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Combination of
Aspirin NSAID
Paracetamol Analgesic
Caffeine Stimulant
Clinical data
Trade names Excedrin, Vanquish, others
AHFS/ excedrin
Routes of
ATC code
Legal status
Legal status

Aspirin/paracetamol/caffeine is a combination drug for the treatment of pain, especially tension headache and migraine.[1] It is sold in the US under the trade name Excedrin, although not all products sold under this name contain this combination. It is sold as Anadin Extra in the UK.

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. 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.[2]

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.[3]

Other trade names[edit]

This combination was introduced in 1964 under the trade name Vanquish by Sterling Drug, which after a series of mergers and acquisitions became a unit of Bayer AG.

In Germany, it is sold as Chephapyrin, dolomo, Dolopyrin, HA-Tabletten N, Melabon, Neuralgin, Novo Petrin, ratiopyrin, Thomapyrin Classic, Thomapyrin Intensiv, Titralgan, in Austria as Thomapyrin, InfluASS, Irocophan, in Israel as Acamol Focus and in Russia as Citramon.


  1. ^ excedrin
  2. ^ Henrich, W; Lawrence E. Agodoa; Brendan Barrett; William M. Bennett; Roland C. Blantz; Vardaman M. Buckalew Jr; Vivette D. D'Agati; Marc E. DeBroe; Geoffrey G. Duggin; Garabed Eknoyan; Monique M. Elseviers; R.Ariel Gomez; Gary R. Matzke; George A. Porter; Sandra Sabatin; Jeffrey S. Stoff; Gary E. Striker; James F. Winchester (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: 162–165. doi:10.1016/S0272-6386(96)90046-3. 
  3. ^ 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.