Prescription medicine
Acetaminophen and caffeine and dihydrocodeine Brand names: Trezix
Acetaminophen and caffeine and dihydrocodeine (Trezix) is a prescription medicine. FDA's NDC Directory lists it from 1 generic labeler.
- Generic listed
- Boxed warning
- DEA Schedule III
Check it at the source: the acetaminophen and caffeine and dihydrocodeine FDA label on DailyMed (effective May 2, 2022, Proficient Rx LP); every acetaminophen and caffeine and dihydrocodeine label on DailyMed.
Highlights of the record
FDA label of May 2, 2022; NDC Directory, Drugs@FDA and Orange Book, October 8, 2026
Death Related to Ultra-Rapid Metabolism of Codeine to Morphine Respiratory depression and death have occurred in children who received codeine following tonsillectomy and/or adenoidectomy and had evidence of being ultra-rapid metabolizers of codeine due to a CYP2D6 polymorphism. Hepatotoxicity Acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplant and death. Most of the cases of liver injury are associated with the use of acetaminophen at doses that exceed 4000 milligrams per day, and often involve more than one acetaminophen containing product.
Used for
From the label: indications and usageTREZIX™ (acetaminophen, caffeine, and dihydrocodeine bitartrate) capsulesare indicated for the relief of moderate to moderately severe pain.
Forms and strengths
- 320.5 mg / 30 mg / 16 mg
Capsule.
On the market
- Generic approvals
- 9 first March 4, 1986; 0 with a marketed status in Drugs@FDA
- Labelers listed (NDC)
- 1 of which 1 under generic applications, 0 under brand applications, repackagers included
Supply and safety
- Pharmacy cost (NADAC)
- Not in the survey
- Shortage (FDA)
- No current entry
- Recalls by its makers (FDA)
- No recall recorded
What is acetaminophen and caffeine and dihydrocodeine used for?
From the label: indications and usageTREZIX™ (acetaminophen, caffeine, and dihydrocodeine bitartrate) capsulesare indicated for the relief of moderate to moderately severe pain.
Conditions named in the indications of acetaminophen and caffeine and dihydrocodeine's FDA labels, with every medicine labeled for each:
FDA pharmacologic class: Central Nervous System Stimulant, Methylxanthine and Opioid Agonist.
Source: FDA drug label (Trezix), ANDA204785 (Key Therap), as published by Proficient Rx LP, effective May 2, 2022 (SPL set 45c3c2a1-6a89-471e-b6d4-5a4cd73b987a), via openFDA; the full label on DailyMed
Is there a generic for acetaminophen and caffeine and dihydrocodeine (Trezix)?
The FDA approved the first generic acetaminophen and caffeine and dihydrocodeine on March 4, 1986. 9 generic applications are approved; 0 of them carry a current (not discontinued) marketing status in Drugs@FDA; that status is not evidence that the generic is on sale.
FDA's NDC Directory lists acetaminophen and caffeine and dihydrocodeine from 1 labeler under a generic (ANDA) application. A listing means the company has registered the product for sale; it does not show that every pharmacy stocks it.
Source: Drugs@FDA, FDA NDC Directory and the Orange Book (openFDA bulk files, October 8, 2026)
What does the acetaminophen and caffeine and dihydrocodeine label say about other medicines?
The acetaminophen and caffeine and dihydrocodeine label names 11 other medicines in its interaction, contraindication or warning sections. The sentences are the labels' own; a label lists what its studies and reports found, not every interaction.
| Medicine named | Section | What the label says |
|---|---|---|
| Aspirin | drug interactions | Caffeine may increase the metabolism of other drugs such as phenobarbital and aspirin. |
| Buprenorphine | drug interactions | Dihydrocodeine with Mixed Agonist/Antagonist Opioid Analgesics: Agonist/antagonist analgesics (i.e., pentazocine, nalbuphine, butorphanol and buprenorphine) may reduce the analgesic effect of this combination product. |
| Butorphanol | drug interactions | Dihydrocodeine with Mixed Agonist/Antagonist Opioid Analgesics: Agonist/antagonist analgesics (i.e., pentazocine, nalbuphine, butorphanol and buprenorphine) may reduce the analgesic effect of this combination product. |
| Carbamazepine | drug interactions | The potential for hepatotoxicity with acetaminophen also may be increased in patients receiving anticonvulsants that induce hepatic microsomal enzymes (including phenytoin, barbiturates, and carbamazepine) or isoniazide. |
| Ciprofloxacin | drug interactions | Caffeine accumulation may occur when products or foods containing caffeine are consumed concomitantly with quinolones such as ciprofloxacin. |
| Codeine | boxed warning | Death Related to Ultra-Rapid Metabolism of Codeine to Morphine Respiratory depression and death have occurred in children who received codeine following tonsillectomy and/or adenoidectomy and had evidence of being ultra-rapid metabolizers of codeine due to a CYP2D6 polymorphism. |
| Disulfiram | drug interactions | Co-administration of caffeine and disulfiram may lead to a substantial decrease in caffeine clearance. |
| Morphine | boxed warning | Death Related to Ultra-Rapid Metabolism of Codeine to Morphine Respiratory depression and death have occurred in children who received codeine following tonsillectomy and/or adenoidectomy and had evidence of being ultra-rapid metabolizers of codeine due to a CYP2D6 polymorphism. |
| Nalbuphine | drug interactions | Dihydrocodeine with Mixed Agonist/Antagonist Opioid Analgesics: Agonist/antagonist analgesics (i.e., pentazocine, nalbuphine, butorphanol and buprenorphine) may reduce the analgesic effect of this combination product. |
| Phenobarbital | drug interactions | Caffeine may increase the metabolism of other drugs such as phenobarbital and aspirin. |
| Phenytoin | drug interactions | The potential for hepatotoxicity with acetaminophen also may be increased in patients receiving anticonvulsants that induce hepatic microsomal enzymes (including phenytoin, barbiturates, and carbamazepine) or isoniazide. |
Check acetaminophen and caffeine and dihydrocodeine against other medicines
Source: FDA drug label (Trezix), ANDA204785 (Key Therap), as published by Proficient Rx LP, effective May 2, 2022 (SPL set 45c3c2a1-6a89-471e-b6d4-5a4cd73b987a), via openFDA; the full label on DailyMed
What else is labeled for the same conditions as acetaminophen and caffeine and dihydrocodeine?
28 other medicines are given the same way (oral) and in the same FDA class as acetaminophen and caffeine and dihydrocodeine or labeled mainly for the same use (pain), the same class first. Pain lists all 80 medicines labeled for it, by any route. The first 8 are below. They are listed as records, not as substitutes: whether one can replace another is a prescriber's decision.
| Medicine | Shared indication | Generic labelers (oral) | Pharmacy cost | Shortage |
|---|---|---|---|---|
| Oxycodone | Pain | 34 labelers | $0.0884 per tablet 5 mg tablet | No current entry |
| Tramadol | Pain | 40 labelers | $0.0248 per tablet 50 mg tablet | No current entry |
| Morphine | Pain | 17 labelers | $0.226 per tablet 15 mg tablet | In shortage |
| Hydromorphone | Pain | 11 labelers | $0.219 per tablet 4 mg tablet | In shortage |
| Methadone | Pain | 17 labelers | $0.177 per tablet 10 mg tablet | No current entry |
| Oxymorphone | Pain | 9 labelers | n/a | No current entry |
| Tapentadol | Pain | 4 labelers | $14.48 per tablet 100 mg tablet | No current entry |
| Hydrocodone | Pain | 1 labeler | $7.95 per capsule 15 mg capsule | No current entry |
Every medicine labeled for the same conditions as acetaminophen and caffeine and dihydrocodeine
Source: FDA drug labels (indications), NDC Directory, NADAC of October 7, 2026, FDA shortages (October 8, 2026)
What next?
- Alternatives to acetaminophen and caffeine and dihydrocodeine
- 28 medicines for the same use
- Other stimulants
- the pharmacologic class, with prices and generics
- Check an interaction
- what two or more labels say about each other