Classes
DEA Class; OTC
Common Brand Names; Excedrin Tension Headache, Excedrin Aspirin Free, APAP-Plus
Analgesics, Other combo
Description
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
Indications
Indicated in Analgesia & Fever
Contraindications
Hypersensitivity
Hepatitis or severe hepatic/renal impairment
Adverse Effects
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)
Warnings
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 and Lactation
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
Maximum Dosage
1 capsule/tablet/geltab PO q4-6hr PRN
Pediatric
Safety & efficacy not established
How supplied
acetaminophen/caffeine
gel tab
500mg/65mg
tablet
500mg/65mg
caplet
500mg/65mg