Acetaminophen/caffeine/magnesium salicylate/phenyltoloxamine (By mouth)


Acetaminophen (a-seet-a-MIN-oh-fen), Caffeine (KAF-een), Magnesium Salicylate (mag-NEE-zee-um sa-LIS-i-late), Phenyltoloxamine (fen-il-tol-OX-a-meen)
Treats mild to moderate pain, including headache, menstrual pain, and muscle or joint pain. Also treats toothache, symptoms of common cold, and minor aches and pains of rheumatism and arthritis. This medicine also helps maintain mental alertness when you feel tired or drowsy.

Brand Name(s)

There may be other brand names for this medicine.

Durabac Forte, Combiflex ES, Cafgesic Forte

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to acetaminophen, caffeine, magnesium salicylate or any salicylate, or phenyltoloxamine. Do not use this medicine if you have kidney disease or liver disease, or if you are using a medicine for blood clotting.

How to Use This Medicine

  • Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
  • This combination medicine contains acetaminophen (Tylenol(R)). Carefully check the labels of all other medicines you are using because they may also contain acetaminophen. It is not safe to use more than 4 grams (4,000 milligrams) of acetaminophen in one day (24 hours).
  • If this medicine upsets your stomach, you may take it with food or milk.
If a dose is missed:
  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
  • Make sure your doctor knows if you are using phenobarbital, aspirin, or a blood thinner such as warfarin (Coumadin®).
  • Avoid foods, drinks, or other medicines that contain caffeine (such as some diet pills and pain relievers). If you take them together with this medicine, you may get too much caffeine and have unwanted side effects.
  • Many combination medicines contain acetaminophen, including products with brand names such as Alka-Seltzer Plus®, Comtrex®, Drixoral®, Excedrin Migraine®, Midol®, Sinutab®, Sudafed®, Theraflu®, and Vanquish®. Carefully check the labels of all other medicines you are using to be sure they do not contain acetaminophen. Using too much of these medicines can cause serious side effects.
  • Do not drink alcohol while you are using this medicine. Acetaminophen can damage your liver and drinking alcohol can increase this risk. If you regularly drink 3 or more alcoholic drinks every day, do not take acetaminophen without asking your doctor.
  • Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have stomach ulcer or any stomach problem, blood clotting disorder, asthma, glaucoma, heart disease, high blood pressure, enlarged prostate, or trouble urinating.
  • This medicine can cause a rare but serious illness called Reye's syndrome. Do not give this medicine to your child or teenager who has fever, chicken pox, or symptoms of an infection unless your doctor has told you to. If your child or teenager has behavior changes along with nausea and vomiting while using this medicine, call the child's doctor right away.
  • If your symptoms do not improve within 10 days, or if they get worse, call your doctor.
  • This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
  • Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:
  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
  • Burning pain on your throat or chest.
  • Change in how much or how often you urinate.
  • Fast, pounding, or irregular heartbeat.
  • Increased hunger or thirst.
  • Lightheadedness, dizziness, drowsiness, or fainting.
  • Rapid breathing.
  • Seizures or tremors.
  • Unusual bleeding or bruising.
  • Unusual tiredness or weakness.
  • Yellowing of your skin or the whites of your eyes.
If you notice these less serious side effects, talk with your doctor:
  • Changes in vision.
  • Dry mouth, throat, or nose.
  • Headache or confusion.
  • Loss of appetite.
  • Nausea, vomiting, diarrhea, stomach cramps, or upset stomach.
  • Nervousness, irritability, increased sweating, or trouble sleeping.
  • Skin rash or itching.
  • Trouble hearing, or ringing in your ears.
  • Warmth or redness in your face, neck, arms, or upper chest.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088
Review Date: 2011-02-04 Reviewed By: Keywords: ,
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