| Combination of | |
|---|---|
| Aspirin | Non-steroidal anti-inflammatory drug (NSAID) |
| Paracetamol | Analgesic |
| Caffeine | Stimulant |
| Clinical data | |
| Trade names | Various |
| AHFS/Drugs.com | Multum Consumer Information |
| Routes of administration | By mouth |
| ATC code | |
| Legal status | |
| Legal status | |
| Identifiers | |
| CAS Number | |
| PubChemCID | |
| ChemSpider | |
| Chemical and physical data | |
| 3D model (JSmol) | |
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Aspirin/paracetamol/caffeine, sold under brand names includingExcedrin andAnadin Extra, is acombination drug for the treatment of pain, especiallytension headache andmigraine.[1] It containsaspirin, anon-steroidal anti-inflammatory drug;paracetamol (acetaminophen), ananalgesic; andcaffeine, astimulant.[1]
All active treatments except caffeine differed significantly fromplacebo, with superior efficacy of thetriple combination; well tolerated; low incidence of adverse events.[2][3]
The recommended dosing has a low risk profile when taken occasionally in a well hydrated state.[2] As with all medications containingparacetamol (acetaminophen), concomitant use withalcohol carries a significant risk ofhepatotoxicity.[4] The combination of paracetamol withaspirin also creates the risk ofrenal 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 theglutathione stores necessary to oxidize it. Additionally, chronic aspirin usage is associated with increased risk of gastrointestinal bleeding.[5]
The combination was first introduced as the name Trigesic, as the formula of 125 mg paracetamol, 230 mg aspirin, and 30 mg caffeine, in July 1950 by Squibb, which is nowBristol Myers Squibb, but was recalled in the following year due to several reports that the drug might cause blooddyscrasia.[6] In 1965 it was marketed under the trade name Vanquish bySterling Drug,[7] which after a series of mergers and acquisitions became a unit ofBayer AG.[8]
In the UK it is sold as Anadin Extra. In the US, it is the brandExcedrin's flagship product. In Germany, it is sold as Dolomo, Dolopyrin AL, HA-Tabletten, Melabon K, Neuralgin, ratiopyrin, Thomapyrin Classic, Thomapyrin Intensiv,[9] in Austria as Thomapyrin, and InfluASS, in Israel as Acamol Focus, Paramol Target and Exidol, in Romania as Antinevralgic P[10] and Antinevralgic Forte,[11] and in Russia, Belarus and Eastern Europe as Citramon.[12]
In South Africa and neighbouring countries, it is known as Grand-Pa, and is most commonly sold as a powder.
| pyrazolones / pyrazolidines | |
|---|---|
| salicylates | |
| acetic acid derivatives and related substances | |
| oxicams | |
| propionic acid derivatives (profens) |
|
| n-arylanthranilic acids (fenamates) | |
| COX-2 inhibitors (coxibs) | |
| other | |
| NSAID combinations | |
Key:underline indicates initially developed first-in-class compound of specific group;#WHO-Essential Medicines;†withdrawn drugs;‡veterinary use. | |
