Combogesic IV 300 mg-1,000 mg/100 mL intravenous solution

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Medication name

Generic name:
Ibuprofen/acetaminophen - injection

Pronunciation
(EYE-bue-PROE-fen/a-SEET-a-MIN-oh-fen)

Brand name(s)
Combogesic IV

Warning

Nonsteroidal anti-inflammatory drugs (including ibuprofen) may rarely increase the risk for a heart attack or stroke. This effect can happen at any time while using this drug but is more likely if you use it for a long time. The risk may be greater in older adults or if you have heart disease or increased risk for heart disease (for example, due to smoking, family history of heart disease, or conditions such as high blood pressure or diabetes). Do not use this drug right before or after heart bypass surgery (CABG).

One ingredient in this product is acetaminophen. Using too much acetaminophen may cause serious (possibly fatal) liver disease. Adults should not use more than 4000 milligrams (4 grams) of acetaminophen a day. People with liver problems should use less acetaminophen. Ask your doctor or pharmacist how much acetaminophen is safe to use.

Do not use with any other drug containing acetaminophen without asking your doctor or pharmacist first. Acetaminophen is in many nonprescription and prescription medications (such as pain/fever drugs or cough-and-cold products). Check the labels on all your medicines to see if they contain acetaminophen, and ask your pharmacist if you are unsure.

Get medical help right away if you use too much acetaminophen (overdose), even if you feel well. Overdose symptoms may include nausea, vomiting, loss of appetite, sweating, stomach/abdominal pain, extreme tiredness, yellowing eyes/skin, and dark urine.

Daily alcohol use, especially when combined with this product, may damage your liver. Daily use of alcohol and tobacco may also increase your risk for stomach bleeding. Avoid alcohol and stop smoking.

This drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. This effect can occur without warning at any time while using this drug. Older adults may be at higher risk for this effect.

Stop using this medication and get medical help right away if you notice any of these rare but serious side effects: stomach/abdominal pain that doesn't go away, black/tarry stools, vomit that looks like coffee grounds, chest/jaw/left arm pain, shortness of breath, unusual sweating, confusion, weakness on one side of the body, trouble speaking, sudden vision changes.

Talk to your doctor or pharmacist about the benefits and risks of using this drug.

Uses

This medication contains 2 ingredients: ibuprofen and acetaminophen. It is used to relieve mild to moderate pain. When used with an opioid (such as morphine), it may be used to relieve moderate to severe pain. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). This combination product works by blocking your body's production of certain natural substances that cause inflammation. This effect helps to decrease swelling and pain.

How to use

If you are using this medication at home, learn all preparation and usage instructions from your health care professional.

Before using, check this product for particles or discoloration. If either is present, do not use the liquid.

This medication is given by injection into a vein as directed by your doctor, usually every 6 hours as needed for pain relief. Each dose is usually given over 15 minutes.

Learn how to store and discard medical supplies safely.

The dosage is based on your medical condition, weight, and response to treatment. To reduce your risk of stomach bleeding and other side effects, use the lowest effective dose for the shortest possible time. Do not increase your dose or use it for more than 5 days unless otherwise directed.

If you are using this drug "as needed" (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.

Tell your doctor if your pain lasts or gets worse.

Side effects

See also Warning section.

Pain at the injection site may occur. Upset stomach, nausea, vomiting, headache, diarrhea, constipation, dizziness, or drowsiness may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if you have any serious side effects, including:

  • easy bruising/bleeding
  • hearing changes (such as ringing in the ears)
  • mental/mood changes
  • vision changes
  • unexplained stiff neck
  • signs of kidney problems (such as change in the amount of urine)
  • symptoms of heart failure (such as swelling ankles/feet, unusual tiredness, unusual/sudden weight gain)

This product may rarely cause serious (possibly fatal) liver disease. Get medical help right away if you have any symptoms of liver damage, including:

  • nausea/vomiting that doesn't stop
  • loss of appetite
  • stomach/abdominal pain
  • yellowing eyes/skin
  • dark urine

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • fever
  • swollen lymph nodes
  • rash
  • itching/swelling (especially of the face/tongue/throat)
  • severe dizziness
  • trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

See also Warning section.

Before using this medication, tell your doctor or pharmacist if you are allergic to ibuprofen or acetaminophen; or to aspirin or other NSAIDs (such as naproxen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

  • asthma
  • aspirin-sensitive asthma (a history of worsening breathing with runny/stuffy nose after taking aspirin or other NSAIDs)
  • blood disorders (such as anemia, bleeding/clotting problems)
  • growths in the nose (nasal polyps)
  • heart disease (such as previous heart attack)
  • high blood pressure
  • liver disease
  • regular use/abuse of alcohol
  • stroke
  • stomach/intestinal/esophagus problems (such as bleeding, heartburn, ulcers)

Kidney problems can sometimes occur with the use of NSAID medications, including ibuprofen/acetaminophen. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have any unusual change in the amount of urine.

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be at greater risk for stomach/intestinal bleeding, kidney problems, heart attack, and stroke while using this drug.

Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks. Tell your doctor if you are pregnant or if you plan to become pregnant. This medication may harm an unborn baby and cause problems with normal labor/delivery. It is not recommended for use in pregnancy from 20 weeks until delivery. If your doctor decides that you need to use this medication between 20 and 30 weeks of pregnancy, you should use the lowest effective dose for the shortest possible time. You should not use this medication after 30 weeks of pregnancy.

This medication passes into breast milk, but is unlikely to harm a nursing infant. Consult your doctor before breastfeeding.

Drug interactions

See also Warning section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug are:

  • aliskiren
  • ACE inhibitors (such as captopril, lisinopril)
  • angiotensin II receptor blockers (such as losartan, valsartan)
  • cidofovir
  • corticosteroids (such as prednisone)
  • ketoconazole
  • levoketoconazole
  • lithium
  • methotrexate
  • "water pills" (diuretics such as furosemide)

This medication may increase the risk of bleeding when used with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, among others.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (including aspirin, NSAIDs such as celecoxib, ketorolac, or naproxen). These drugs are similar to ibuprofen and may increase your risk of side effects if used together. However, if your doctor has told you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should keep taking the aspirin unless your doctor tells you not to. Daily use of ibuprofen may decrease aspirin's ability to prevent heart attack/stroke. Talk to your doctor about using a different medication (such as acetaminophen by itself) to treat pain/fever. If you must use this medication, talk to your doctor about taking immediate-release aspirin (not enteric-coated/EC) while using ibuprofen/acetaminophen. Use this medication at least 8 hours before or at least 2 hours after your aspirin dose. Do not increase your daily dose of aspirin or change the way you take aspirin/other medications without your doctor's approval.

This medication may interfere with certain lab tests, possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: severe stomach pain, trouble breathing, extreme drowsiness.

Notes

Do not share this medication with others.

Lab and/or medical tests (such as complete blood count, liver/kidney function, blood pressure) may be done while you are using this medication. Keep all medical and lab appointments.

This medication has been prescribed for your current condition only. Do not use it later for another condition unless your doctor tells you to. A different medication may be necessary in those cases.

Missed dose

Not applicable.

Storage

Store at room temperature away from heat. Do not refrigerate or freeze. Keep the medication in the original carton to protect from light. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Important note

HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Information last revised November 2024.

Selected from NATIONAL DRUG DATA FILE (NDDF) data included with permission and copyrighted by First Databank, Inc., 2019. This copyrighted material has been downloaded from a licensed data provider.

The above information is intended to supplement, not substitute for, the expertise and judgment of your health care professional. You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment.