What the FDA labels say about taking them together
Acetaminophen/caffeine/dihydrocodeine and nalbuphine
Acetaminophen/caffeine/dihydrocodeine's FDA label of May 2, 2022 names nalbuphine in its drug interactions section; nalbuphine's label does not name acetaminophen/caffeine/dihydrocodeine itself but warns about its class (Stimulants, Opioids (opioid agonists)). The acetaminophen/caffeine/dihydrocodeine label: “Dihydrocodeine with Mixed Agonist/Antagonist Opioid Analgesics: Agonist/antagonist analgesics may reduce the analgesic effect of this combination product.”
Check it at the source: the acetaminophen/caffeine/dihydrocodeine FDA label on DailyMed (effective May 2, 2022, Proficient Rx LP); the nalbuphine FDA label on DailyMed (effective December 31, 2025, Hospira, Inc.).
What does the acetaminophen/caffeine/dihydrocodeine label say about nalbuphine?
Acetaminophen/caffeine/dihydrocodeine label, drug interactionsDihydrocodeine 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.
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 does the nalbuphine label say about acetaminophen/caffeine/dihydrocodeine?
Nalbuphine's label does not name acetaminophen/caffeine/dihydrocodeine itself; it warns about its class (Stimulants, Opioids (opioid agonists)):
Nalbuphine label, warningsLife-Threatening Respiratory Depression Serious, life-threatening, or fatal respiratory depression has been reported with the use of opioids, even when used as recommended.
Nalbuphine label, boxed warningSERIOUS AND LIFE-THREATENING RISKS FROM USE OF NALBUPHINE HYDROCHLORIDE INJECTION Addiction, Abuse, and Misuse Because the use of Nalbuphine Hydrochloride Injection exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death, assess each patient's risk prior to prescribing and reassess all patients regularly for the development of these behaviors and conditions [see WARNINGS ].
Source: FDA drug label (Nalbuphine Hydrochloride), Hospira, Inc., effective December 31, 2025 (SPL set 6025e8d4-5083-4c3a-58a0-050e7b0b6150), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Acetaminophen/caffeine/dihydrocodeine | Nalbuphine | |
|---|---|---|
| Labeled for | Pain | Pain |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | n/a | $4.32 per mL 10 mg/mL ampul |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once