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Paracetamol/Caffeine

    DEA Class;  OTC

    Common Brand Names; Excedrin Tension Headache, Excedrin Aspirin Free, APAP-Plus

    Analgesics, Other combo

    Acetaminophen: Acetaminophen: Inhibitis prostaglandin sythesis in CNS and may block peripheral pain impulse generation; acts on hypothalamus to antipyresis

    Caffeine: Vasoconstrictive properties may be helpful when treating vascular headaches

    Indicated in Analgesia & Fever

    Hypersensitivity

    Hepatitis or severe hepatic/renal impairment

    Acetaminophen

    Pruritic maculopapular rash

    Urticaria

    Laryngeal edema

    Angioedema

    Anaphylactoid reaction

    Thrombocytopenia

    Leukopenia

    Pancytopenia

    Neutropenia

    Thrombocytopenic purpura

    Agranulocytosis

    Hepatotoxicity

    May increase uric acid, chloride, glucose

    May decrease sodium, calcium, bicarbonate

    Caffeine

    Insomnia

    Restlessness

    Nervousness

    Tremor

    Tinnitus

    Irritability

    Nausea

    Vomiting

    Diarrhea

    Tachycardia

    Diuresis

    Palpitations (dose dependent)

    Discontinue use and ask a healthcare professional if any new symptoms occur, painful area is red or swollen, pain gets worse or lasts for more than 10 days, fever gets worse or lasts for more than 3 days

    Pregnancy

    Acetaminophen

    Drug crosses placenta and can be detected in cord blood, newborn serum, and urine immediately after delivery

    Increased risk of teratogenic effects not reported following maternal use of drug during pregnancy

    Use of normal doses during pregnancy not associated with increased risk of miscarriage or stillbirth; however, increase in fetal death or spontaneous abortion may be seen with maternal overdose if treatment delayed

    Wheezing and asthma in early childhood associated with frequent maternal use of drug during pregnancy

    Caffeine

    Caffeine crosses placenta; serum concentration in fetus are similar to that of the mother; dietary exposure unlikely to cause congenital malformations; unknown whether it may increase risk of other adverse events, including abortion or growth retardation

    Current maternal consumption of high amounts of caffeine during pregnancy may lead to neonatal withdrawal at delivery; current guidelines recommend limiting caffeine intake from all sources to <200 mg/day during pregnancy

    Lactation

    Acetaminophen

    Drug is excreted in milk; in general, breastfeeding is generally acceptable if relative infant dose (RID) is <10%; avoid breastfeeding when RID>25%

    Caffeine

    Caffeine and metabolites are present in breast milk; moderate amounts of caffeine are considered acceptable with breastfeeding; ingestion of <300 mg/day recommended; use caution if breastfeeding premature infants, or infants small for gestational age, or consuming unusually high amounts of caffeine

    Adults

    1 capsule/tablet/geltab PO q4-6hr PRN

    Pediatric

    Safety & efficacy not established

    acetaminophen/caffeine

    gel tab

    • 500mg/65mg

    tablet

    • 500mg/65mg

    caplet

    • 500mg/65mg