Drug Dependence

Dihydrocodeine can produce drug dependence of the codeine type and therefore has the potential of being abused. Psychic dependence, physical dependence, and tolerance may develop upon repeated administration of dihydrocodeine, and it should be prescribed and administered with the same degree of caution appropriate to the use of other oral narcotic-containing medications. Like other narcotic-containing medications, dihydrocodeine is subject to the provisions of the Federal Controlled Substances Act.

Usage in Ambulatory Patients

Dihydrocodeine may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks, such as driving a car or operating machinery. The patient using aspirin, caffeine, and dihydrocodeine bitartrate capsule should be cautioned accordingly.

Interactions with other Central Nervous System Depressants

Patients receiving other narcotic analgesics, general anesthetics, tranquilizers, sedative-hypnotics, or other CNS depressants (including alcohol) concomitantly with aspirin, caffeine, and dihydrocodeine bitartrate capsule may exhibit an additive CNS depression. When such combined therapy is contemplated, the dose of one or both agents should be reduced.

Usage in Pregnancy

Reproduction studies have not been performed in animals. There is no adequate information on whether this drug may affect fertility in human males and females or has a teratogenic potential or other adverse effect on the fetus.

Usage in Children

Preparations containing aspirin should be kept out of the reach of children. Aspirin, caffeine, and dihydrocodeine bitartrate capsule is not recommended for patients 12 years of age and under. Since there is no experience in children who have received this drug, safety and efficacy in children have not been established.

Drug Interactions

The CNS-depressant effects of aspirin, caffeine, and dihydrocodeine bitartrate capsule may be additive with that of other CNS depressants. See “WARNINGS.”

Aspirin may enhance the effects of anticoagulants and inhibit the uricosuric effects of uricosuric agents.

Geriatric Use

Clinical studies of aspirin, caffeine, and dihydrocodeine bitartrate capsule did not include sufficient numbers of subjects aged 65 and over to determine whether elderly subjects respond differently from younger subjects.

In general, dose selection for an elderly patient should be cautious, starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.