringent labeling requirements for caffeine content in beverages and supplements

Reevaluating Over-the-Counter Status

In some countries, the availability of acetaminophen as an over-the-counter medication may need to be reevaluated in light of this new information. Policymakers may consider options such as:

• Implementing stricter controls on the sale of acetaminophen, such as limiting package sizes or requiring pharmacist intervention
• Moving certain high-dose or combination products to behind-the-counter status
• Enhancing monitoring and reporting systems for adverse events related to acetaminophen use

These regulatory considerations will need to balance the importance of access to pain relief medications with the need to protect public health and safety.

The Role of Technology in Promoting Safe Medication Use

As we grapple with the complexities of drug interactions and their potential risks, technology can play a crucial role in promoting safe medication use. How can digital tools and innovations help address the challenges posed by the acetaminophen-caffeine interaction and similar issues?

Medication Tracking Apps

Smartphone apps and other digital tools can help individuals track their medication use and potential interactions. These apps could:

• Allow users to log their acetaminophen intake and caffeine consumption
• Provide alerts when potentially risky combinations are detected
• Offer educational resources about safe medication use and potential interactions
• Integrate with wearable devices to monitor relevant health metrics

Artificial Intelligence and Machine Learning

Advanced technologies like artificial intelligence (AI) and machine learning can be leveraged to improve our understanding of drug interactions and enhance patient safety. Potential applications include:

• Analyzing large datasets to identify previously unknown drug interactions
• Developing predictive models to assess an individual’s risk of adverse drug reactions
• Creating chatbots or virtual assistants to provide personalized medication safety advice
• Enhancing pharmacovigilance systems to detect and respond to emerging safety concerns more quickly

By harnessing the power of technology, we can create more robust systems for monitoring and promoting safe medication use, ultimately improving patient outcomes and public health.

Caffeine and acetaminophen don’t mix well

• Download PDF Copy

Sep 27 2007

Consuming large amounts of caffeine while taking acetaminophen, one of the most widely used painkillers in the United States, could potentially cause liver damage, according to a preliminary laboratory study reported in the Oct. 15 print issue of ACS’ Chemical Research in Toxicology, a monthly journal.

The toxic interaction could occur not only from drinking caffeinated beverages while taking the painkiller but also from using large amounts of medications that intentionally combine caffeine and acetaminophen for the treatment of migraine headaches, menstrual discomfort and other conditions, the researchers say.

Health experts have warned for years that consuming excess alcohol while taking acetaminophen can trigger toxic interactions and cause liver damage and even death. However, this is the first time scientists have reported a potentially harmful interaction while taking the painkiller with caffeine, the researchers say.

While the studies are preliminary findings conducted in bacteria and laboratory animals, they suggest that consumers may want to limit caffeine intake — including energy drinks and strong coffee — while taking acetaminophen.

Chemist Sid Nelson, Ph.D., and colleagues, of the University of Washington in Seattle, tested the effects of acetaminophen and caffeine on E. coli bacteria genetically engineered to express a key human enzyme in the liver that detoxifies many prescription and nonprescription drugs. The researchers found that caffeine triples the amount of a toxic byproduct, N-acetyl-p-benzoquinone imine (NAPQI), that the enzyme produces while breaking down acetaminophen. This same toxin is responsible for liver damage and failure in toxic alcohol-acetaminophen interactions, they say.

In previous studies, the same researchers showed that high doses of caffeine can increase the severity of liver damage in rats with acetaminophen-induced liver damage, thus supporting the current finding.

“People should be informed about this potentially harmful interaction,” Nelson says. “The bottom line is that you don’t have to stop taking acetaminophen or stop taking caffeine products, but you do need to monitor your intake more carefully when taking them together, especially if you drink alcohol.”

Nelson points out that the bacteria used in the study were exposed to ‘megadoses’ of both acetaminophen and caffeine, much higher than most individuals would normally consume on a daily basis. Most people would similarly need to consume unusually high levels of these compounds together to have a dangerous effect, but the toxic threshold has not yet been determined, he says.

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Certain groups may be more vulnerable to the potentially toxic interaction than others, Nelson says. This includes people who take certain anti-epileptic medications, including carbamazepine and phenobarbital, and those who take St. John’s Wort, a popular herbal supplement. These products have been shown to boost levels of the enzyme that produces the toxic liver metabolite NAPQI, an effect that will likely be heightened when taking both acetaminophen and caffeine together, he says.

Likewise, people who drink a lot of alcohol may be at increased risk for the toxic interaction, Nelson says. That’s because alcohol can trigger the production of yet another liver enzyme that produces the liver toxin NAPQI. The risks are also higher for those who take large amounts of medications that combine both acetaminophen and caffeine, which are often used together as a remedy for migraine headaches, arthritis and other conditions.

The researchers are currently studying the mechanism by which this toxic interaction occurs and are considering human studies in the future, they say. The National Institutes of Health funded the initial animal and bacterial studies.

http://www.acs.org/

Posted in: Drug Trial News

Tags: Acetaminophen, Alcohol, Anti-Epileptic Drug, Arthritis, Bacteria, Caffeine, Coffee, Drugs, E. coli, Enzyme, Laboratory, Liver, Metabolite, Migraine, OCT, Painkiller, Research, Toxicology, Toxin

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Mixing large doses of both acetaminophen painkiller and caffeine may increase risk of liver damage

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• 2007

• September

• Mixing large doses of both acetaminophen painkiller and caffeine may increase risk of liver damage

FOR IMMEDIATE RELEASE | September 26, 2007

WASHINGTON, Sept. 26 2007 — Consuming large amounts of caffeine while taking acetaminophen, one of the most widely used painkillers in the United States, could potentially cause liver damage, according to a preliminary laboratory study reported in the Oct. 15 print issue of ACS’ Chemical Research in Toxicology, a monthly journal. The toxic interaction could occur not only from drinking caffeinated beverages while taking the painkiller but also from using large amounts of medications that intentionally combine caffeine and acetaminophen for the treatment of migraine headaches, menstrual discomfort and other conditions, the researchers say.

Health experts have warned for years that consuming excess alcohol while taking acetaminophen can trigger toxic interactions and cause liver damage and even death. However, this is the first time scientists have reported a potentially harmful interaction while taking the painkiller with caffeine, the researchers say.

While the studies are preliminary findings conducted in bacteria and laboratory animals, they suggest that consumers may want to limit caffeine intake — including energy drinks and strong coffee — while taking acetaminophen.

Chemist Sid Nelson, Ph.D., and colleagues, of the University of Washington in Seattle, tested the effects of acetaminophen and caffeine on E. coli bacteria genetically engineered to express a key human enzyme in the liver that detoxifies many prescription and nonprescription drugs. The researchers found that caffeine triples the amount of a toxic byproduct, N-acetyl-p-benzoquinone imine (NAPQI), that the enzyme produces while breaking down acetaminophen. This same toxin is responsible for liver damage and failure in toxic alcohol-acetaminophen interactions, they say.

In previous studies, the same researchers showed that high doses of caffeine can increase the severity of liver damage in rats with acetaminophen-induced liver damage, thus supporting the current finding.

“People should be informed about this potentially harmful interaction,” Nelson says. “The bottom line is that you don’t have to stop taking acetaminophen or stop taking caffeine products, but you do need to monitor your intake more carefully when taking them together, especially if you drink alcohol. ”

Nelson points out that the bacteria used in the study were exposed to ‘megadoses’ of both acetaminophen and caffeine, much higher than most individuals would normally consume on a daily basis. Most people would similarly need to consume unusually high levels of these compounds together to have a dangerous effect, but the toxic threshold has not yet been determined, he says.

Certain groups may be more vulnerable to the potentially toxic interaction than others, Nelson says. This includes people who take certain anti-epileptic medications, including carbamazepine and phenobarbital, and those who take St. John’s Wort, a popular herbal supplement. These products have been shown to boost levels of the enzyme that produces the toxic liver metabolite NAPQI, an effect that will likely be heightened when taking both acetaminophen and caffeine together, he says.

Likewise, people who drink a lot of alcohol may be at increased risk for the toxic interaction, Nelson says. That’s because alcohol can trigger the production of yet another liver enzyme that produces the liver toxin NAPQI. The risks are also higher for those who take large amounts of medications that combine both acetaminophen and caffeine, which are often used together as a remedy for migraine headaches, arthritis and other conditions.

The researchers are currently studying the mechanism by which this toxic interaction occurs and are considering human studies in the future, they say. The National Institutes of Health funded the initial animal and bacterial studies.

— Mark T. Sampson

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202-872-4400

Acetaminophen, Caffeine, and Codeine | Memorial Sloan Kettering Cancer Center

Adult Medication

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Provided by Lexicomp ^® , this document contains all the information you need to know about this medicine, including indications, directions for use, side effects, and when your healthcare provider should be contacted.

Brand names: Canada

Atasol-15 [DSC]; TEVA-Lenoltec No. 1; TEVA-Lenoltec No. 2; TEVA-Lenoltec No 3; Triatec-8 Forte [DSC]; Tylenol #2 [DSC]; Tylenol #3 [DSC]; Wampole-Acetaminophen/Cod/Caff [DSC]

Warning

• This drug is a strong pain reliever that can be habit-forming, abused or misused. Misuse or abuse of this drug can lead to overdose and death. Consult with your doctor.
• You will be closely monitored to avoid misuse, abuse, or dependence on this drug.
• This drug can cause very bad and sometimes deadly breathing problems. Call your doctor right away if breathing is slow, shallow, or difficult.
• The risk of serious and sometimes deadly respiratory problems may be increased when this drug is started or the dose is increased.
• Even one dose of this drug, taken by another person or by mistake, can be deadly, especially in children. If this drug has been taken by another person or by mistake, get medical help right away.
• Keep all medicines in a safe place. Keep all medicines out of the reach of children and pets.
• This medicine contains acetaminophen. During the use of acetaminophen, liver disorders were recorded. In some cases, these disorders have required liver transplantation or have resulted in death. The majority of liver problems occurred in patients taking more than 4,000 milligrams (mg) of acetaminophen per day. Often, patients used not 1, but several drugs containing acetaminophen.
• This drug contains an opioid. Serious side effects have occurred when using opioids with benzodiazepines, alcohol, marijuana, or other forms of cannabis, as well as prescription or over-the-counter drugs that can cause drowsiness or slow action. These effects include slow or labored breathing and death. Benzodiazepines include drugs such as alprazolam, diazepam, and lorazepam. Benzodiazepines can be used to treat many health conditions such as anxiety, sleep disorders, or seizures. If you have any questions, please consult your doctor.
• Many drugs interact with this drug and may increase the risk of side effects such as life-threatening breathing problems. Check with your doctor and pharmacist to make sure it is safe to use this drug with all your other drugs.
• Do not take with alcohol or products containing alcohol. Dangerous, sometimes deadly, effects may develop.
• Seek immediate medical attention if you feel very drowsy, severely dizzy, or if you lose consciousness. Caregivers or others should seek immediate medical attention if the patient does not respond, does not respond, or does not respond in the usual way, or if he sleeps and does not wake up.
• Long-term use of this drug during pregnancy may cause withdrawal symptoms in the newborn. This can be life threatening. Consult your doctor.

What is this drug used for?

• Used to relieve pain.

What should I tell my doctor BEFORE taking this drug?

• If you have an allergy to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergies and how they have manifested.
• If you have any of the following health conditions: Lung or breathing problems such as asthma, shortness of breath, or sleep apnea; high levels of carbon dioxide in the blood; gastrointestinal obstruction or narrowing.
• If you have any of the following health problems: heart disease, kidney disease, or liver disease.
• If you have any of the following health conditions: abdominal pain, appendicitis, or pancreatitis.
• If you have recently drunk large amounts of alcohol or taken a drug that slows your reaction, such as phenobarbital or certain pain medications, such as oxycodone.
• If you have seizures.
• If you currently have alcohol withdrawal.
• If you have a health problem or are taking a drug that causes drowsiness.
• If you have recently suffered a head or brain injury, or if you have recently developed a tumor or increased intracranial pressure.
• If you are giving birth.
• If you have taken medications for depression or Parkinson’s disease in the past 14 days. These include isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. An episode of very high blood pressure may occur.
• If you are taking any of the following drugs: buprenorphine, butorphanol, linezolid, methylene blue, nalbuphine, or pentazocine.
• If your doctor has told you that your body metabolizes certain drugs faster.
• If you are breastfeeding. Do not breastfeed while taking this drug.
• If the patient is a child Do not give this drug to a child.

This list of drugs and conditions that may interact with this drug is not exhaustive.

Tell your doctor and pharmacist about all medicines you take (both prescription and over-the-counter, natural products and vitamins) and any health problems you have. You need to make sure that this drug is safe for your conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s advice.

What do I need to know or do while taking this drug?

• Tell all your health care workers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
• It is not recommended to use other medicines containing acetaminophen. Carefully study the instructions for medicines. Taking acetaminophen in excessive amounts can lead to liver problems.
• Follow the instructions exactly. Do not exceed your daily dose of acetaminophen. If you are not sure what your daily dose of acetaminophen is, ask your doctor or pharmacist for it. Some people may take this drug in doses up to 4,000 milligrams (mg) per day as directed by their doctor. Some patients (eg, those with liver disease and children) require a dose reduction of acetaminophen. If you have exceeded your daily dose of acetaminophen, contact your doctor immediately, even if you do not feel worse.
• Avoid driving and other activities that require increased attention until you see how this drug affects you.
• To reduce the risk of dizziness or loss of consciousness, get up slowly from a lying or sitting position. Walking up and down stairs should be done with care.
• Long-term or regular use of opioid medications like this can lead to addiction. Reducing the dose or stopping this drug suddenly can cause a serious risk of withdrawal reactions or other serious problems. Talk to your doctor before reducing your dose or stopping this drug. You must follow the doctor’s instructions. Tell your doctor if you have severe pain, mood changes, suicidal thoughts, or any other side effects.
• This drug may affect the results of some lab tests. Tell all your health care workers and laboratory staff that you are taking this drug.
• Long-term use of an opioid medicine can lead to a decrease in the level of sex hormones. If you have a decreased interest in sex, fertility problems, no menstruation, or problems with ejaculation, see your doctor.
• This drug may increase the risk of seizures in some people, including people who have had seizures in the past. Talk to your doctor to find out if your risk of seizures is increased with this drug.
• Limit caffeine (such as tea, coffee, and cola) and chocolate. When taken with this drug, it can cause nervousness, tremors, and tachycardia.
• Taking opioids like this can cause a rare but severe adrenal disorder. If you feel very tired or weak, pass out, or have severe dizziness, severe nausea, vomiting, or loss of appetite, call your healthcare provider right away.
• If you are 65 years of age or older, use this drug with caution. You may experience more side effects.
• Children may have a higher risk of very serious side effects. This risk may be more likely in children with respiratory failure. Some children have experienced life-threatening respiratory problems when using codeine. Consult your doctor.
• When used during pregnancy, the drug may have a harmful effect on the fetus. If you are pregnant or become pregnant while taking this drug, call your doctor right away.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, this drug can cause serious and sometimes deadly side effects in some patients. Contact your doctor or seek medical attention right away if you have any of the following signs or symptoms that may be associated with serious side effects:

• Signs of an allergic reaction, such as rash, hives, itching, red and swollen skin with blisters or peeling, possibly accompanied by fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat.
• Signs of liver problems such as dark urine, fatigue, lack of appetite, nausea or abdominal pain, light-colored stools, vomiting, yellowing of the skin or eyes.
• Labored, slow or shallow breathing.
• Noisy breathing.
• Severe dizziness or fainting.
• Seizures.
• Confusion of consciousness.
• Severe constipation or abdominal pain. These may be signs of a severe bowel disorder.
• Difficulty urinating or a change in the amount of urine produced.
• Mood changes.
• Hallucinations (a person sees or hears something that is not in reality).
• Vision change.
• High fever, chills, or sore throat.
• Any unexplained bruising or bleeding.
• Weakness.
• With problems in controlling body movements.
• Feeling of abnormal heartbeat.
• Possible severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis). This can lead to severe health problems, which can be permanent, and sometimes death. Seek immediate medical attention if you experience symptoms such as redness, swelling of the skin with blistering or peeling (with or without fever), redness or irritation of the eyes, and sores in the mouth, throat, nose, or eyes.
• When this drug is taken with certain other drugs, a bad and sometimes deadly condition called serotonin syndrome can develop. Call your doctor right away if you experience agitation, balance problems, confusion, hallucinations, high fever, tachycardia or abnormal heart rhythms, flushing, muscle twitching or stiffness, seizures, tremors or tremors, excessive sweating, severe diarrhea, nausea or vomiting , severe headache.

What are some other side effects of this drug?

Any medicine can have side effects. However, for many people, side effects are either minor or non-existent. Contact your doctor or seek medical attention if these or any other side effects bother you or do not go away:

• Feeling dizzy or sleepy.
• Nausea or vomiting.
• Constipation.
• Pain in the intestines.
• Decreased appetite.
• Dry mouth.
• Excessive sweating.
• Sleep disorders.
• Headache.
• Anxiety.
• Nervous tension and agitation.

This list of possible side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Board.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

• Take with or without food. Take with food if medicine causes nausea.
• Swallow whole. Do not chew, break or dissolve.
• Do not take the drug in higher doses than prescribed by your doctor. Taking more than the prescribed amount of the drug increases the risk of serious side effects.
• Do not take this drug for longer than the length of time your doctor has prescribed.
• If this drug is taken for a long time or at high doses, its effectiveness may be reduced and a higher dose may be needed to achieve the same effect. The so-called tolerance to the drug develops. Talk to your doctor if this drug stops working as you want. Do not take the drug in higher doses than prescribed by your doctor.
• Do not take this drug with other strong pain medications or if you are using a pain patch without talking to your doctor first.

What if I miss a dose of a drug?

• If you are taking the drug regularly, take the missed dose as soon as you can.
• If it’s time for your next dose, don’t take the missed dose and then go back to your regular dosing schedule.
• Do not take 2 doses or an additional dose at the same time.
• In most cases, this drug is used as needed. Do not take the drug more often than prescribed by your doctor.

How do I store and/or discard this drug?

• Store at room temperature, protected from light. Store in a dry place. Do not store in the bathroom.
• The lid must be tightly closed.
• Keep this medicine in a protected place out of sight and reach of children and out of the reach of other people. A box or room that is locked with a key can act as a secure storage place for the drug. Keep all medicines out of the reach of pets.
• Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

General information about medicines

• If your health does not improve or even worsens, see your doctor.
• Do not give your medicine to anyone and do not take other people’s medicines.
• Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
• Some medicines may come with other patient information leaflets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
• If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened.

Consumer Use of Information and Limitation of Liability

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Coffee as a medicine – Latest news from Russia and the world today

Say a word about the benefits of coffee…

For the first time, people paid attention to coffee not because of its taste, but because of its healing qualities. According to legend, this happened in the 9th century, when an Ethiopian shepherd noticed how cheerfully frolicking goats, having tasted the berries of an unknown tree. He followed their example and experienced their amazing tonic properties for himself. Coffee owes its energizing property to the alkaloid caffeine contained in it. Influencing the central and autonomic nervous systems, it stimulates the heart, speeds up metabolism and respiration, reduces fatigue and drowsiness, increases efficiency and mental activity, and relieves headaches. Caffeine also increases muscle tone and improves coordination, increases gastric acid production, and increases sweating. Another advantage of coffee is that it is rich in polyphenols, which have the ability to repair damaged cells. Recently, scientists at the Brazilian Center for Human Reproduction have proven that caffeine improves sperm quality and male fertility. It is not surprising that coffee is under the scrutiny of doctors of various specialties, who still cannot make an unambiguous verdict whether it is good or bad. After all, coffee, like alcohol, in small doses has the properties of a medicine, in large doses it becomes a poison. The optimal dosage is also known: a single dose of caffeine should not exceed 100 mg – this amount is contained in one cup of coffee, and a daily dose – 300 mg. Don’t forget that caffeine is also found in tea (50 mg per cup), as well as energy drinks (about 80 mg per standard can), cola (130 mg per liter), and chocolate. All the taste qualities of natural coffee are retained by the so-called day coffee, which contains only 5 mg of caffeine per cup.

What are the risks of coffee lovers

Neurologists make many complaints about coffee. They argue that avid drinkers who are accustomed to regularly improve their performance with coffee develop addiction and dependence, because the caffeine contained in the drink is a classic psychomotor stimulant. Its effect on the body is similar to the drugs amphetamine and cocaine, although much weaker. As a result of addiction, the coffee lover needs more and more doses of coffee, because without the doping that has become habitual, they feel lethargic and drowsy, irritated over trifles. After some time, such people develop an exhaustion of the nervous system, and the deprivation of coffee causes an abstinence reaction in them, as in the rejection of alcohol. Another danger of coffee, or rather, the caffeine contained in it, is that it removes vitamin B1 (thiamine) necessary for the normal functioning of the heart, nervous and digestive systems from the body. To make up for its deficiency, coffee lovers should lean on beans, peas, spinach and wholemeal bread or take a pharmacy drug, best of all phosphothiamin. Abuse (more than three to four cups a day) of coffee is dangerous for women during menopause. As a diuretic, coffee leaches calcium from the blood, making bones porous and brittle. To avoid having to pay for the love of coffee with osteoporosis, doctors advise drinking coffee with milk.

Gastroenterologists don’t like coffee either. Caffeine increases the secretion of gastric juice and increases intestinal motility, and because of this, food moves through the gastrointestinal tract too quickly, without having time to be completely digested, begins to ferment and rot. To prevent this from happening, coffee can be drunk at least an hour or an hour after a meal.

Cardiologists also have an ambiguous attitude towards coffee. To provide a tonic effect due to coffee, the body has to increase oxygen consumption, and this is a big load on the heart muscle. Those who abuse coffee do not tolerate heat well. Under the influence of caffeine, the breakdown of glycogen increases, which leads to an increase in blood sugar levels. Coffee is also responsible for such a misfortune of modern man as high cholesterol. True, caffeine has nothing to do with it. It’s all about the special substances coffeestrol and coffeeol, which increase cholesterol. But this problem is easily solved. Brew coffee not on the stove, but in an espresso coffee maker, then all harmful substances will remain on the filter. Safe from this point of view and instant coffee.

Prescription coffee

Ever since German pharmacist F. Runge isolated caffeine from coffee in 1820, pharmacists have been using it to make medicines by extracting it from tea and coffee waste.