DIPHENHYDRAMINE AND IBUPROFEN

(DYE fen HYE dra meen and EYE bue proe fen) Brand: Advil PM, Advil PM Liqui-Gels, Ibuprofen PM, Motrin PM

What is the most significant information I must know about diphenhydramine and ibuprofen?

• You must not use this medicine if you have severe constipation, a blockage in your stomach or intestines, if you are unable to urinate, or if you have ever had a severe allergic reaction caused by taking aspirin.

• Do not use this medication if you have untreated or uncontrolled illness such as glaucoma, asthma or COPD, heart malady, or overactive thyroid.

• Ibuprofen may reason life-threatening heart or circulation problems such as heart onslaught or stroke, especially if you use it long term. Do not use ibuprofen just till or after heart bypass surgery (coronary artery bypass graft, or CABG).

• Get abnormal medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

• Ibuprofen may also reason serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking ibuprofen, especially in older adults.

• Call your doctor at once if you have symptoms of stomach bleeding such as black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

• Do not take more of this medicine than is recommended. An overdose of ibuprofen can reason hurt to your stomach or intestines.

What is diphenhydramine and ibuprofen?

• Diphenhydramine is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can manufacture symptoms of sneezing, itching, watery eyes, and runny nose. Antihistamines can reason drowsiness, which can help in the treatment of casual sleep problems (insomnia).

• Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). Ibuprofen works by reducing hormones that reason inflammation and pain in the body.

• The combination of diphenhydramine and ibuprofen is used to treat casual insomnia associated with minor aches and pains.

• Diphenhydramine and ibuprofen is not for use in treating sleeplessness without pain, or sleep problems that occur often.

• Diphenhydramine and ibuprofen may also be used for purposes not listed in this medicine guide.

What must I discuss with my healthcare provider till taking diphenhydramine and ibuprofen?

• Do not use this medicine just till or after heart bypass surgery (coronary artery bypass graft, or CABG).

• Do not use this medication if you have untreated or uncontrolled illness such as glaucoma, asthma or COPD, tall blood pressure, heart malady, coronary artery malady, or a thyroid disorder.

• Ibuprofen may reason life-threatening heart or circulation problems such as heart onslaught or stroke, especially if you use it long term.

• Ask a doctor or pharmacist if it is safety for you to take diphenhydramine and ibuprofen if you have:

· a history of heart onslaught, stroke, or blood clot;

· heart malady, congestive heart failure, tall blood pressure;

· a history of stomach ulcers or bleeding;

· a colostomy or ileostomy;

· liver or kidney disease;

· enlarged prostate or urination problems;

· asthma;

· cough with mucus, or cough caused by smoking, emphysema, or chronic bronchitis;

· polyps in your nose;

· systemic lupus erythematosus (SLE);

· a bleeding or blood clotting mess; or

· if you take potassium (Cytra, Epiklor, K-Lyte, K-Phos, Kaon, Klor-Con, Polycitra, Urocit-K).

• Taking ibuprofen during the recent 3 months of pregnancy may harm the unborn baby. Do not take diphenhydramine and ibuprofen without medical advice if you are pregnant.

• Diphenhydramine and ibuprofen may pass into breast milk and may harm a nursing child. Antihistamines may also slow breast milk manufacture. Do not use this medication without medical advice if you are breast-feeding a baby.

• Do not give this medicine to a baby younger than 12 years old. Always ask a doctor till giving an antihistamine to a child. Death can occur from the misuse of antihistamines in very young children.

How must I take diphenhydramine and ibuprofen?

• Use exactly as directed on the label, or as predesigned by your doctor. Do not use in larger or less amounts or for longer than recommended. This medication is generally taken only for a short time before your symptoms clear up.

• Do not take more of this medicine than is recommended. An overdose of ibuprofen can reason hurt to your stomach or intestines.

• Do not take for longer than 10 days in a row. Conversation with your doctor if your symptoms do not improve after 10 days of treatment, or if you have any new symptoms.

• Take with food or milk to lessen stomach upset.

• If you need surgery or medical trials, speak the surgeon or doctor onward of time if you have taken this medication within the past little days.

• Store at room temperature away from moisture and heat.

What happens if I miss a dose?

• Since this medication is taken when needed, you may not be on a dosing schedule. If you are taking the medicine regularly, take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222.

• Overdose symptoms may include severe forms of some of the side effects listed in this medicine guide.

What must I avoid while taking diphenhydramine and ibuprofen?

• Avoid taking ibuprofen if you are taking aspirin to prevent stroke or heart onslaught. Ibuprofen can create aspirin smaller effective in protecting your heart and blood vessels. If you should use both medications, take the ibuprofen at least 8 hours till or 30 minutes after you take the aspirin (non-enteric coated form).

• This medicine may reason blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

• Avoid drinking alcohol. It may magnify your risk of stomach bleeding while taking ibuprofen.

• Ask a doctor or pharmacist till using any cool, cough, allergy, or another sleep medication. Antihistamines and NSAIDs are contained in much combination medicines. Taking determined commodity together can reason you to get too many of a determined drug. Check the label to see if a medication contains an antihistamine or ibuprofen (or similar NSAIDs such as aspirin, naproxen, ketoprofen, and others).

What are the possible side effects of diphenhydramine and ibuprofen?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your person, lips, tongue, or throat.

· chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;

· black, bloody, or tarry stools, coughing up blood or vomit that looks like coffee grounds;

· quick or uneven heart course, feeling short of breath;

· mood changes;

· tremor, seizure (convulsions);

· unusual bleeding, unusual weakness; or

· urinating smaller than normal or not at all.

• Smaller serious side effects may include:

· day-time drowsiness, dizziness, "hangover" feeling;

· problems with memory or concentration;

· dry mouth, nose, or throat;

· mild itching or rash;

· upset stomach, mild heartburn, diarrhea, constipation;

· blurred vision;

· feeling nervous or restless; or

· ringing in your ears.

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect diphenhydramine and ibuprofen?

• Ask a doctor or pharmacist till using this medication if you regularly use another medicines that create you sleepy (such as narcotic pain medicine, sedatives, sleeping pills, muscle relaxers, and medication for seizures, depression or anxiety). They can add to sleepiness caused by diphenhydramine.

• Ask a doctor or pharmacist if it is safety for you to take diphenhydramine and ibuprofen if you are also using any of the next drugs:

· atropine (Atreza, Sal-Tropine);

· benztropine (Cogentin);

· diphenhydramine (Benadryl) applied to the skin;

· lithium (Eskalith, Lithobid);

· methotrexate (Rheumatrex, Trexall);

· topiramate (Topamax);

· zonisamide (Zonegran);

· anti-nausea medications such as belladonna (Donnatal), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm Scop);

· aspirin or another NSAIDs such as naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others;

· bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), solifenacin (Vesicare), tolterodine (Detrol), or Urogesic Blue;

· a blood thinner such as warfarin (Coumadin, Jantoven);

· bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);

· a diuretic (water pill);

· heart or blood pressure medication such as benazepril (Lotensin), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others;

· irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro Banthine);

· steroids (prednisone and others); or

· ulcer medication such as glycopyrrolate (Robinul) or mepenzolate (Cantil).

• This list is not complete and another drugs may interact with diphenhydramine and ibuprofen. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about diphenhydramine and ibuprofen.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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