Aspirin/paracetamol/caffeine is a combination drug for the treatment of pain, especially tension headache and migraine.[1] It contains aspirin, a non-steroidal anti-inflammatory drug; paracetamol (acetaminophen), an analgesic; and caffeine, a stimulant.[1]

Combination of
Clinical data
Trade namesExcedrin, Vanquish, others
AHFS/Drugs.comMultum Consumer Information
Routes of
By mouth
ATC code
Legal status
Legal status
CAS Number
PubChem CID
Chemical and physical data
3D model (JSmol)
  • O=C(Nc1ccc(O)cc1)C.O=C(O)c1ccccc1OC(=O)C.O=C2N(c1ncn(c1C(=O)N2C)C)C
  • InChI=1S/C9H8O4.C8H10N4O2.C8H9NO2/c1-6(10)13-8-5-3-2-4-7(8)9(11)12;1-10-4-9-6-5(10)7(13)12(3)8(14)11(6)2;1-6(10)9-7-2-4-8(11)5-3-7/h2-5H,1H3,(H,11,12);4H,1-3H3;2-5,11H,1H3,(H,9,10)

Adverse effects edit

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 edit

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

Society and culture edit

Brand names edit

The combination was first introduced as the name Triagesic in 1950 by Bristol-Myers,[citation needed] which is now Bristol Myers Squibb. The right to use the name Triagesic belongs to the Argentine company Roemmers,[5] though it is not produced anymore.[citation needed] In 1964 it was marketed under the trade name Vanquish by Sterling Drug,[citation needed] which after a series of mergers and acquisitions became a unit of Bayer AG.[6]

In the UK it is sold as Anadin Extra. In Germany, it is sold as dolomo, Dolopyrin AL, HA-Tabletten, Melabon K, Neuralgin, ratiopyrin, Thomapyrin Classic, Thomapyrin Intensiv,[7] in Austria as Thomapyrin, and InfluASS, in Israel as Acamol Focus, Paramol Target and Exidol, in Romania as Antinevralgic P [8] and Antinevralgic Forte,[9] and in Russia, Belarus and Eastern Europe as Citramon.[10]

References edit

  1. ^ a b "Acetaminophen, aspirin, and caffeine Uses, Side Effects & Warnings". 19 July 2022. Retrieved 12 July 2023.
  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. ^ Transformación en la industria farmacéutica argentina: del liderazgo de las empresas internacionales Big Pharma al dominio de las corporaciones locales de genéricos de marca (2003-2018)
  6. ^ 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.
  7. ^ "Rote Liste". Retrieved 2020-01-24.
  8. ^ "Antinevralgic P comprimate" (PDF). Agenția Natională a Medicamentului și a Dispozitivelor Medicale din România.
  9. ^ Blanaru C (26 June 2013). "The launch of Antinevralgic Forte – reinventing a traditional brand". Branding Business. AdHugger.
  10. ^ "International Drug Names". Retrieved 2020-01-24.