Orphenadrine and Aspirin (Systemic)

Brand name(s): Norgesic

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For orphenadrine and aspirin combination, the following should be considered:

Allergies-Tell your doctor if you have ever had any unusual or allergic reaction to orphenadrine, caffeine, aspirin or other salicylates including methyl salicylate (oil of wintergreen), or to any of the following medicines:

• Diclofenac (e.g., Voltaren)
• Diflunisal (e.g., Dolobid)
• Etodolac (e.g., Lodine)
• Fenoprofen (e.g., Nalfon)
• Floctafenine (e.g., Idarac)
• Flurbiprofen, oral (e.g., Ansaid)
• Ibuprofen (e.g., Motrin)
• Indomethacin (e.g., Indocin)
• Ketoprofen (e.g., Orudis)
• Ketorolac (e.g., Toradol)
• Meclofenamate (e.g., Meclomen)
• Mefenamic acid (e.g., Ponstel)
• Nabumetone (e.g., Relafen)
• Naproxen (e.g., Naprosyn)
• Oxaprozin (e.g., Daypro)
• Oxyphenbutazone (e.g., Tandearil)
• Phenylbutazone (e.g., Butazolidin)
• Piroxicam (e.g., Feldene)
• Sulindac (e.g., Clinoril)
• Suprofen (e.g., Suprol)
• Tenoxicam (e.g., Mobiflex)
• Tiaprofenic acid (e.g., Surgam)
• Tolmetin (e.g., Tolectin)
• Zomepirac (e.g., Zomax)

Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy-

• For aspirin: Studies in humans have not shown that aspirin causes birth defects. However, aspirin has caused birth defects in animal studies.Some reports have suggested that too much use of aspirin late in pregnancy may cause a decrease in the newborn's weight and possible death of the fetus or newborn baby. However, the mothers in these reports had been taking much larger amounts of aspirin than are usually recommended. Studies of mothers taking aspirin in the doses that are usually recommended did not show these unwanted effects.Regular use of aspirin late in pregnancy may cause unwanted effects on the heart or blood flow in the fetus or in the newborn baby. Also, use of aspirin during the last 2 weeks of pregnancy may cause bleeding problems in the fetus before or during delivery or in the newborn baby. In addition, too much use of aspirin during the last 3 months of pregnancy may increase the length of pregnancy, prolong labor, cause other problems during delivery, or cause severe bleeding in the mother before, during, or after delivery. Do not take aspirin during the last 3 months of pregnancy unless it has been ordered by your doctor.
• For orphenadrine: Orphenadrine has not been reported to cause birth defects or other problems in humans.

Breast-feeding-This medicine has not been shown to cause problems in nursing babies. However, aspirin passes into the breast milk. Also, caffeine passes into the breast milk in small amounts. It is not known whether orphenadrine passes into the breast milk.

Children-Do not give a medicine containing aspirin to a child or a teenager with a fever or other symptoms of a virus infection, especially flu or chickenpox, without first discussing its use with your child's doctor. This is very important because aspirin may cause a serious illness called Reye's syndrome in children with fever caused by a virus infection, especially flu or chickenpox. Children who do not have a virus infection may also be more sensitive to the effects of aspirin, especially if they have a fever or have lost large amounts of body fluid because of vomiting, diarrhea, or sweating. This may increase the chance of side effects during treatment.

There is no specific information about the use of orphenadrine in children.

Older adults-Elderly people are especially sensitive to the effects of aspirin. This may increase the chance of side effects during treatment.

There is no specific information about the use of orphenadrine in the elderly.

Other medicines-Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking orphenadrine and aspirin combination, it is especially important that your health care professional know if you are taking any of the following:

• Anticoagulants (blood thinners) or
• Carbenicillin by injection (e.g., Geopen) or
• Cefamandole (e.g., Mandol) or
• Cefoperazone (e.g., Cefobid) or
• Cefotetan (e.g., Cefotan) or
• Dipyridamole (e.g., Persantine) or
• Divalproex (e.g., Depakote) or
• Heparin or
• Medicine for inflammation or pain, except narcotics, or
• Moxalactam (e.g., Moxam) or
• Pentoxifylline (e.g., Trental) or
• Plicamycin (e.g., Mithracin) or
• Ticarcillin (e.g., Ticar) or
• Valproic acid (e.g., Depakene)-Taking these medicines together with aspirin may increase the chance of bleeding

• Anticholinergics (medicine for abdominal or stomach spasms or cramps) or
• Central nervous system (CNS) depressants or
• Methotrexate (e.g., Mexate) or
• Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) or
• Vancomycin (e.g., Vancocin)-The chance of side effects may be increased

• Antidiabetics, oral (diabetes medicine you take by mouth)-Aspirin may increase the effects of the antidiabetic medicine; a change in dose may be needed if aspirin is taken regularly

• Probenecid (e.g., Benemid) or
• Sulfinpyrazone (e.g., Anturane)-Aspirin can keep these medicines from working properly for treating gout; also, taking aspirin together with sulfinpyrazone may increase the chance of bleeding

• Urinary alkalizers (medicine that makes the urine less acid, such as acetazolamide [e.g., Diamox], dichlorphenamide [e.g., Daranide], methazolamide [e.g., Neptazane], potassium or sodium citrate and/or citric acid)-These medicines may make aspirin less effective by causing it to be removed from the body more quickly

• Zidovudine (e.g., AZT; Retrovir)-Aspirin may increase the blood levels of zidovudine, which increases the chance of serious side effects

Other medical problems-The presence of other medical problems may affect the use of orphenadrine and aspirin combination. Make sure you tell your doctor if you have any other medical problems, especially:

• Anemia or
• Overactive thyroid or
• Stomach ulcer or other stomach problems-Aspirin may make your condition worse

• Asthma, allergies, and nasal polyps, history of or
• Glucose-6-phosphate dehydrogenase (G6PD) deficiency or
• Kidney disease or
• Liver disease-The chance of side effects may be increased

• Disease of the digestive tract, especially esophagus disease or intestinal blockage, or
• Enlarged prostate or
• Fast or irregular heartbeat or
• Glaucoma or
• Myasthenia gravis or
• Urinary tract blockage-Orphenadrine has side effects that may be harmful to people with these conditions

• Gout-Aspirin can make this condition worse and can also lessen the effects of some medicines used to treat gout

• Heart disease-The chance of some side effects may be increased. Also, the caffeine present in this combination medicine can make your condition worse

• Hemophilia or other bleeding problems or
• Vitamin K deficiency-Aspirin may increase the chance of bleeding

Last Revised: 08/11/1994