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.

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.

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.

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 (including a history of worsening breathing 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.

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.

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.

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.

Not applicable.

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.