Tengam

Acetaminophen (Tengam) (with the Optizorb formulation) also contains the following excipients: Pregelatinized maize starch, calcium carbonate, alginic acid, crospovidone, povidone, magnesium stearate, colloidal anhydrous silica, parahydroxybenzoates (sodium methyl, ethyl and propyl), OPADRY YS-1-7003 white, carnauba wax, purified water.

It contains no sugar, lactose or gluten.

A centrally acting central muscle relaxant with sedative properties. It is claimed to inhibit muscle spasm by exerting an effect primarily at the level of the spinal cord and subcortical areas of the brain. (From Martindale, The Extra Pharmacopoea, 30th ed, p1202)

Acetaminophen (Tengam)® (Acetaminophen (Tengam)) injection is indicated for

• the management of mild to moderate pain
• the management of moderate to severe pain with adjunctive opioid analgesics
• the reduction of fever.

Chlorzoxazone (Tengam) is indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions. The mode of action of this drug has not been clearly identified, but may be related to its sedative properties. Chlorzoxazone (Tengam) does not directly relax tense skeletal muscles in man.

Acetaminophen (Tengam) injection is used together with other medicines (eg, narcotic pain relievers) to relieve moderate to severe pain.

Acetaminophen (Tengam) is used to relieve mild to moderate pain and reduce fever in patients. It does not become habit-forming when taken for a long time. Acetaminophen (Tengam) may cause unwanted effects when taken in large doses, including liver damage.

Acetaminophen (Tengam) is available only with your doctor's prescription.

Chlorzoxazone (Tengam) is used to relax certain muscles in your body and relieve the discomfort caused by acute (short-term), painful muscle or bone conditions. However, Chlorzoxazone (Tengam) does not take the place of rest, exercise, physical therapy, or other treatments that your doctor may recommend for your medical condition.

Chlorzoxazone (Tengam) is a skeletal muscle relaxant. It acts on the central nervous system (CNS) to relax muscles.

Chlorzoxazone (Tengam) is available only with your doctor's prescription.

General Dosing Information

Acetaminophen (Tengam) may be given as a single or repeated dose for the treatment of acute pain or fever. No dose adjustment is required when converting between oral Acetaminophen (Tengam) and Acetaminophen (Tengam) dosing in adults and adolescents who weigh 50 kg and above. Calculated maximum daily dose of Acetaminophen (Tengam) is based on all routes of administration (i.e., intravenous, oral, and rectal) and all products containing Acetaminophen (Tengam). Exceeding the maximum mg/kg daily dose of Acetaminophen (Tengam) as described in Tables 1 and 2 may result in hepatic injury, including the risk of liver failure and death. To avoid the risk of overdose, ensure that the total amount of Acetaminophen (Tengam) from all routes and from all credits does not exceed the maximum recommended dose.

Recommended

Dosage: Adults and Adolescents

Adults and adolescents weighing 50 kg and over: the recommended dosage of Acetaminophen (Tengam) is 1000 mg every 6 hours or 650 mg every 4 hours, with a maximum single dose of Acetaminophen (Tengam) of 1000 mg, a minimum dosing interval of 4 hours, and a maximum daily dose of Acetaminophen (Tengam) of 4000 mg per day (includes all routes of administration and all Acetaminophen (Tengam)-containing products including combination products).

Adults and adolescents weighing under 50 kg: the recommended dosage of Acetaminophen (Tengam) is 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single dose of Acetaminophen (Tengam) of 15 mg/kg, a minimum dosing interval of 4 hours, and a maximum daily dose of Acetaminophen (Tengam) of 75 mg/kg per day (includes all routes of administration and all Acetaminophen (Tengam)-containing products including combination products).

Table 1: Dosing for Adults and Adolescents

Recommended

Dosage: Children

Children 2 to 12 years of age: the recommended dosage of Acetaminophen (Tengam) is 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single dose of Acetaminophen (Tengam) of 15 mg/kg, a minimum dosing interval of 4 hours, and a maximum daily dose of Acetaminophen (Tengam) of 75 mg/kg per day.

Table 2: Dosing for Children

Instructions For

Intravenous Administration

For adult and adolescent patients weighing ≥ 50 kg requiring 1000 mg doses of Acetaminophen (Tengam), administer the dose by inserting a vented intravenous set through the septum of the 100 mL vial. Acetaminophen (Tengam) may be administered without further dilution. Examine the vial contents before dose preparation or administering. DO NOT USE if particulate matter or discoloration is observed. Administer the contents of the vial intravenously over 15-minutes. Use aseptic technique when preparing Acetaminophen (Tengam) for intravenous infusion. Do not add other medications to the Acetaminophen (Tengam) vial or infusion device.

For doses less than 1000 mg, the appropriate dose must be withdrawn from the vial and placed into a separate container prior to administration. Using aseptic technique, withdraw the appropriate dose (650 mg or weight-based) from an intact sealed Acetaminophen (Tengam) vial and place the measured dose in a separate empty, sterile container (e.g. glass bottle, plastic intravenous container, or syringe) for intravenous infusion to avoid the inadvertent delivery and administration of the total volume of the commercially available container. The entire 100 mL vial of Acetaminophen (Tengam) is not intended for use in patients weighing less than 50 kg. Acetaminophen (Tengam) is a single-use vial and the unused portion must be discarded.

Place small volume pediatric doses up to 60 mL in volume in a syringe and administer over 15 minutes using a syringe pump.

Monitor the end of the infusion in order to prevent the possibility of an air embolism, especially in cases where the Acetaminophen (Tengam) infusion is the primary infusion.

Once the vacuum seal of the glass vial has been penetrated, or the contents transferred to another container, administer the dose of Acetaminophen (Tengam) within 6 hours.

Do not add other medications to the Acetaminophen (Tengam) solution. Diazepam and chlorpromazine hydrochloride are physically incompatible with Acetaminophen (Tengam), therefore do not administer simultaneously.

How supplied

Dosage Forms And Strengths

Acetaminophen (Tengam) is a sterile, clear, colorless, non pyrogenic, preservative free, isotonic formulation of Acetaminophen (Tengam) intended for intravenous infusion. Each 100 mL glass vial contains 1000 mg Acetaminophen (Tengam) (10 mg/mL).

Storage And Handling

NDC 43825-102-01 - Acetaminophen (Tengam)® (Acetaminophen (Tengam)) Injection is supplied in a 100 mL glass vial containing 1000 mg Acetaminophen (Tengam) (10 mg/mL) in cartons of 24 vials.

Acetaminophen (Tengam) should be stored at 20°C to 25°C (68°F to 77°F).

For single use only. The product should be used within 6 hours after opening. Do not refrigerate or freeze.

Manufactured for: Mallinckrodt Hospital Products Inc., Hazelwood, MO 63042 USA. Revised: Dec 2014

Usual Adult Dosage

Chlorzoxazone (Tengam)® Tablets (Chlorzoxazone (Tengam) USP) 375 mg

One tablet three or four times daily. If adequate response is not obtained with this dose, the 375 mg tablets may be increased to two tablets (750 mg) three or four times daily. As improvement occurs dosage can usually be reduced.

Chlorzoxazone (Tengam)® Tablets (Chlorzoxazone (Tengam) USP) 750 mg

1/3 tablet (250 mg) three or four times daily. Initial dosage for painful musculoskeletal condition should be 2/3 tablet (500 mg) three to four times daily. If adequate response is not obtained with this dose, it may be increased to one tablet (750 mg) three or four times daily. As improvement occurs dosage can usually be reduced.

How supplied

Chlorzoxazone (Tengam)® Tablets (Chlorzoxazone (Tengam) USP) are supplied as follows:

375 mg

A white capsule shaped tablet, debossed “ADG” on one side and “375” on the other side, in bottles of 100 tablets, NDC 68025-046-10.

750 mg

A white capsule shaped tablet, debossed “ADG” on the trisected side and “750” on the bisected side, in bottles of 100 tablets, NDC 68025-047-10.

Dispense in a tight container as defined in the official compendium.

Store at 20° to 25° C (68° to 77° F).

Manufactured for: Vertical Pharmaceuticals, LLC, Sayreville, NJ 08872. Revised: 2014

See also:
What is the most important information I should know about Acetaminophen (Tengam)?

There are many brands and forms of Acetaminophen (Tengam) available and not all brands are listed on this leaflet.

Do not take more of this medication than is recommended. An overdose of Acetaminophen (Tengam) can damage your liver or cause death.

Know the amount of Acetaminophen (Tengam) in the specific product you are taking.

Do not take this medication without a doctor's advice if you have ever had alcoholic liver disease (cirrhosis) or if you drink more than 3 alcoholic beverages per day. You may not be able to take Acetaminophen (Tengam).

Avoid drinking alcohol. It may increase your risk of liver damage while taking Acetaminophen (Tengam).

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have liver disease or a history of alcoholism.

Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (Tengam) (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much Acetaminophen (Tengam) which can lead to a fatal overdose. Check the label to see if a medicine contains Acetaminophen (Tengam) or APAP.

See also:
What is the most important information I should know about Chlorzoxazone (Tengam)?

Chlorzoxazone (Tengam) Chlorzoxazone (Tengam) is contraindicated in patients with known intolerance to the drug.

Use Acetaminophen (Tengam) injection as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Acetaminophen (Tengam) injection is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Acetaminophen (Tengam) injection at home, a health care provider will teach you how to use it. Be sure you understand how to use Acetaminophen (Tengam) injection. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
• Do not mix other medicines (especially chlorpromazine or diazepam) in the same container or IV line as Acetaminophen (Tengam) injection. Contact your health care provider if you have any questions about how to give Acetaminophen (Tengam) injection with other medicines.
• Do not use Acetaminophen (Tengam) injection if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
• Use Acetaminophen (Tengam) injection within 6 hours after opening.
• If you miss a dose of Acetaminophen (Tengam) injection and you are using it regularly, use it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised by your health care provider. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Acetaminophen (Tengam) injection.

Use Chlorzoxazone (Tengam) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Chlorzoxazone (Tengam) by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• If you miss a dose of Chlorzoxazone (Tengam), take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Chlorzoxazone (Tengam).

This drug is used to treat mild to moderate pain (from headaches, menstrual periods, toothaches, backaches, osteoarthritis, or cold/flu aches and pains) and to reduce fever.

How to use Acetaminophen (Tengam) Extra Strength

Take this product by mouth as directed. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist.

There are many brands and forms of Acetaminophen (Tengam) available. Read the dosing instructions carefully for each product because the amount of Acetaminophen (Tengam) may be different between products. Do not take more Acetaminophen (Tengam) than recommended.

If you are giving Acetaminophen (Tengam) to a child, be sure you use a product that is meant for children. Use your child's weight to find the right dose on the product package. If you don't know your child's weight, you can use their age.

For suspensions, shake the medication well before each dose. Some liquids do not need to be shaken before use. Follow all directions on the product package. Measure the liquid medication with the provided dose-measuring spoon/dropper/syringe to make sure you have the correct dose. Do not use a household spoon.

For rapidly-dissolving tablets, chew or allow to dissolve on the tongue, then swallow with or without water. For chewable tablets, chew thoroughly before swallowing.

Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

For effervescent tablets, dissolve the dose in the recommended amount of water, then drink.

Pain medications work best if they are used as the first signs of pain occur. If you wait until the symptoms have worsened, the medication may not work as well.

Do not take this medication for fever for more than 3 days unless directed by your doctor. For adults, do not take this product for pain for more than 10 days (5 days in children) unless directed by your doctor. If the child has a sore throat (especially with high fever, headache, or nausea/vomiting), consult the doctor promptly.

Tell your doctor if your condition persists or worsens or if you develop new symptoms. If you think you may have a serious medical problem, get medical help right away.

Chlorzoxazone (Tengam) is used to treat muscle spasms/pain. It is usually used along with rest, physical therapy, and other treatment. It works by helping to relax the muscles.

How to use Chlorzoxazone (Tengam)

Take this medication by mouth with or without food as directed by your doctor, usually 3 or 4 times a day.

The dosage is based on your medical condition and response to treatment. Do not increase your dose or take it more often than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.

Tell your doctor if your condition does not improve or if it worsens.

See also:
What other drugs will affect Acetaminophen (Tengam)?

Acetaminophen (Tengam) is metabolized (eliminated by conversion to other chemicals) by the liver. Therefore drugs that increase the action of liver enzymes that metabolize Acetaminophen (Tengam) [for example, carbamazepine (Tegretol), isoniazid (INH, Nydrazid, Laniazid), rifampin (Rifamate, Rifadin, Rimactane)] reduce the levels of Acetaminophen (Tengam) and may decrease the action of Acetaminophen (Tengam). Doses of Acetaminophen (Tengam) greater than the recommended doses are toxic to the liver and may result in severe liver damage. The potential for Acetaminophen (Tengam) to harm the liver is increased when it is combined with alcohol or drugs that also harm the liver.

Cholestyramine (Questran) reduces the effect of Acetaminophen (Tengam) by decreasing its absorption into the body from the intestine. Therefore, Acetaminophen (Tengam) should be administered 3 to 4 hours after cholestyramine or one hour before cholestyramine.

Acetaminophen (Tengam) doses greater than 2275 mg per day may increase the blood thinning effect of warfarin (Coumadin) by an unknown mechanism. Therefore, prolonged administration or large doses of Acetaminophen (Tengam) should be avoided during warfarin therapy

See also:
What other drugs will affect Chlorzoxazone (Tengam)?

Alcohol (Ethyl): May enhance the CNS depressant effect of Chlorzoxazone (Tengam). Alcohol (Ethyl) may decrease the serum concentration of Chlorzoxazone (Tengam). Specifically, chronic alcohol ingestion may decrease serum concentrations of Chlorzoxazone (Tengam). Monitor therapy

Alizapride: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

ARIPiprazole: CYP3A4 Inhibitors (Weak) may increase the serum concentration of ARIPiprazole. Management: Monitor for increased aripiprazole pharmacologic effects. Aripiprazole dose adjustments may or may not be required based on concomitant therapy and/or indication. Consult full interaction monograph for specific recommendations. Monitor therapy

Azelastine (Nasal): CNS Depressants may enhance the CNS depressant effect of Azelastine (Nasal). Avoid combination

Blonanserin: CNS Depressants may enhance the CNS depressant effect of Blonanserin. Consider therapy modification

Botulinum Toxin-Containing Products: Muscle Relaxants (Centrally Acting) may enhance the adverse/toxic effect of Botulinum Toxin-Containing Products. Specifically, the risk for increased muscle weakness may be enhanced. Monitor therapy

Brexanolone: CNS Depressants may enhance the CNS depressant effect of Brexanolone. Monitor therapy

Brimonidine (Topical): May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Bromopride: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Bromperidol: May enhance the CNS depressant effect of CNS Depressants. Avoid combination

Buprenorphine: CNS Depressants may enhance the CNS depressant effect of Buprenorphine. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Initiate buprenorphine at lower doses in patients already receiving CNS depressants. Consider therapy modification

Cannabidiol: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Cannabis: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Chlormethiazole: May enhance the CNS depressant effect of Chlorzoxazone (Tengam). Chlormethiazole may increase the serum concentration of Chlorzoxazone (Tengam). Management: Consider reduced doses of Chlorzoxazone (Tengam) when combined with chlormethiazole. Monitor patients for increased Chlorzoxazone (Tengam) effects/toxicities (ie, CNS depression, sedation) if these agents are combined. Consider therapy modification

Chlorphenesin Carbamate: May enhance the adverse/toxic effect of CNS Depressants. Monitor therapy

CNS Depressants: May enhance the adverse/toxic effect of other CNS Depressants. Monitor therapy

CYP2E1 Inhibitors (Strong): May increase the serum concentration of Chlorzoxazone (Tengam). Monitor therapy

Dimethindene (Topical): May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Dofetilide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Dofetilide. Monitor therapy

Doxylamine: May enhance the CNS depressant effect of CNS Depressants. Management: The manufacturer of Diclegis (doxylamine/pyridoxine), intended for use in pregnancy, specifically states that use with other CNS depressants is not recommended. Monitor therapy

Dronabinol: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Droperidol: May enhance the CNS depressant effect of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Consider therapy modification

Esketamine: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Flibanserin: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Flibanserin. Monitor therapy

Flunitrazepam: CNS Depressants may enhance the CNS depressant effect of Flunitrazepam. Consider therapy modification

HydrOXYzine: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Isoniazid: May increase the serum concentration of Chlorzoxazone (Tengam). Isoniazid may decrease the serum concentration of Chlorzoxazone (Tengam). Specifically, it may decrease Chlorzoxazone (Tengam) concentrations below baseline after isoniazid discontinuation. Monitor therapy

Kava Kava: May enhance the adverse/toxic effect of CNS Depressants. Monitor therapy

Lemborexant: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Lemborexant. Management: The maximum recommended dosage of lemborexant is 5 mg, no more than once per night, when coadministered with weak CYP3A4 inhibitors. Consider therapy modification

Lemborexant: May enhance the CNS depressant effect of CNS Depressants. Management: Dosage adjustments of lemborexant and of concomitant CNS depressants may be necessary when administered together because of potentially additive CNS depressant effects. Close monitoring for CNS depressant effects is necessary. Consider therapy modification

Lofexidine: May enhance the CNS depressant effect of CNS Depressants. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Monitor therapy

Lomitapide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Lomitapide. Management: Patients on lomitapide 5 mg/day may continue that dose. Patients taking lomitapide 10 mg/day or more should decrease the lomitapide dose by half. The lomitapide dose may then be titrated up to a max adult dose of 30 mg/day. Consider therapy modification

Magnesium Sulfate: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Methotrimeprazine: CNS Depressants may enhance the CNS depressant effect of Methotrimeprazine. Methotrimeprazine may enhance the CNS depressant effect of CNS Depressants. Management: Reduce adult dose of CNS depressant agents by 50% with initiation of concomitant methotrimeprazine therapy. Further CNS depressant dosage adjustments should be initiated only after clinically effective methotrimeprazine dose is established. Consider therapy modification

MetyroSINE: CNS Depressants may enhance the sedative effect of MetyroSINE. Monitor therapy

Minocycline (Systemic): May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Nabilone: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

NiMODipine: CYP3A4 Inhibitors (Weak) may increase the serum concentration of NiMODipine. Monitor therapy

Opioid Agonists: CNS Depressants may enhance the CNS depressant effect of Opioid Agonists. Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Consider therapy modification

Orphenadrine: CNS Depressants may enhance the CNS depressant effect of Orphenadrine. Avoid combination

Oxomemazine: May enhance the CNS depressant effect of CNS Depressants. Avoid combination

OxyCODONE: CNS Depressants may enhance the CNS depressant effect of OxyCODONE. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Consider therapy modification

Paraldehyde: CNS Depressants may enhance the CNS depressant effect of Paraldehyde. Avoid combination

Perampanel: May enhance the CNS depressant effect of CNS Depressants. Management: Patients taking perampanel with any other drug that has CNS depressant activities should avoid complex and high-risk activities, particularly those such as driving that require alertness and coordination, until they have experience using the combination. Consider therapy modification

Pimozide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Pimozide. Avoid combination

Piribedil: CNS Depressants may enhance the CNS depressant effect of Piribedil. Monitor therapy

Pramipexole: CNS Depressants may enhance the sedative effect of Pramipexole. Monitor therapy

ROPINIRole: CNS Depressants may enhance the sedative effect of ROPINIRole. Monitor therapy

Rotigotine: CNS Depressants may enhance the sedative effect of Rotigotine. Monitor therapy

Rufinamide: May enhance the adverse/toxic effect of CNS Depressants. Specifically, sleepiness and dizziness may be enhanced. Monitor therapy

Selective Serotonin Reuptake Inhibitors: CNS Depressants may enhance the adverse/toxic effect of Selective Serotonin Reuptake Inhibitors. Specifically, the risk of psychomotor impairment may be enhanced. Monitor therapy

Sodium Oxybate: May enhance the CNS depressant effect of CNS Depressants. Management: Consider alternatives to combined use. When combined use is needed, consider minimizing doses of one or more drugs. Use of sodium oxybate with alcohol or sedative hypnotics is contraindicated. Consider therapy modification

Suvorexant: CNS Depressants may enhance the CNS depressant effect of Suvorexant. Management: Dose reduction of suvorexant and/or any other CNS depressant may be necessary. Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended. Consider therapy modification

Tetrahydrocannabinol: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Tetrahydrocannabinol and Cannabidiol: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Thalidomide: CNS Depressants may enhance the CNS depressant effect of Thalidomide. Avoid combination

Tolperisone: May enhance the adverse/toxic effect of Muscle Relaxants (Centrally Acting). Management: Monitor for increased sedation or CNS effects if tolperisone is combined with other centrally acting muscle relaxants. Consider decreasing the tolperisone dose if these agents are combined. Consider therapy modification

Triazolam: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Triazolam. Management: Consider triazolam dose reduction in patients receiving concomitant weak CYP3A4 inhibitors. Consider therapy modification

Trimeprazine: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Ubrogepant: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Ubrogepant. Management: In patients taking weak CYP3A4 inhibitors, the initial and second dose (if needed) of ubrogepant should be limited to 50 mg. Consider therapy modification

Zolpidem: CNS Depressants may enhance the CNS depressant effect of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol. Consider therapy modification

See also:
What are the possible side effects of Acetaminophen (Tengam)?

Applies to Acetaminophen (Tengam): capsule, capsule liquid filled, elixir, liquid, powder, powder for solution, solution, suppository, suspension, syrup, tablet, tablet chewable, tablet disintegrating, tablet effervescent, tablet extended release

Other dosage forms:

• intravenous solution

Along with its needed effects, Acetaminophen (Tengam) (the active ingredient contained in Acetaminophen (Tengam)) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking Acetaminophen (Tengam):

Rare

• Bloody or black, tarry stools
• bloody or cloudy urine
• fever with or without chills (not present before treatment and not caused by the condition being treated)
• pain in the lower back and/or side (severe and/or sharp)
• pinpoint red spots on the skin
• skin rash, hives, or itching
• sore throat (not present before treatment and not caused by the condition being treated)
• sores, ulcers, or white spots on the lips or in the mouth
• sudden decrease in the amount of urine
• unusual bleeding or bruising
• unusual tiredness or weakness
• yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur while taking Acetaminophen (Tengam):

Symptoms of overdose

• Diarrhea
• increased sweating
• loss of appetite
• nausea or vomiting
• stomach cramps or pain
• swelling, pain, or tenderness in the upper abdomen or stomach area

See also:
What are the possible side effects of Chlorzoxazone (Tengam)?

Applies to Chlorzoxazone (Tengam): oral capsule, oral tablet

In addition to its needed effects, some unwanted effects may be caused by Chlorzoxazone (Tengam) (the active ingredient contained in Chlorzoxazone (Tengam)). In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking Chlorzoxazone (Tengam):

Rare

• Bloody or black, tarry stools
• clay-colored stools
• constipation
• cough
• dark urine
• decreased appetite
• difficulty swallowing
• dizziness
• fast heartbeat
• fever
• headache
• hives
• itching
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• loss of appetite
• nausea and vomiting
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• severe stomach pain
• shortness of breath
• skin rash
• swelling of the feet or lower legs
• tightness in the chest
• unusual tiredness or weakness
• vomiting of blood or material that looks like coffee grounds
• wheezing
• yellow eyes or skin

If any of the following symptoms of overdose occur while taking Chlorzoxazone (Tengam), get emergency help immediately:

Symptoms of overdose:

• Diarrhea
• difficult or troubled breathing
• drowsiness
• general feeling of discomfort or illness
• headache
• irregular, fast or slow, or shallow breathing
• lightheadedness
• nausea
• pale or blue lips, fingernails, or skin
• sluggishness
• vomiting

Minor Side Effects

Some of the side effects that can occur with Chlorzoxazone (Tengam) may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Rare

• Bruising
• large, flat, blue, or purplish patches in the skin
• small red or purple spots on the skin