Generic Name: acetaminophen, aspirin, and caffeine (ah SEET a MIN oh fen, ASP i rin, and KAF een)Brand names: Anacin Advanced Headache Formula, Excedrin, Excedrin Express Gels, Excedrin Extra Strength, Excedrin Extra Strength Geltab, Excedrin Geltab, Excedrin Menstrual Express Gels, Excedrin Migraine, Excedrin Migraine Geltab, Genace, Goodys Extra Strength, Goodys Headache Powders, Pain Reliever Plus, Supac
Acetaminophen is a pain reliever and a fever reducer.
Aspirin is in a group of drugs called salicylates (sa-LIS-il-ates). It works by reducing substances in the body that cause pain, fever, and inflammation.
Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow.
The combination of acetaminophen, aspirin, and caffeine is used to treat pain caused by tension headaches, migraine headaches, muscle aches, menstrual cramps, arthritis, toothaches, the common cold, or nasal congestion.
Aspirin should be used for cardiovascular conditions only under the supervision of a doctor.
Acetaminophen, aspirin, and caffeine may also be used for other purposes not listed in this medication guide.
Do not use this medication without first talking to your doctor if you drink more than three alcoholic beverages per day or if you have had alcoholic liver disease (cirrhosis). You may not be able to use acetaminophen.
Ask a doctor or pharmacist about using acetaminophen, aspirin, and caffeine if you have asthma or seasonal allergies, fever with a stiff neck, a stomach ulcer or pain, heartburn, a bleeding or blood clotting disorder, diabetes, or gout.Do not use more of this medication than is recommended. An overdose of acetaminophen can cause serious harm. The maximum amount of acetaminophen for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day.
Stop using this medication and call your doctor at once if you have any symptoms of liver damage or bleeding in your stomach or intestines. Symptoms of liver damage include nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, and jaundice (yellowing of the skin or eyes). Symptoms of stomach bleeding include weakness or fainting, bloody or tarry stools, and coughing up blood or vomit that looks like coffee grounds.Avoid drinking alcohol while you are taking this medication. Alcohol may increase your risk of stomach bleeding while taking aspirin, or liver damage while taking acetaminophen. Do not use any other over-the-counter cough, cold, allergy, pain, menstrual symptom, or fever medication without first asking your doctor or pharmacist. Acetaminophen (sometimes abbreviated as "APAP"), aspirin, and caffeine are contained in many combination medicines. If you use certain products together you may accidentally use too much of a certain drug.
a recent history of stomach or intestinal bleeding;
asthma or severe allergic reaction caused by taking aspirin or an NSAID (non-steroidal anti-inflammatory drug), especially "aspirin triad syndrome"; or
if you are allergic to an NSAID such as Advil, Motrin, Aleve, Orudis, Indocin, Lodine, Voltaren, Toradol, Mobic, Relafen, Feldene, and others.
Ask a doctor or pharmacist if it is safe for you to take acetaminophen, aspirin, and caffeine if you have:
asthma or seasonal allergies;
fever with a stiff neck;
a stomach ulcer, heartburn, or stomach pain;
a bleeding or blood clotting disorder such as hemophilia;
If you take acetaminophen, aspirin, and caffeine to treat headache pain, seek medical attention if you have:
a headache so bad you have to lie down;
a headache that causes vomiting;
what feels like the worst headache you've ever had;
a headache that seems different from your usual headaches;
a headache every day;
a headache after coughing, bending, exercising, or head injury;
if you have never had migraines diagnosed by a doctor; or
if you are having your first headache after age 50.
Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger or smaller amounts, or use it for longer than recommended.Do not use more of this medication than is recommended. An overdose of acetaminophen can cause serious harm. The maximum amount for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. Using more acetaminophen could cause damage to your liver.
If you drink more than three alcoholic beverages per day, talk to your doctor before taking acetaminophen and never use more than 2 grams (2000 mg) per day.Take this medication with a full glass of water. Take the medicine with food or milk if it makes your stomach upset. Stop using acetaminophen, aspirin, and caffeine and call your doctor if your symptoms do not improve, or if they get worse while taking this medication.
Acetaminophen can cause false results with some urine glucose tests. Talk to your doctor if you are diabetic and you notice changes in your glucose levels while taking this medication.
If you need to have any type of surgery, tell the surgeon ahead of time that you are taking aspirin. You may need to stop using the medicine for a short time.Store acetaminophen, aspirin, and caffeine at room temperature away from heat and moisture.
See also: Acetaminophen, aspirin, and caffeine dosage in more detail
Since this medication is often used only when needed, you may not be on a dosing schedule. If you are using the medication regularly, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.
The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.
An overdose of acetaminophen, aspirin, and caffeine can also cause ringing in your ears, headache, diarrhea, dizziness, restlessness, hallucinations, fast or slow heart rate, or seizure (convulsions).
Avoid taking an NSAID such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others.Avoid coffee, tea, cola, energy drinks or other sources of caffeine while taking this medication. They can add to the side effects of the caffeine in the medication.
weakness or fainting;
black, bloody, or tarry stools;
coughing up blood or vomit that looks like coffee grounds;
severe nausea, vomiting, or stomach pain;
redness or swelling;
low fever with nausea, stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
fever lasting longer than 3 days;
pain lasting longer than 10 days; or
hearing problems, ringing in your ears.
Less serious side effects may include:
upset stomach, heartburn;
feeling nervous or excited; or
sleep problems (insomnia).
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Analgesic/Antipyretic:
Up to a total of 650 of acetaminophen and aspirin combined every 4-6 hours as needed.
Usual Adult Dose for Migraine:
500 mg acetaminophen, 500 mg aspirin, and 130 mg of caffeine in combination per day as needed.Maximum duration of migraine therapy: 48 hours
Tell your doctor if you are taking an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor). Taking any of these drugs with aspirin may cause you to bruise or bleed easily.
Before taking acetaminophen, aspirin, and caffeine, tell your doctor if you are using any of the following drugs:
a blood thinner such as warfarin (Coumadin);
salicylates such as aspirin, Backache Relief Extra Strength, Novasal, Nuprin Backache Caplet, Doan's Pills Extra Strength, Tricosal, and others; or
medication used to prevent blood clots, such as alteplase (Activase), clopidogrel (Plavix), dipyridamole (Persantine), ticlopidine (Ticlid), and urokinase (Abbokinase).
This list is not complete and there may be other drugs that can interact with acetaminophen, aspirin, and caffeine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.