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CARISOPRODOL-ASPIRIN-CODEINE (CODEINE PHOS/CARISOPRODOL/ASPIRIN)
- Muscle spasm
carisoprodol 200 mg-aspirin 325 mg-codeine 16 mg tablet
- 1 tablet by oral route 4 times per day as needed
carisoprodol 200 mg-aspirin 325 mg-codeine 16 mg tablet
- 1 tablet by oral route 4 times per day as needed
Muscle spasm
- 1 tablet by oral route 4 times per day as needed
- 2 tablets by oral route 4 times per day as needed
- Depade
- ketorolac
- Mifeprex
- mifepristone
- naltrexone
- naltrexone microspheres
- Revia
- Sprix
- Vivitrol
Contraindicated
- Agrylin
- Alimta
- anagrelide
- apixaban
- Brilinta
- Coumadin
- Eliquis
- flu vac,qval 2013-14 (2-49yrs)
- Flumist 2013-2014
- Jantoven
- Methotrexate (anti-rheumatic)
- methotrexate sodium
- methotrexate sodium (PF)
- pemetrexed
- Rheumatrex
- rivaroxaban
- ticagrelor
- Trexall
- varicella virus vacc live (PF)
- Varivax (pf)
- warfarin
- Xarelto
Severe
Moderate
- A-hydrocort
- A-methapred
- Accupril
- Accuretic
- Aceon
- acetazolamide
- acetazolamide sodium
- Altace
- Amaryl
- amlodipine-benazepril
- Anucort-hc
- Anusol-hc
- Aplenzin
- Aristospan Intra-articular
- Aristospan Intralesional
- Arixtra
- benazepril
- benazepril-hydrochlorothiazide
- betamethasone acet & sod phos
- Brintellix
- Brisdelle
- budesonide
- Buprenex
- buprenorphine
- buprenorphine-naloxone
- Buproban
- bupropion HBr
- bupropion HCl
- butorphanol tartrate
- Butrans
- captopril
- captopril-hydrochlorothiazide
- Celestone Soluspan
- Celexa
- citalopram
- colchicine-probenecid
- Colocort
- Cortef
- Cortenema
- Cortifoam
- cortisone
- Cymbalta
- dalteparin (porcine)
- Depacon
- Depakene
- Depakote
- Depakote Er
- Depakote Sprinkles
- Depo-medrol
- desvenlafaxine
- desvenlafaxine fumarate
- desvenlafaxine succinate
- dexamethasone
- Dexamethasone Intensol
- dexamethasone sodium phos (PF)
- dexamethasone sodium phosphate
- Dexpak 10 Day
- Dexpak 13 Day
- Dexpak 6 Day
- dextromethorphan-quinidine
- Diabeta
- Diamox Sequels
- divalproex
- Duetact
- duloxetine
- Effexor Xr
- Elmiron
- enalapril maleate
- enalapril-hydrochlorothiazide
- enalaprilat
- enoxaparin
- Entocort Ec
- Epaned
- escitalopram oxalate
- Ez Use Joint-tunnel-trigger
- Fanatrex
- Fetzima
- First-duke's
- First-mary's Mouthwash
- Flo-pred
- fludrocortisone
- fluoxetine
- fluvoxamine
- fondaparinux
- Forfivo Xl
- fosinopril
- fosinopril-hydrochlorothiazide
- Fragmin
- gabapentin
- gabapentin enacarbil
- glimepiride
- glipizide
- glipizide-metformin
- Glucotrol
- Glucotrol Xl
- Glucovance
- glyburide
- glyburide micronized
- glyburide-metformin
- Glynase
- Gralise
- Gralise 30-day Starter Pack
- Grx Hicort 25
- Hemril-30
- heparin (porcine)
- heparin (porcine) in D5W
- heparin(porcine) in 0.45% NaCl
- heparin, porcine (PF)
- Horizant
- hydrocortisone
- hydrocortisone acetate
- hydrocortisone sod succ (PF)
- hydrocortisone sod succinate
- Kenalog
- Khedezla
- lepirudin
- levomilnacipran
- Lexapro
- lisinopril
- lisinopril-hydrochlorothiazide
- Lotensin
- Lotrel
- Lovenox
- Luvox Cr
- Mavik
- Medrol
- Medrol (pak)
- methazolamide
- methylprednisolone
- methylprednisolone acetate
- methylprednisolone sod suc(PF)
- methylprednisolone sodium succ
- methylprednisolone-bupivacaine
- Millipred
- Millipred Dp
- milnacipran
- moexipril
- moexipril-hydrochlorothiazide
- nalbuphine
- nateglinide
- Neptazane
- Neurontin
- Nuedexta
- nystatin-hydrocortisone-diphen
- nystatin-TCN-HC-diphenhydramin
- olanzapine-fluoxetine
- Orapred
- Orapred Odt
- paroxetine HCl
- paroxetine mesylate
- Paxil
- Paxil Cr
- Pediapred
- pentosan polysulfate sodium
- perindopril erbumine
- Pexeva
- Physicians Ez Use M-pred
- pioglitazone-glimepiride
- prednisolone
- prednisolone acetate
- prednisolone sodium phosphate
- prednisone
- Prednisone Intensol
- Prinivil
- Pristiq
- probenecid
- Proctocort
- Prozac
- Prozac Weekly
- quinapril
- quinapril-hydrochlorothiazide
- quinidine gluconate
- quinidine sulfate
- ramipril
- Rayos
- Rectacort-hc
- Refludan
- Sarafem
- Savella
- sertraline
- Solu-cortef
- Solu-cortef (pf)
- Solu-medrol
- Solu-medrol (pf)
- Starlix
- Stavzor
- Suboxone
- Symbyax
- Tarka
- ticlopidine
- tolazamide
- tolbutamide
- trandolapril
- trandolapril-verapamil
- triamcinolone acetonide
- triamcinolone hexacetonide
- triamcinolone-lidocaine
- Uceris
- Uniretic
- Univasc
- valproate sodium
- valproic acid
- valproic acid (as sodium salt)
- Vaseretic
- Vasotec
- venlafaxine
- Veripred 20
- Viibryd
- vilazodone
- vortioxetine
- Wellbutrin
- Wellbutrin Sr
- Wellbutrin Xl
- Zestoretic
- Zestril
- Zoloft
- Zubsolv
- Zyban
- Acute intermittent porphyria
- Adenoidectomy in pediatric patient
- Aspirin exacerbated respiratory disease
- Gastrointestinal hemorrhage
- Hemolytic anemia from PK and g6PD deficiencies
- Hemophilia
- Lactating mother
- Peptic ulcer
- Pregnancy
- Respiratory depression
- Reye's syndrome
- Sleep apnea
- Tonsillectomy in pediatric patient
- Von willebrand's disease
Contraindicated
- Acute asthma attack
- Acute pancreatitis
- Alcohol intoxication
- Alcoholism
- Asthma
- Chronic obstructive pulmonary disease
- CYp2d6 poor metabolizer
- CYp2d6 ultrarapid metabolizer
- Drug abuse
- Drug dependence
- Erosive gastritis
- Gastrointestinal obstruction
- Gastrointestinal ulcer
- Gout
- History of opioid overdose
- Hypoprothrombinemia
- Intracranial hypertension
- Kidney disease with likely reduction in GFR
- Obstructive sleep apnea syndrome
- Sedation
- Seizure disorder
- Shock
- Systemic mastocytosis
- Thrombocytopenic disorder
- Thrombotic thrombocytopenic purpura
Severe
Moderate
- Adrenal cortical insufficiency
- Alcohol intoxication
- Anemia
- Biliary tract disorder
- Constipation
- Cor pulmonale
- CYp2c19 poor metabolizer
- Debilitation
- Disease of liver
- Hypotension
- Kidney disease with reduction in GFR
- Lower seizure threshold
- Nasal polyp
- Seizure disorder
- Severe hepatic disease
- Untreated hypothyroidism
- Urinary retention
- Vitamin K deficiency
CARISOPRODOL-ASPIRIN-CODEINE (CODEINE PHOS/CARISOPRODOL/ASPIRIN)
- Muscle spasm
- None
- Abdominal pain with cramps
- Constipation
- Dizziness
- Drowsy
- Gastric acid hypersecretory conditions
- Gastrointestinal irritation
- Headache disorder
- Heartburn
- Nausea
- Sedation
- Vomiting
More Frequent
Severe
Less Severe
- Allergic dermatitis
- Atelectasis
- Bronchospastic pulmonary disease
- CNS depression
- Dyspnea
- Orthostatic hypotension
- Pruritus of skin
- Respiratory depression
- Skin rash
- Urticaria
- Wheezing
- Acute confusion
- Anorexia
- Dizziness
- Dysphoric mood
- Gastrointestinal irritation
- General weakness
- Headache disorder
- Hiccups
- Hyperhidrosis
- Hypotension
- Nervousness
- Oliguria
- Palpitations
- Pruritus of skin
- Skin rash
- Syncope
- Urticaria
- Visual changes
- Vomiting
- Xerostomia
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Acute respiratory insufficiency
- Adrenal cortical insufficiency
- Allergic dermatitis
- Anaphylaxis
- Androgen deficiency
- Anemia
- Angioedema
- Blistering skin
- Bradycardia
- Bronchospastic pulmonary disease
- Cardiac arrest
- Circulatory depression
- Drug fever
- Drug-induced hepatitis
- Dyspnea
- Eosinophilia
- Erythema multiforme
- Gastrointestinal hemorrhage
- Gastrointestinal perforation
- Gastrointestinal ulcer
- Hemolytic anemia
- Hemorrhage
- Ileus
- Interstitial nephritis
- Intracranial bleeding
- Leukopenia
- Opioid dependence
- Orthostatic hypotension
- Pancreatitis
- Pancytopenia
- Platelet aggregation inhibition
- Purpura
- Rectal bleeding
- Seizure disorder
- Shock
- Sleep apnea
- Syncope
- Tachycardia
- Thrombocytopenic disorder
- Urticaria
- Wheezing
Less Severe
- Abnormal hepatic function tests
- Agitation
- Anorexia
- Ataxia
- Biliary spasm
- Black tarry stools
- Blurred vision
- Depression
- Diarrhea
- Diplopia
- Drowsy
- Dyspepsia
- Epistaxis
- Erectile dysfunction
- Erythema
- Euphoria
- Fatigue
- Flushing
- Gastritis
- Gastrointestinal irritation
- Gingival bleeding
- Hematoma
- Infertility
- Insomnia
- Irritability
- Libido changes
- Nausea
- Pruritus of skin
- Sedation
- Skin rash
- Symptoms of anxiety
- Tinnitus
- Tremor
- Unsteady gait
- Upper abdominal pain
- Vertigo
- Visual changes
- Vomiting
Contraindicated
Codeine (analgesic)
Increased risk of CNS and respiratory depression. Contraindicated age < 12 years. Respiratory depression and death reported in CYP2D6 ultra-rapid metabolizers post tonsillectomy or adenoidectomy. Risk increases with obesity, asthma, obstructive sleep apnea or other underlying lung or breathing problem. With any opioid, access to naloxone for emergency reversal can mitigate risk from accidental ingestion/overdose.
- 1 Day – 12 Years
- 1 Increased risk of CNS and respiratory depression. Contraindicated age < 12 years. Respiratory depression and death reported in CYP2D6 ultra-rapid metabolizers post tonsillectomy or adenoidectomy. Risk increases with obesity, asthma, obstructive sleep apnea or other underlying lung or breathing problem. With any opioid, access to naloxone for emergency reversal can mitigate risk from accidental ingestion/overdose.
Severe Precaution
Aspirin
Reye syndrome risk with viral illness, fever, and/or flu symptoms.
Risk of life-threatening respiratory depression, death. Contraindicated post-tonsillectomy and post-adenoidectomy. Avoid in patients with obesity, obstructive sleep apnea, asthma or other underlying breathing problems. Avoid in CYP2D6 ultra-rapid metabolizers. Analgesic use not recommended without prior CYP2D6 testing. Not recommended for cough because benefit does not outweigh risk. With any opioid, access to naloxone for emergency reversal can mitigate risk from accidental ingestion/overdose.
- 1 Day – 16 Years
- Reye syndrome risk with viral illness, fever, and/or flu symptoms.
- 12 Years – 18 Years
- Reye syndrome risk with viral illness, fever, and/or flu symptoms.
Codeine (analgesic)
Reye syndrome risk with viral illness, fever, and/or flu symptoms.
Risk of life-threatening respiratory depression, death. Contraindicated post-tonsillectomy and post-adenoidectomy. Avoid in patients with obesity, obstructive sleep apnea, asthma or other underlying breathing problems. Avoid in CYP2D6 ultra-rapid metabolizers. Analgesic use not recommended without prior CYP2D6 testing. Not recommended for cough because benefit does not outweigh risk. With any opioid, access to naloxone for emergency reversal can mitigate risk from accidental ingestion/overdose.
- 1 Day – 16 Years
- Risk of life-threatening respiratory depression, death. Contraindicated post-tonsillectomy and post-adenoidectomy. Avoid in patients with obesity, obstructive sleep apnea, asthma or other underlying breathing problems. Avoid in CYP2D6 ultra-rapid metabolizers. Analgesic use not recommended without prior CYP2D6 testing. Not recommended for cough because benefit does not outweigh risk. With any opioid, access to naloxone for emergency reversal can mitigate risk from accidental ingestion/overdose.
- 12 Years – 18 Years
- Risk of life-threatening respiratory depression, death. Contraindicated post-tonsillectomy and post-adenoidectomy. Avoid in patients with obesity, obstructive sleep apnea, asthma or other underlying breathing problems. Avoid in CYP2D6 ultra-rapid metabolizers. Analgesic use not recommended without prior CYP2D6 testing. Not recommended for cough because benefit does not outweigh risk. With any opioid, access to naloxone for emergency reversal can mitigate risk from accidental ingestion/overdose.
Management or Monitoring Precaution
Carisoprodol
Safety and efficacy not established in children less than 16 years.
- 1 Day – 16 Years
- Safety and efficacy not established in children less than 16 years.
Aspirin (>150Mg)
- Severity Level:
1
- Additional Notes: No fda category; not recommended especially in 3rd trimester or near term
Carisoprodol
- Severity Level:
2
- Additional Notes: Insufficient human data available.
Codeine
- Severity Level:
C
- Additional Notes: Neonatal withdrawal/resp.depress. w/chronic or high dose; small teratogenic risk
Contraindicated
Aspirin (>150Mg)
One report of metabolic acidosis; risk of reye's synd in viral illness.
Cns/respiratory depression,apnea possible;Caution w/ fast cyp2D6 metabolizer
| General | Excretion Potential | Effect on Infant | Notes |
| Drug should not be given to breast feeding mothers | Excreted | Drug shown to have adverse effect | One report of metabolic acidosis; risk of reye's synd in viral illness. |
Codeine
One report of metabolic acidosis; risk of reye's synd in viral illness.
Cns/respiratory depression,apnea possible;Caution w/ fast cyp2D6 metabolizer
| General | Excretion Potential | Effect on Infant | Notes |
| Drug should not be given to breast feeding mothers | Excreted | Drug shown to have adverse effect | Cns/respiratory depression,apnea possible;Caution w/ fast cyp2D6 metabolizer |
Precaution Exists
Carisoprodol
Limited data suggest infant sedation may be greater with exposure
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Excreted | Not known; no or inclusive data | Limited data suggest infant sedation may be greater with exposure |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Carisoprodol
Neuro/Psych-Generally not recommended due to risks for confusion, cognitive impairment and sedation leading to increased falls.
General-Consider adding naloxone Rx. Pulmonary-Life threatening respiratory depression risk with high doses, cachexia, or debilitation due to altered pharmacokinetics (poor fat stores, muscle wasting, or altered clearance). Monitor closely at initiation and dose titration. Neuro/Psych-Risk for increased confusion and delirium. May increase fall risk. Avoid treatment with 3 or more CNS active drugs. Gastrointestinal-Constipation risk. Urogenital-Urinary retention risk.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | Y | Y | N | Y | N | N |
BEERS: Y HEDIS: Y STOPP: N
Codeine
Neuro/Psych-Generally not recommended due to risks for confusion, cognitive impairment and sedation leading to increased falls.
General-Consider adding naloxone Rx. Pulmonary-Life threatening respiratory depression risk with high doses, cachexia, or debilitation due to altered pharmacokinetics (poor fat stores, muscle wasting, or altered clearance). Monitor closely at initiation and dose titration. Neuro/Psych-Risk for increased confusion and delirium. May increase fall risk. Avoid treatment with 3 or more CNS active drugs. Gastrointestinal-Constipation risk. Urogenital-Urinary retention risk.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | Y | Y | Y | Y | N |
BEERS: Y HEDIS: N STOPP: Y
No Known Risk
None
- Codeine has a risk for abuse and addiction, which can lead to overdose and death. Codeine may also cause severe, possibly fatal, breathing problems. To lower your risk, your doctor should have you take the smallest dose of codeine that works, and take it for the shortest possible time.<br /><br />See also How to Use section for more information about addiction. The risk for severe breathing problems is higher when you start this medication and after a dose increase, or if you take the wrong dose/strength. Taking this medication with alcohol or other drugs that can cause drowsiness or breathing problems may cause very serious side effects, including death.<br /><br />Also, other medications can affect the removal of codeine from your body, which may affect how codeine works. Be sure you know how to take this medication and what other drugs you should avoid taking with it. See also Drug Interactions section.<br /><br />Get medical help right away if any of these very serious side effects occur: slow/shallow breathing, unusual lightheadedness, severe drowsiness/dizziness, difficulty waking up. Keep this medicine in a safe place to prevent theft, misuse, or abuse. If someone accidentally swallows this medication, get medical help right away.<br /><br /> Children younger than 12 years should not use products that contain codeine. Children between 12 and 18 years old should not use codeine after certain surgeries (including tonsil/adenoid removal). Also, codeine use is not recommended for children between 12 and 18 years old who are obese or have breathing problems.<br /><br />Some children are more sensitive to codeine and have had very serious (rarely fatal) breathing problems such as slow/shallow breathing (see also Side Effects section). Talk with your doctor or pharmacist about the risks and benefits of this medication.
| Muscle spasm | |
| M62.83 | Muscle spasm |
| M62.830 | Muscle spasm of back |
| M62.831 | Muscle spasm of calf |
| M62.838 | Other muscle spasm |
| R25.2 | Cramp and spasm |
| 0-9 | A-Z |
|---|---|
| M62.83 | Muscle spasm |
| M62.830 | Muscle spasm of back |
| M62.831 | Muscle spasm of calf |
| M62.838 | Other muscle spasm |
| R25.2 | Cramp and spasm |
Formulary Reference Tool