Aspirin/paracetamol/caffeine

Aspirin/paracetamol(acetaminophen)/caffeine is a combination drug for the treatment of pain, especially tension headache and migraine.[1] It is sold in the US under the trade names Goody's Powder and Excedrin, although not all products sold under the Excedrin brand contain this combination. It is sold in the UK under various brandnames including Anadin Extra.

Aspirin/paracetamol/caffeine
Combination of
AspirinNSAID
ParacetamolAnalgesic
CaffeineStimulant
Clinical data
Trade namesExcedrin, Vanquish, others
AHFS/Drugs.comexcedrin
Routes of
administration		Oral
ATC code
Legal status
Legal status
Identifiers
PubChem CID
ChemSpider
Chemical and physical data
3D model (JSmol)

Adverse effects
See also: Aspirin § Adverse effects, Paracetamol § Adverse effects, and Caffeine § Adverse effects

The recommended dosing has a low risk profile when taken occasionally in a well hydrated state. As with all medications containing paracetamol (acetaminophen), concomitant use with alcohol carries a significant risk of hepatotoxicity.[2] The combination of paracetamol with aspirin also creates the risk of renal papillary necrosis if large doses are taken chronically. This is because paracetamol yields a toxic metabolite that can accumulate in the kidney while aspirin works to deplete the glutathione stores necessary to oxidize it. Additionally, chronic aspirin usage is associated with increased risk of gastrointestinal bleeding.[3]

Chemical detection

The combination of these three compounds can be detected in pharmaceutical formulations, urine and blood serum in trace quantities using electrochemical methods.[4]

Other trade names

The combination was introduced in 1964 under the trade name Vanquish by Sterling Drug, which after a series of mergers and acquisitions became a unit of Bayer AG.[5]

In Germany, it is sold as dolomo, Dolopyrin AL, HA-Tabletten, Melabon K, Neuralgin, ratiopyrin, Thomapyrin Classic, Thomapyrin Intensiv,[6] in Austria as Thomapyrin, and InfluASS, in Israel as Acamol Focus, in Romania as Antinevralgic P [7] and Antinevralgic Forte,[8] and in Russia as Citramon.[9]

References
  1. Drugs.com: excedrin
  2. Haberfeld H, ed. (2019). Austria-Codex (in German). Vienna: Österreichischer Apothekerverlag. Thomapyrin-Tabletten.
  3. Henrich WL, Agodoa LE, Barrett B, Bennett WM, Blantz RC, Buckalew VM, et al. (January 1996). "Analgesics and the kidney: summary and recommendations to the Scientific Advisory Board of the National Kidney Foundation from an Ad Hoc Committee of the National Kidney Foundation". American Journal of Kidney Diseases. 27 (1): 162–5. doi:10.1016/S0272-6386(96)90046-3. PMID 8546133.
  4. Sanghavi BJ, Srivastava AK (2010). "Simultaneous voltammetric determination of acetaminophen, aspirin and caffeine using an in situ surfactant-modified multiwalled carbon nanotube paste electrode". Electrochimica Acta. 55 (28): 8638–48. doi:10.1016/j.electacta.2010.07.093.
  5. Olmos D (September 14, 1994). "German Firm to Reclaim Bayer Aspirin Name : Drugs: It will acquire Sterling Winthrop's over-the-counter business and recover the rights it lost after WWI". Los Angeles Times. Retrieved May 3, 2013.
  6. "Rote Liste". Retrieved 2020-01-24.
  7. "Antinevralgic P comprimate" (PDF). Agenția Natională a Medicamentului și a Dispozitivelor Medicale din România.
  8. Blanaru C (26 June 2013). "The launch of Antinevralgic Forte – reinventing a traditional brand". Branding Business. AdHugger.
  9. "International Drug Names". Drugs.com. Retrieved 2020-01-24.
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