codeine/aspirin/carisoprodol (Rx)

Brand and Other Names:Soma Compound with Codeine
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

codeine/aspirin/carisoprodol

tablet: Schedule III

  • 16mg/325mg/200mg
more...

Musculoskeletal Pain

1-2 tab/cap PO QID for up to 2-3 weeks

Dosage Forms & Strengths

codeine/aspirin/carisoprodol

tablet: Schedule III

  • 16mg/325mg/200mg
more...

Musculoskeletal Pain

<16 years: Safety & efficacy not established

16 years or older: As adults; 1-2 tab/cap PO QID for up to 2-3 weeks

Next:

Interactions

Interaction Checker

and codeine/aspirin/carisoprodol

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            Adverse Effects

            >10%

            Codeine

            • Constipation
            • Drowsiness

            Carisoprodol

            • Drowsiness (13-17%)

            1-10%

            Codeine

            • Hypotension, tachycardia or bradycardia, confusion, dizziness, false feeling of well being, headache, lightheadedness, malaise, paradoxical CNS stimulation, restlessness, rash, urticaria, anorexia, nausea, vomiting, xerostomia, ureteral spasm, urination decreased, LFT's increased, burning at injection site, weakness, blurred vision, dyspnea, histamine release

            Carisoprodol

            • Dizziness (7-8%)
            • Headache (3-5%)

            Frequency Not Defined

            Carisoprodol

            • Cardiovascular: orthostatic hypotension, syncope, tachycardia, central nervous system: agitation, irritability, depression, allergic/idiosyncratic reactions (eg, pruritus, rash, dizziness), gastrointestinal: epigastric distress, N/V, facial flushing, weakness

            Aspirin

            • stomach pain, heartburn, nausea, vomiting, dyspepsia, tinnitus (high or chronic dose), rash, urticaria
            Previous
            Next:

            Warnings

            Black Box Warnings

            Postoperative pain in children

            • Deaths have occurred in children with obstructive sleep apnea who receive codeine for postoperative pain following tonsillectomy and/or adenoidectomy
            • Codeine is converted to morphine by the liver; these children had evidence of being ultra-rapid metabolizers (via CYP2D6) of codeine, which is an inherited (genetic) ability that causes codeine to be converted rapidly into life-threatening or fatal amounts of morphine (see Pharmacology)

            Contraindications

            Hypersensitivity

            Children younger than 16 years old because of potential for Reye syndrome

            Bronchospastic reaction to aspirin

            Peptic ulcer disease

            Repeated administration in patients with anemia, cardiovascular, pulmonary, or renal disease

            Porphyria

            Postoperative use in children following tonsillectomy and/or adenoidectomy (see Black Box Warnings)

            Cautions

            Gastrointestinal bleeding; particular caution in patients with history of GI bleed, alcoholism, or bleeding disorders

            Avoid driving car or operating machinery

            Reye syndrome may occur in children because of aspirin component; do not use for chickenpox or flu symptoms

            Avoid in severe renal impairment (ie, CrCl <10 mL/min)

            May increase respiratory depressant effects; caution with head injury, COPD, or other conditions with decreased respiratory drive

            Codeine and carisoprodol may cause tolerance/dependency

            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy category: D; avoid during pregnancy, particularly in third trimester because of risk for premature closure of the ductus arteriosus because of aspirin component; codeine may prolong delivery and cause respiratory depression/withdrawal symptoms in newborn

            Lactation: excreted in breast milk; do not breast feed

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Codeine: Opioid agonist; analgesia

            Aspirin: Acts on hypothalamus to produce antipyresis; anti-inflammatory properties attributed to prostaglandin synthetase inhibition resulting in decreased formation of thromboxane A2

            Carisoprodol: Centrally acting skeletal muscle relaxant (no direct muscle relaxation); partially metabolized to meprobamate which elicits anxiolytic/sedative effects

            Pharmacogenomics

            10% of codeine is metabolized to morphine by CYP2D6; the active morphine metabolite has a higher affinity for opioid receptors

            CYP2D6 poor metabolizers may not achieve adequate analgesia

            Ultra-rapid metabolizers (up to 7% of Caucasians and up to 30% of Asian and African populations) may have increased toxicity due to rapid conversion

            Previous
            Next:

            Images

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous