Signs and Symptoms
Any of the following which have been reported with the individual ingredients
may occur and may be modified to a varying degree by the effects of the other
ingredients present in Carisoprodol and Aspirin Tablets.
Carisoprodol: Stupor, coma, shock, respiratory depression and
very rarely, death. Overdosage with carisoprodol in combination with alcohol,
other CNS depressants, or psychotropic agents can have additive effects, even
when one of the agents has been taken in the usually recommended dosage.
Aspirin: Headache, tinnitus, hearing difficulty, dim vision,
dizziness, lassitude, hyperpnea, rapid breathing, thirst, nausea, vomiting,
sweating and occasionally diarrhea are characteristic of mild to moderate salicylate
poisoning. Salicylate poisoning should be considered in children with symptoms
of vomiting, hyperpnea, and hyperthermia.
Hyperpnea is an early sign of salicylate poisoning, but dyspnea supervenes
at plasma levels above 50 mg/dl. These respiratory changes eventually lead to
serious acid-base disturbances, Metabolic acidosis is a constant finding in
infants but occurs in older children only with severe poisoning; adults usually
exhibit respiratory alkalosis initially and acidosis terminally.
Other symptoms of severe salicylate poisoning include hyperthermia, dehydration,
delirium and mental disturbances. Skin eruptions, GI hemorrhage, or pulmonary
edema are less common.
Early CNS stimulation is replaced by increasing depression, stupor, and coma.
Death is usually due to respiratory failure or cardiovascular collapse.
General: Provide symptomatic and supportive treatment, as indicated.
Any drug remaining in the stomach should be removed using appropriate procedures
and caution to protect the airway and prevent aspiration, especially in the
stuporous or comatose patient.
Incomplete gastric emptying with delayed absorption of carisoprodol has been
reported as a cause for relapse. Should respiration or blood pressure become
compromised, respiratory assistance, central nervous system stimulants and pressor
agents should be administered cautiously as indicated.
Carisoprodol: The following have been used successfully in overdosage
with the related drug meprobamate: diuretics, osmotic (mannitol) diuresis, peritoneal
dialysis, and hemodialysis (see CLINICAL PHARMACOLOGY).
Careful monitoring of urinary output is necessary and caution should be taken
to avoid overhydration. Carisoprodol can be be measured in biological fluid
by gas chromatography (Douglas, J.F., et al: J Pharm Sci 58:145, 1969).
Aspirin: Since there are no specific antidotes for salicylate
poisoning, the aim of treatment is to enhance elimination of salicylate and
prevent or reduce further absorption; to correct any fluid electrolyte or metabolic
imbalance; and to provide general and cardiorespiratory support. If acidosis
is present, intravenous sodium bicarbonate must be given, along with adequate
hydration, until salicylate levels decrease to within the therapeutic range.
To enhance elimination, forced diuresis and alkalinization of the urine may
be beneficial. The need for hemoperfusion or hemodialysis is rare and should
be used only when other measures have failed.
Acute intermittent prophyria; bleeding disorders; allergic or idiosyncratic reactions to carisoprodol, aspirin, or related compounds.