This combination product contains acetylsalicylic acid (ASA), caffeine, codeine, and meprobamate. Codeine and ASA are pain relievers, while meprobamate is a muscle relaxant. Caffeine is added to enhance the pain-relieving effects of the medication. This medication is used for the treatment of pain associated with muscle tightness.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended adult dose of ASA - caffeine - meprobamate - codeine varies according to need and circumstances but is often 1 or 2 tablets every 4 to 6 hours as required. No more than 4 g of ASA (11 tablets) should be taken in any 24-hour period.

This medication has the potential for being abused and for becoming habit forming and should be taken only as needed for pain unless otherwise directed by your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not take this medication if you:

• are allergic to ASA, caffeine, meprobamate, codeine, or any of the ingredients of the medication
• are allergic or sensitive to other anti-inflammatory drugs or muscle relaxants
• are in the last three months of pregnancy
• are receiving blood thinning drugs such as warfarin
• are 12 years of age or younger
• have a history of blood clotting problems
• have porphyria (a condition of the liver)
• have pre-existing respiratory depression
• have severe anemia
• have stomach ulcers or duodenal ulcers
• children 12 years of age or younger

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• difficult, painful, or decreased urination
• dizziness, lightheadedness, or feeling faint
• drowsiness
• dryness of mouth
• false sense of well-being
• frequent urge to urinate
• general feeling of discomfort or illness
• headache
• heartburn or indigestion
• loss of appetite
• nausea or vomiting
• nervousness or restlessness
• nightmares or unusual dreams
• stomach pain (mild)
• trouble sleeping

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Stop taking the medication and seek immediate medical attention if any of the following occur:

• shortness of breath
• tightness in chest
• troubled breathing
• wheezing

Get emergency help immediately if any of the following symptoms of overdose occur:

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Constipation: This medication can cause constipation or make existing constipation worse. If you have chronic constipation, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Dependence and withdrawal: Physical dependence, psychological dependence, and abuse have occurred with the use of this medication. When excessive dosage has continued for weeks or months, your doctor will likely advise you to reduce the dose gradually over a period of 1 to 2 weeks rather than stopping it suddenly.

Drowsiness/reduced alertness: This medication may reduce the mental or physical abilities required to carry out potentially dangerous tasks such as driving or operating machinery.

Head injury: People with head injuries should be monitored by their doctor while taking this medication, as it may worsen their condition or affect their breathing.

Gout: ASA may cause or worsen attacks of gout.

Kidneys: Excessive and prolonged therapy with this medication may promote kidney disease.

Other medical conditions: If you have any of the following conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed:

• asthma and other allergic conditions
• bleeding tendencies
• certain blood disorders
• heartburn
• reduced kidney or liver function

Surgery: Do not take this medication for 5 to 7 days before any surgery, including dental surgery, unless otherwise directed by your doctor or dentist.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. As well, one ingredient of this medication, codeine, is converted to morphine (a more powerful painkiller) in the body. Some people convert codeine into morphine much faster and more completely than others, resulting in higher levels of morphine in the body and the risk of a morphine overdose for the breast-feeding baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of meprobamate have not been established for use by children under the age of 6 years.

The use of ASA may be associated with the development of Reye's syndrome in children and teenagers who have illnesses accompanied by fever, especially influenza and chickenpox. ASA should not be given to, or used by, children or teenagers who have chickenpox or flu symptoms, unless a doctor is consulted.

ASA is one of the most frequent causes of accidental poisoning in toddlers and infants. Medications that contain ASA should be kept out of the reach of all children.

Seniors: Seniors are more likely to become drowsy as a result of the side effects of this medication.

There may be an interaction between ASA - caffeine - meprobamate - codeine and any of the following:

• acetazolamide
• alcohol
• antidiabetic drugs (e.g., insulin, glyburide)
• carbamazepine
• methotrexate
• naltrexone
• other anti-inflammatory drugs (e.g., ibuprofen, naproxen)
• probenecid
• sedatives/tranquilizers (e.g., diazepam, lorazepam)
• spironolactone
• sulfinpyrazone
• tricyclic antidepressants (e.g., amitriptyline, imipramine, nortriptyline)
• valproic acid
• vancomycin
• warfarin
• zidovudine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.