Analgesic combinations

What are Analgesic combinations?

Analgesic combinations contain at least one analgesic in combination with another medicine or medicines. An analgesic is the name given to a medicine that relieves pain without putting you to sleep or making you lose consciousness. Analgesics may also be known as painkillers or pain relievers.

If an analgesic combination product contains two analgesics, these generally have different ways of working to relieve pain.

Analgesic combination products tend to either have acetaminophen, an NSAID (such as ibuprofen or naproxen), or an opioid (such as codeine) as one of their ingredients.

What are analgesic combinations used for?

Analgesic combinations may be taken to relieve pain that arises from a wide range of conditions, such as:

appendicitis
cancer
congenital conditions such as curvature of the spine
fibromyalgia
gallbladder disease
gastrointestinal disorders
headaches
heart disease
improper lifting techniques or poor posture
infection
menstruation
migraines
multiple sclerosis
nerve damage
osteoarthritis
pain syndromes
poor posture
rheumatoid arthritis
sprains
strains
surgery
trauma
toothache
wound cleansing and debridement.

It is important to note that not all analgesic combinations are appropriate for all these conditions.

What are the differences between the different analgesic combinations?

Analgesic combinations differ in the ingredients they contain which means there are vast differences in the way they work, their potency, (how strong they are), and in the way they are absorbed, distributed, metabolized, and excreted within the body.

Some analgesic combinations contain NSAIDs, whereas others contain opioids (narcotics). Other ingredients may include caffeine, which enhances the pain-relieving effect of an analgesic, and diphenhydramine, which is used for its sleep-inducing properties.

Analgesic combinations that contain opioids should only be used if other analgesics or analgesic combinations have proved ineffective as they are potentially addictive.

Common Analgesic combinations available in the U.S.

Generic name	Brand name examples
acetaminophen + aspirin	Generic
acetaminophen + aspirin + caffeine	Arthriten, Excedrin, Goody's Extra-Strength
acetaminophen + butalbital	Allzital, Bupap
acetaminophen + butalbital + caffeine	Capacet, Fioricet
acetaminophen + caffeine	Excedrin Quick Tab, Excedrin Tension Headache
acetaminophen +caffeine + isometheptene mucate	Discontinued
Acetaminophen + caffeine + magnesium salicylate	Generic
Acetaminophen + diphenhydramine	Midol PM
acetaminophen + phenyltoloxamine CR	Discontinued
aspirin + butalbital + caffeine	Fiorinal
codeine + acetaminophen	Generic
codeine + acetaminophen + butalbital + caffeine	Fioricet with codeine
codeine + aspirin + butalbital + caffeine	Ascomp with codeine, Fiorinal with codeine
dihydrocodeine + acetaminophen + caffeine	Trezix
hydrocodone + acetaminophen	Generic
hydrocodone + ibuprofen	Generic
ibuprofen + diphenhydramine	Advil PM
naproxen + diphenhydramine	Aleve PM, Excedrin PM, Tylenol PM
oxycodone + acetaminophen	Nalocet, Primlev
tramadol + acetaminophen	Ultracet

Are analgesic combinations safe?

Most analgesic combinations are considered safe when taken for short periods of time and exactly as directed on the packaging or by a doctor. Some analgesic combinations, such as those containing acetaminophen or ibuprofen, may be considered safer than others.

Narcotic analgesic combinations have been associated with some serious risks such as respiratory depression (unusually slow and shallow breathing), opioid-use disorder, and potentially fatal overdose. They are potentially addictive and should only be used for certain conditions and under strict monitoring.

What are the side effects of analgesic combinations?

All medicines have side effects but how vulnerable a person is to them depends on several different factors such as age, genetics, kidney function and gender (see Managing Common Drug Side Effects)

Narcotic analgesic combinations have many side effects, although people with cancer or a terminal illness taking narcotic analgesic combinations for long periods of time may become tolerant to some of these side effects.

Drowsiness, sleepiness, or dizziness are common with most narcotic analgesic combinations. These side effects may affect driving or a person's ability to operate machinery and perform other hazardous tasks. Alcohol may potentiate these effects

Combination analgesics containing NSAIDs may also cause side effects, especially when used at higher than recommended dosages for long periods of time. Gastrointestinal side effects that may occur include bloating, diarrhea, constipation, irritation of the lining of the stomach, nausea or vomiting. Combination products containing NSAIDs may also affect kidney function and reduce how quickly blood flows through the kidneys. They may cause retention of sodium and water which can lead to edema and high potassium levels. Occasionally, they may cause more serious damage to the kidneys. NSAIDs have also been associated with a higher risk of cardiovascular disease.

Combination products that contain agents that enhance sleep such as diphenhydramine may also cause drowsiness and affect a person’s ability to drive, operate machinery, or perform other hazardous tasks.

Please refer to each combination product for a full list of side effects.

List drug with Analgesic combinations

Drug Name
Acetaminophen and butalbital Generic name: Acetaminophen And Butalbital
Acetaminophen and caffeine Generic name: Acetaminophen And Caffeine
Acetaminophen and diphenhydramine Generic name: Acetaminophen And Diphenhydramine
Acetaminophen and ibuprofen Generic name: Acetaminophen And Ibuprofen
Acetaminophen and phenyltoloxamine Generic name: Acetaminophen And Phenyltoloxamine
Acetaminophen, aspirin, and caffeine Generic name: Acetaminophen, Aspirin, And Caffeine
Acetaminophen, butalbital, and caffeine Generic name: Acetaminophen, Butalbital, And Caffeine
Acetaminophen, caffeine, and magnesium salicylate Generic name: Acetaminophen, Caffeine, And Magnesium Salicylate
Acetaminophen, magnesium salicylate, and pamabrom Generic name: Acetaminophen, Magnesium Salicylate, And Pamabrom
Acetaminophen, pamabrom, and pyrilamine Generic name: Acetaminophen, Pamabrom, And Pyrilamine
Acuflex Generic name: Acetaminophen And Phenyltoloxamine
Advil Dual Action With Acetaminophen Generic name: Acetaminophen And Ibuprofen
Advil PM Generic name: Diphenhydramine And Ibuprofen
Advil PM Liqui-Gels Generic name: Diphenhydramine And Ibuprofen
Aleve PM Generic name: Diphenhydramine And Naproxen
Alka-Seltzer Morning Relief Generic name: Aspirin And Caffeine
Allzital Generic name: Acetaminophen And Butalbital
Anacin Generic name: Aspirin And Caffeine
Anacin Advanced Headache Formula Generic name: Acetaminophen, Aspirin, And Caffeine
Anacin Extra Strength Generic name: Aspirin And Caffeine
Anolor 300 Generic name: Butalbital, Acetaminophen, And Caffeine
Arthriten Generic name: Acetaminophen, Aspirin, And Caffeine
Aspirin and caffeine Generic name: Aspirin And Caffeine
Aspirin, butalbital, and caffeine Generic name: Aspirin, Butalbital, And Caffeine
Combogesic Generic name: Acetaminophen And Ibuprofen
Combogesic (Acetaminophen/ibuprofen Oral) Generic name: Acetaminophen/ibuprofen
Combogesic (Ibuprofen and acetaminophen Oral) Generic name: Ibuprofen And Acetaminophen
Cope Generic name: Aspirin And Caffeine
Backaid IPF Generic name: Acetaminophen, Aspirin, And Caffeine
Bayer Back and Body Generic name: Aspirin And Caffeine
BC Generic name: Aspirin And Caffeine
BC Arthritis Generic name: Aspirin And Caffeine
Bupap Generic name: Acetaminophen And Butalbital
Bupivacaine and meloxicam Generic name: Bupivacaine And Meloxicam
Butalbital and acetaminophen Generic name: Butalbital And Acetaminophen
Butalbital, acetaminophen, and caffeine Generic name: Butalbital, Acetaminophen, And Caffeine
Butalbital, aspirin, and caffeine Generic name: Butalbital, Aspirin, And Caffeine
Cephadyn Generic name: Butalbital And Acetaminophen
Diphenhydramine and ibuprofen Generic name: Diphenhydramine And Ibuprofen
Diphenhydramine and magnesium salicylate Generic name: Diphenhydramine And Magnesium Salicylate
Diphenhydramine and naproxen Generic name: Diphenhydramine And Naproxen
Doans PM Generic name: Diphenhydramine And Magnesium Salicylate
Dolgic LQ Generic name: Butalbital, Acetaminophen, And Caffeine
Dologesic Generic name: Acetaminophen And Phenyltoloxamine
Dologesic DF Generic name: Acetaminophen And Phenyltoloxamine
Esgic Generic name: Acetaminophen, Butalbital, And Caffeine
Esgic-Plus Generic name: Butalbital, Acetaminophen, And Caffeine
Excedrin Generic name: Acetaminophen, Aspirin, And Caffeine
Excedrin Migraine Generic name: Acetaminophen, Aspirin, And Caffeine
Excedrin Quick Tab Peppermint Generic name: Acetaminophen And Caffeine
Excedrin Quick Tab Spearmint Generic name: Acetaminophen And Caffeine
Excedrin Tension Headache Generic name: Acetaminophen And Caffeine
Excedrin Tension Headache Caplet Generic name: Acetaminophen And Caffeine
Excedrin Tension Headache Express Gels Generic name: Acetaminophen And Caffeine
Excedrin Tension Headache Geltab Generic name: Acetaminophen And Caffeine
Ezol Generic name: Butalbital, Acetaminophen, And Caffeine
Fioricet Generic name: Acetaminophen, Butalbital, And Caffeine
Fiorinal Generic name: Aspirin, Butalbital, And Caffeine
Flextra Generic name: Acetaminophen, Caffeine, And Phenyltoloxamine
Fortabs Generic name: Butalbital, Aspirin, And Caffeine
Genace Generic name: Acetaminophen, Aspirin, And Caffeine
Geone Generic name: Butalbital, Acetaminophen, And Caffeine
Goody's Headache Powders Generic name: Acetaminophen, Aspirin, And Caffeine
Goodys Extra Strength Generic name: Acetaminophen, Aspirin, And Caffeine
Headache Relief PM Generic name: Acetaminophen And Diphenhydramine
Ibuprofen and acetaminophen Generic name: Ibuprofen And Acetaminophen
Ibuprofen PM Generic name: Diphenhydramine And Ibuprofen
Laniroif Generic name: Butalbital, Aspirin, And Caffeine
Legatrin PM Generic name: Acetaminophen And Diphenhydramine
Margesic Generic name: Butalbital, Acetaminophen, And Caffeine
Medigesic Generic name: Butalbital, Acetaminophen, And Caffeine
Midol PM Generic name: Acetaminophen And Diphenhydramine
Midol PMS Maximum Strength Generic name: Acetaminophen, Pamabrom, And Pyrilamine
MigraTen Generic name: Acetaminophen, Caffeine, And Isometheptene
Motrin PM Generic name: Diphenhydramine And Ibuprofen
Nonbac Generic name: Butalbital, Acetaminophen, And Caffeine
Orbivan CF Generic name: Butalbital And Acetaminophen
P-A-C Analgesic Generic name: Aspirin And Caffeine
Pacaps Generic name: Butalbital, Acetaminophen, And Caffeine
Pain Reliever Plus Generic name: Acetaminophen, Aspirin, And Caffeine
Pamprin Cramp Formula Generic name: Acetaminophen, Magnesium Salicylate, And Pamabrom
Pamprin Multi-Symptom Generic name: Acetaminophen, Pamabrom, And Pyrilamine
Percogesic Extra Strength Generic name: Acetaminophen And Diphenhydramine
Percogesic Original Strength Generic name: Acetaminophen And Diphenhydramine
Phrenilin Generic name: Butalbital And Acetaminophen
Phrenilin Forte Generic name: Butalbital And Acetaminophen
Premesyn PMS Generic name: Acetaminophen, Pamabrom, And Pyrilamine
Repan Generic name: Butalbital, Acetaminophen, And Caffeine
Stanback Generic name: Aspirin And Caffeine
Tylenol PM Generic name: Acetaminophen And Diphenhydramine
Zebutal Generic name: Acetaminophen, Butalbital, And Caffeine
Zynrelef Generic name: Bupivacaine And Meloxicam

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