Aspirin/paracetamol/caffeine

<h2 id="efficacy">Efficacy</h2>
All active treatments except caffeine differed significantly from <a href="/facts/Placebo/3fw50t53">placebo</a>, with superior efficacy of the <a href="/facts/Drug_synergy/lfcwWuAc">triple combination</a>; well tolerated; low incidence of adverse events.<a class="footnote-ref" id="fnref:3" href="#fn:3">3</a><a class="footnote-ref" id="fnref:4" href="#fn:4">4</a>

<h2 id="adverse-effects">Adverse effects</h2>
See also: <a href="/facts/Aspirin/opMK4qLk">Aspirin § Adverse effects</a>, <a href="/facts/Paracetamol/SNDfQWcf">Paracetamol § Adverse effects</a>, and <a href="/facts/Caffeine/Hx6E2QC5">Caffeine § Adverse effects</a>
The recommended dosing has a low risk profile when taken occasionally in a well hydrated state.<a class="footnote-ref" id="fnref:5" href="#fn:5">5</a> As with all medications containing <a href="/facts/Paracetamol/SNDfQWcf">paracetamol</a> (acetaminophen), concomitant use with <a href="/facts/Alcohol_(drug)/IeK2fVd5">alcohol</a> carries a significant risk of <a href="/facts/Hepatotoxicity/xbLcKPNG">hepatotoxicity</a>.<a class="footnote-ref" id="fnref:6" href="#fn:6">6</a> The combination of paracetamol with <a href="/facts/Aspirin/opMK4qLk">aspirin</a> also creates the risk of <a href="/facts/Renal_papillary_necrosis/0DJtM2Y6">renal papillary necrosis</a> 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 <a href="/facts/Glutathione/5bSxjusL">glutathione</a> stores necessary to oxidize it. Additionally, chronic aspirin usage is associated with increased risk of gastrointestinal bleeding.<a class="footnote-ref" id="fnref:7" href="#fn:7">7</a>

<h2 id="chemical-detection">Chemical detection</h2>
The combination of these three compounds can be detected in pharmaceutical formulations, urine and blood serum in trace quantities using <a href="/facts/Electrochemical/C0RUWpBH">electrochemical</a> methods.<a class="footnote-ref" id="fnref:8" href="#fn:8">8</a>

<h2 id="society-and-culture">Society and culture</h2>
<h3>Brand names</h3>
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 now <a href="/facts/Bristol_Myers_Squibb/HK47xMNF">Bristol Myers Squibb</a>, but was recalled in the following year due to several reports that the drug might cause blood <a href="/facts/Dyscrasia/fDQCus30">dyscrasia</a>.<a class="footnote-ref" id="fnref:9" href="#fn:9">9</a> In 1964 it was marketed under the trade name Vanquish by <a href="/facts/Sterling_Drug/Xq8YbRPj">Sterling Drug</a>, which after a series of mergers and acquisitions became a unit of <a href="/facts/Bayer_AG/fnYepBcG">Bayer AG</a>.<a class="footnote-ref" id="fnref:10" href="#fn:10">10</a>
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,<a class="footnote-ref" id="fnref:11" href="#fn:11">11</a> in Austria as Thomapyrin, and InfluASS, in Israel as Acamol Focus, Paramol Target and Exidol, in Romania as Antinevralgic P <a class="footnote-ref" id="fnref:12" href="#fn:12">12</a> and Antinevralgic Forte,<a class="footnote-ref" id="fnref:13" href="#fn:13">13</a> and in Russia, Belarus and Eastern Europe as Citramon.<a class="footnote-ref" id="fnref:14" href="#fn:14">14</a>
In South Africa and neighbouring countries, it is known as Grand-Pa, and is most commonly sold as a powder<a class="footnote-ref" id="fnref:15" href="#fn:15">15</a>

<h2 id="references">References</h2>

<ol>
<li id="fn:1">"Acetaminophen, aspirin, and caffeine Uses, Side Effects & Warnings". Drugs.com. 19 July 2022. Retrieved 12 July 2023. <a href="https://www.drugs.com/mtm/acetaminophen-aspirin-and-caffeine.html" target="_blank">https://www.drugs.com/mtm/acetaminophen-aspirin-and-caffeine.html</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></li>
<li id="fn:2">"Acetaminophen, aspirin, and caffeine Uses, Side Effects & Warnings". Drugs.com. 19 July 2022. Retrieved 12 July 2023. <a href="https://www.drugs.com/mtm/acetaminophen-aspirin-and-caffeine.html" target="_blank">https://www.drugs.com/mtm/acetaminophen-aspirin-and-caffeine.html</a> <a href="#fnref:2" class="footnote-back-ref">↩</a></li>
<li id="fn:3">"The fixed combination of acetylsalicylic acid, paracetamol and caffeine is more effective than single substances and dual combination for the treatment of headache: a multicentre, randomized, double-blind, single-dose, placebo-controlled parallel group study - PubMed". web.archive.org. 2025-04-21. Retrieved 2025-04-21. <a href="https://web.archive.org/web/20250421083606/https://pubmed.ncbi.nlm.nih.gov/16162254/" target="_blank">https://web.archive.org/web/20250421083606/https://pubmed.ncbi.nlm.nih.gov/16162254/</a> <a href="#fnref:3" class="footnote-back-ref">↩</a></li>
<li id="fn:4">"The efficacy and tolerability of a fixed combination of acetylsalicylic acid, paracetamol, and caffeine in patients with severe headache: a post-hoc subgroup analysis from a multicentre, randomized, double-blind, single-dose, placebo-controlled parallel group study - PubMed". web.archive.org. 2025-04-21. Retrieved 2025-04-21. <a href="https://web.archive.org/web/20250421083743/https://pubmed.ncbi.nlm.nih.gov/21908446/" target="_blank">https://web.archive.org/web/20250421083743/https://pubmed.ncbi.nlm.nih.gov/21908446/</a> <a href="#fnref:4" class="footnote-back-ref">↩</a></li>
<li id="fn:5">"The fixed combination of acetylsalicylic acid, paracetamol and caffeine is more effective than single substances and dual combination for the treatment of headache: a multicentre, randomized, double-blind, single-dose, placebo-controlled parallel group study - PubMed". web.archive.org. 2025-04-21. Retrieved 2025-04-21. <a href="https://web.archive.org/web/20250421083606/https://pubmed.ncbi.nlm.nih.gov/16162254/" target="_blank">https://web.archive.org/web/20250421083606/https://pubmed.ncbi.nlm.nih.gov/16162254/</a> <a href="#fnref:5" class="footnote-back-ref">↩</a></li>
<li id="fn:6">Haberfeld H, ed. (2019). Austria-Codex (in German). Vienna: Österreichischer Apothekerverlag. Thomapyrin-Tabletten. <a href="#fnref:6" class="footnote-back-ref">↩</a></li>
<li id="fn:7">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. <a href="http://www.ajkd.org/article/S0272-6386%2896%2990046-3/abstractref" target="_blank">http://www.ajkd.org/article/S0272-6386%2896%2990046-3/abstractref</a> <a href="#fnref:7" class="footnote-back-ref">↩</a></li>
<li id="fn:8">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): 8638–8648. doi:10.1016/j.electacta.2010.07.093. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:8" class="footnote-back-ref">↩</a></li>
<li id="fn:9">Spooner, J. B., & Harvey, J. G. (1976). The history and usage of paracetamol. Journal of International Medical Research, 4(4_suppl), 1-6. <a href="#fnref:9" class="footnote-back-ref">↩</a></li>
<li id="fn:10">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. <a href="https://www.latimes.com/archives/la-xpm-1994-09-13-fi-38019-story.html" target="_blank">https://www.latimes.com/archives/la-xpm-1994-09-13-fi-38019-story.html</a> <a href="#fnref:10" class="footnote-back-ref">↩</a></li>
<li id="fn:11">"Rote Liste". Retrieved 2020-01-24. <a href="https://www.rote-liste.de/" target="_blank">https://www.rote-liste.de/</a> <a href="#fnref:11" class="footnote-back-ref">↩</a></li>
<li id="fn:12">"Antinevralgic P comprimate" (PDF). Agenția Natională a Medicamentului și a Dispozitivelor Medicale din România. <a href="https://www.anm.ro/_/_PRO/pro_5499_14.07.05.pdf" target="_blank">https://www.anm.ro/_/_PRO/pro_5499_14.07.05.pdf</a> <a href="#fnref:12" class="footnote-back-ref">↩</a></li>
<li id="fn:13">Blanaru C (26 June 2013). "The launch of Antinevralgic Forte – reinventing a traditional brand". Branding Business. AdHugger. <a href="https://www.adhugger.net/2013/06/26/the-launch-of-antinevralgic-forte-reinventing-a-traditional-brand/" target="_blank">https://www.adhugger.net/2013/06/26/the-launch-of-antinevralgic-forte-reinventing-a-traditional-brand/</a> <a href="#fnref:13" class="footnote-back-ref">↩</a></li>
<li id="fn:14">"International Drug Names". Drugs.com. Retrieved 2020-01-24. <a href="https://www.drugs.com/international/" target="_blank">https://www.drugs.com/international/</a> <a href="#fnref:14" class="footnote-back-ref">↩</a></li>
<li id="fn:15">"Products". <a href="https://www.grand-pa.co.za/products/" target="_blank">https://www.grand-pa.co.za/products/</a> <a href="#fnref:15" class="footnote-back-ref">↩</a></li>
</ol>

Aspirin/paracetamol/caffeine open-in-new

Aspirin/paracetamol/caffeine