Acetaminophen/Aspirin/Caffeine, Oral

What are other names for this medicine?

Type of medicine: analgesic (painkiller)

Generic and brand names: acetaminophen/caffeine/aspirin, oral; Excedrin Extra Strength; Excedrin Migraine; Genaced Extra Strength; Goody's Extra Strength; Genaced Extra Strength

What is this medicine used for?

This medicine is taken by mouth to relieve pain and reduce fever.

What should my healthcare provider know before I take this medicine?

Tell your healthcare provider or pharmacist if you are taking any other medicines, including any nonprescription products, to avoid the risk of taking an overdose.

Many prescription and nonprescription medicines for pain, headache, and sinus congestion contain acetaminophen. Read the labels of nonprescription products to find out which may contain acetaminophen. If you cannot tell if you are taking more than the recommended dosage per day, ask your healthcare provider and pharmacist to review all of your medicines.

Tell your healthcare provider if you have ever had an allergic reaction to any medicine. Check with your healthcare provider before taking this medicine if you have:

• asthma
• bleeding problems
• diabetes
• gout
• high blood pressure
• stomach problems such as heartburn, stomach pain or ulcers
• liver or kidney disease.

Females of childbearing age: Tell your healthcare provider if you are pregnant, plan to become pregnant, or are breast-feeding.

Aspirin should not be used during the last 3 months of pregnancy unless your healthcare provider approves because it may cause problems in the unborn baby or complications during delivery.

How should I use it?

Take this medicine exactly as your healthcare provider prescribes. Do not take more of it or take it longer than directed. Taking too much may cause liver damage. If you purchased this medicine without a prescription, follow the directions on the package. Read all of the precautions and warnings printed on the package.

Take the medicine with a full glass of water.

What should I watch out for?

Taking more than the recommended dose of acetaminophen in any 24 hour period may cause liver damage. The maximum adult dosage per day is usually 4000 mg.

Aspirin can cause Reye's syndrome in children and teens with viral infections such as the flu or chickenpox. Ask your healthcare provider before giving this medicine to children with flu symptoms.

Contact your healthcare provider if you take this medicine for fever and it gets worse or does not improve in 3 days. If you take this medicine for pain and it does not improve in 10 days, contact your healthcare provider.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

If you think you have taken an overdose, get medical help right away. Some signs of overdose are ringing in the ears, heavy sweating, diarrhea, nausea, vomiting, and stomach pain.

Alcohol may increase the chance of liver damage by this medicine. Do not drink alcohol while taking this medicine. Ask your healthcare provider about this.

This medicine contains caffeine. The recommended dose of this medicine contains about as much caffeine as a cup of coffee. Limit the use of other medicines, foods, or drinks that contain caffeine while taking this product. Too much caffeine may cause nervousness, irritability, sleeplessness, and a fast heartbeat.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Yellowish eyes or skin, rash, hives, itching, bloody or cloudy urine, trouble urinating, fainting, weakness, sore throat, fever, unusual bleeding or bruising, dark urine, light-colored bowel movements, severe stomach pain, ringing in the ears or hearing loses, severe nausea or vomiting.

Other: Heartburn, nervousness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antacids (take this medicine 2 hours before or 2 hours after you take an antacid)
• blood thinners such as warfarin (Coumadin) heparin, enoxaparin (Lovenox), ticlopidine (Ticlid), clopidogrel (Plavix), dipyridamole (Persantine), pentoxifylline (Trental) and dalteparin (Fragmin)
• cholestyramine (Questran) (Take this medicine 1 hour after or 4 hours before taking other medicines.)
• diabetes medicines such as insulin, glipizide (Glucotrol), glyburide (DiaBeta, Micronase, Glynase), metformin (Glucophage), acarbose (Precose), repaglinide (Prandin), rosiglitazone (Avandia), and pioglitazone (Actos)
• herbal remedies such as cat's claw, dong quai, evening primrose, feverfew, garlic, ginger, ginkgo, red clover, horse chestnut, green tea, and ginseng
• methotrexate (Folex)
• NSAIDS such as ibuprofen (Motrin, Motrin IB, Advil, Nuprin), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), ketoprofen (Orudis, Orudis KT, Oruvail), nabumetone (Relafen), indomethacin (Indocin), ketorolac (Toradol), sulindac (Clinoril), piroxicam (Feldene), diclofenac (Voltaren, Cataflam), and oxaprozin (Daypro)
• other medicines that contain salicylates such as Alka Seltzer and Pepto Bismol
• probenecid (Benemid)
• stimulants such as dextroamphetamine (Dexedrine), amphetamine/dextroamphetamine (Adderall), methylphenidate (Ritalin), caffeine (coffee, cola, tea), diet pills, and some cough and cold medicines such as pseudoephedrine (Sudafed, Neo-Synephrine)
• valproic acid (Depakote).

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.