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This medication contains both ibuprofen and acetaminophen, and while effective for pain relief, carries certain risks and precautions you need to be aware of. Always consult with your healthcare provider to ensure safe usage. Below are important safety considerations:

• Heart Risks: This drug may increase the likelihood of heart attack or stroke, especially with prolonged use or if you have existing heart conditions. This risk is higher among older adults. Avoid this medication before or after heart bypass surgery (CABG). Seek immediate medical attention if you experience chest pain, trouble breathing, or weakness on one side of your body.

• Liver Concerns: Acetaminophen can cause severe liver damage if taken in large amounts. Adults should not exceed 4,000 mg of acetaminophen per day, and those with liver issues or children should take less. Avoid combining with other drugs containing acetaminophen and limit alcohol consumption to prevent liver damage. Watch for symptoms like dark urine, fatigue, or yellowing of the skin and eyes, and contact your provider immediately if they occur.

• Stomach and Intestinal Bleeding: NSAIDs like ibuprofen can cause serious stomach or intestinal bleeding, particularly in older adults or those with a history of bleeding disorders. Symptoms include black stools, vomiting blood, or persistent stomach pain. Seek medical help if these occur.

• Kidney Health: The combination of ibuprofen and acetaminophen may affect kidney function, especially in older adults, those with diabetes, or when using other medications that impact the kidneys. Symptoms of kidney problems include changes in urination, fatigue, and muscle cramps. Consult your healthcare provider if you have these risk factors.

• Blood Pressure and Heart Failure: Ibuprofen can cause fluid retention, increasing blood pressure or leading to heart failure. Inform your provider about any heart conditions or blood pressure medication use beforehand. Look out for symptoms like unexplained fainting or chest pain during physical activity, and contact your provider if they occur.

• Allergic Reactions: Severe allergic reactions are rare but possible. If you have a history of allergies to aspirin or NSAIDs, let your provider know before using this medication. Watch for signs like hives, swelling, or difficulty breathing, and seek immediate medical help if they appear.

• Overdose Risks: Be cautious of accidental overdose, especially when using multiple medications containing acetaminophen or ibuprofen. This can lead to severe consequences such as bleeding, liver, kidney, or heart damage. If overdose is suspected, seek medical help or contact Poison Control immediately.

Contraindications: Do not use this medication if you are taking other drugs containing acetaminophen, ibuprofen, or other NSAIDs, have a history of allergic reactions to these drugs, or following coronary artery bypass graft surgery (CABG). Always check with your healthcare provider to confirm that this medication is safe for you.

When taking this medication, you may experience some common side effects, which are usually mild and temporary. These include dizziness, nausea, upset stomach, headache, diarrhea, constipation, drowsiness, and skin rashes. If these effects persist or worsen, it is important to consult a healthcare provider for guidance.

There are also other side effects that have been reported, such as heartburn, ringing in the ears (tinnitus), gas, vomiting, itching, and loss of appetite. While these effects are less common, they should still be monitored, and any concerns should be discussed with your healthcare provider.

It is crucial to be aware of more serious side effects, although they are rare. These include symptoms of stroke, such as tiredness, lightheadedness, and blurred vision; heart attack signs, like chest pain and trouble breathing; and heart failure symptoms, such as swelling in the body and sudden weight gain. Stomach bleeds, indicated by blood in vomit or black stool, and signs of liver damage, like severe stomach pain and yellowing of the skin or eyes, also require immediate medical attention. Kidney damage can present as changes in urination, nausea, and swelling in the legs. Additionally, severe asthma attacks and serious allergic or skin reactions, including fever, rash, and painful blisters, necessitate urgent care.

While this is a comprehensive list, if you observe any other unusual effects or have concerns, reaching out to a healthcare professional is advised.

Certain medications can interact with this drug, which may affect its efficacy or increase side effects. These include:

• Aliskiren, ACE inhibitors (like Captopril, Lisinopril), and angiotensin II receptor blockers (such as Losartan, Valsartan).
• Cidofovir and corticosteroids (like Prednisone).
• Antifungal drugs like Ketoconazole and levoketoconazole.
• Lithium and Methotrexate.
• Diuretics, commonly known as "water pills," such as Furosemide.

This drug may also heighten bleeding risks if taken with other medications that have similar effects, such as:

• Anti-platelet drugs like Clopidogrel.
• Anticoagulants, often referred to as "blood thinners," such as Dabigatran, Enoxaparin, or Warfarin.

It's important to review all prescription and over-the-counter labels, as many contain pain relievers or fever reducers, including Aspirin or NSAIDs like Celecoxib, Ketorolac, or Naproxen. These can increase side effects when combined with this medication. However, if your doctor has recommended low-dose aspirin (81-162 mg daily) for heart attack or stroke prevention, continue taking it unless advised otherwise. Daily use of this drug might reduce aspirin's protective effect against heart attack or stroke, so discuss alternative pain or fever treatments like Acetaminophen with your doctor. If both drugs are necessary, consult your healthcare provider about using immediate-release aspirin, and take this medication at least 8 hours before or 2 hours after your aspirin dose. Do not modify your aspirin dosage or method of taking it without your doctor's guidance.

Additionally, this drug may interfere with certain lab tests, potentially leading to inaccurate results. Ensure that all healthcare providers and lab personnel are informed about your use of this medication.