Consists of caffeine anhydrous, Paracetamol, phenylephrine HCl
What is Caffeine anhydrous?
Caffeine anhydrous is a central nervous system stimulant. It works by stimulating the brain. Caffeine anhydrous is found naturally in foods and beverages such as coffee, tea, colas, energy and chocolate. Botanical sources of Caffeine anhydrous include kola nuts, guarana, and yerba mate. Caffeine anhydrous is also available in prescription and non-prescription medications.
Caffeine anhydrous is used to restore mental alertness or wakefulness during fatigue or drowsiness. Caffeine anhydrous is also found in some headache and migraine medications, in certain dietary supplements used for weight loss, and in many popular energy drinks.
Caffeine anhydrous citrate (Cafcit) is available by prescription only. It is used for short-term treatment of neonatal apnea (breathing problems).
Caffeine anhydrous may also be used for other conditions as determined by your health care provider.
Caffeine anhydrous indications
Caffeine anhydrous and Sodium Benzoate Injection has been used in conjunction with supportive measure to treat respiratory depression associated with overdosage with CNS depressant drugs (e.g., narcotic analgesics, alcohol). However, because of questionable benefit and transient action, most authorities believe Caffeine anhydrous and other analeptics should not be used in these conditions and recommend other supportive therapy.
How should I use Caffeine anhydrous?
Use Caffeine anhydrous as directed by your health care provider. If the medication is OTC, check the label on the bottle for the exact dosing instructions. If you have any questions about the use of an OTC medication, ask your pharmacist.
- Caffeine anhydrous may be taken with or without food. If Caffeine anhydrous upsets your stomach, take it with food.
- Do not exceed the recommended dose of Caffeine anhydrous. Caffeine anhydrous can be habit-forming.
- Most OTC medications used for mental alertness contain 200 milligrams of Caffeine anhydrous per tablet or capsule. The usual maximum recommended dose of OTC Caffeine anhydrous is no more than 200 mg every 3-4 hours, or 1600 mg per day.
- Do not double-up on your Caffeine anhydrous dose if you should miss the time for next dose.
- The average cup of coffee contains 150-200 milligrams (mg) of Caffeine anhydrous per cup, while a cup of tea will have about 60 mg of Caffeine anhydrous. Cola products have about 30-40 mg of Caffeine anhydrous, and most energy drinks have about 60-70 mg. Be sure to account for any dietary Caffeine anhydrous that is consumed.
Ask your health care provider any questions you may have about how to use Caffeine anhydrous.
Uses of Caffeine anhydrous in details
Use: Labeled Indications
Caffeine anhydrous citrate: Treatment of idiopathic apnea of prematurity
Caffeine anhydrous and sodium benzoate: See Off-Label uses.
Caffeine anhydrous [OTC labeling]: Restore mental alertness or wakefulness when experiencing fatigue
Off Label Uses
Augmentation of seizure induction during electroconvulsive therapy (Caffeine anhydrous and sodium benzoate)
Data from a randomized, double blind study as well as a few unblinded studies support the use of Caffeine anhydrous/sodium benzoate in the treatment of augmentation of seizure induction during electroconvulsive therapy (ECT).
Caffeine anhydrous description
A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine anhydrous's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of Caffeine anhydrous have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [PubChem]
Caffeine anhydrous dosage
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Injection, solution, as citrate [preservative free]:
Cafcit: 60 mg/3 mL (3 mL) [equivalent to 10 mg/mL Caffeine anhydrous base]
Generic: 60 mg/3 mL (3 mL) [equivalent to 10 mg/mL Caffeine anhydrous base]
Injection, solution [with sodium benzoate]:
Generic: Caffeine anhydrous 125 mg/mL and sodium benzoate 125 mg/mL (2 mL)
Solution, oral, as citrate [preservative free]:
Cafcit: 60 mg/3 mL (3 mL) [equivalent to 10 mg/mL Caffeine anhydrous base] [DSC]
Generic: 60 mg/3 mL (3 mL) [equivalent to 10 mg/mL Caffeine anhydrous base]
Tablet, oral:
Keep Caffeine anhydrous: 200 mg
NoDoz Maximum Strength: 200 mg [DSC]
Stay Awake: 200 mg
Stay Awake Maximum Strength: 200 mg
Vivarin: 200 mg
Generic: 200 mg
Dosing: Adult
Note: Caffeine anhydrous citrate should not be interchanged with the Caffeine anhydrous sodium benzoate formulation. Dosing presented as the combination of Caffeine anhydrous and sodium benzoate unless otherwise noted (Caffeine anhydrous base amount is 50% of the Caffeine anhydrous and sodium benzoate combination).
Augmentation of seizure induction during electroconvulsive therapy (ECT) (off-label use): IV: Initial: 500 to 1,000 mg Caffeine anhydrous and sodium benzoate (equivalent to 250 to 500 mg Caffeine anhydrous base); if necessary during subsequent ECT sessions, may titrate dose up or down in increments of 250 to 500 mg Caffeine anhydrous and sodium benzoate (equivalent to 125 to 250 mg Caffeine anhydrous base); a maximum dose of 2,000 mg Caffeine anhydrous and sodium benzoate (equivalent to 1,000 mg Caffeine anhydrous base) during an ECT session has been reported (Coffey 1987; Hinkle 1987; McCall 1993; Shapira 1987).
Postdural puncture headache (off-label use):
IV: 500 mg Caffeine anhydrous and sodium benzoate (equivalent to 250 mg Caffeine anhydrous base) in 1,000 mL NS infused over 1 hour, followed by 1,000 mL NS infused over 2 hours; after 4 hours, a second course of Caffeine anhydrous can be given for unrelieved headache pain (Choi 1996; Jarvis 1986; Yucel 1999).
Oral: 300 mg (Caffeine anhydrous base) as a single dose (Camann 1990)
Reversal of dipyridamole- or regadenoson-induced adverse reactions (eg, angina, hypotension) during nuclear cardiac stress testing (alternative agent) (off-label use): Caffeine anhydrous citrate: IV: 60 mg (diluted in 25 mL of D5W) over 3 to 5 minutes (Doran 2017; Singleton 2018)
Stimulant: OTC labeling:
Oral: 100 to 200 mg (Caffeine anhydrous base) every 3 to 4 hours as needed
Dosing: Geriatric
Refer to adult dosing.
Dosing: Pediatric
Note: Caffeine anhydrous citrate should not be interchanged with the Caffeine anhydrous sodium benzoate formulation. Caffeine anhydrous and sodium benzoate dosing presented as the combination (Caffeine anhydrous base amount is 50% of the Caffeine anhydrous and sodium benzoate combination).
Stimulant: OTC labeling: Caffeine anhydrous (base): Children ≥12 years and Adolescents:
Oral: 100 to 200 mg every 3 to 4 hours as needed
Caffeine anhydrous interactions
See also:
What other drugs will affect Caffeine anhydrous?
Acebrophylline: May enhance the stimulatory effect of CNS Stimulants. Avoid combination
Adenosine: Caffeine anhydrous and Caffeine anhydrous Containing Products may diminish the therapeutic effect of Adenosine. Management: Monitor for decreased effect of adenosine if patient is receiving Caffeine anhydrous. Discontinue Caffeine anhydrous in advance of scheduled diagnostic use of adenosine whenever possible. Consider therapy modification
Amifampridine: Agents With Seizure Threshold Lowering Potential may enhance the neuroexcitatory and/or seizure-potentiating effect of Amifampridine. Monitor therapy
AtoMOXetine: May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. Monitor therapy
Broccoli: May decrease the serum concentration of CYP1A2 Substrates (High risk with Inducers). Monitor therapy
Bromperidol: Caffeine anhydrous and Caffeine anhydrous Containing Products may decrease the absorption of Bromperidol. Monitor therapy
BuPROPion: May enhance the neuroexcitatory and/or seizure-potentiating effect of Agents With Seizure Threshold Lowering Potential. Monitor therapy
Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Exceptions: Cannabidiol. Monitor therapy
Cannabis: May decrease the serum concentration of CYP1A2 Substrates (High risk with Inducers). Monitor therapy
CloZAPine: CYP1A2 Inhibitors (Weak) may increase the serum concentration of CloZAPine. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Monitor therapy
Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Consider therapy modification
CYP1A2 Inducers (Moderate): May decrease the serum concentration of Caffeine anhydrous and Caffeine anhydrous Containing Products. Monitor therapy
CYP1A2 Inhibitors (Moderate): May increase the serum concentration of Caffeine anhydrous and Caffeine anhydrous Containing Products. Monitor therapy
CYP1A2 Inhibitors (Strong): May increase the serum concentration of Caffeine anhydrous and Caffeine anhydrous Containing Products. Monitor therapy
Doxofylline: Caffeine anhydrous and Caffeine anhydrous Containing Products may enhance the adverse/toxic effect of Doxofylline. Avoid combination
Esketamine: May enhance the hypertensive effect of CNS Stimulants. Monitor therapy
Formoterol: Caffeine anhydrous and Caffeine anhydrous Containing Products may enhance the adverse/toxic effect of Formoterol. Caffeine anhydrous and Caffeine anhydrous Containing Products may enhance the hypokalemic effect of Formoterol. Monitor therapy
Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Monitor therapy
Indacaterol: Caffeine anhydrous and Caffeine anhydrous Containing Products may enhance the adverse/toxic effect of Indacaterol. Caffeine anhydrous and Caffeine anhydrous Containing Products may enhance the hypokalemic effect of Indacaterol. Monitor therapy
Iohexol: Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iohexol. Specifically, the risk for seizures may be increased. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iohexol. Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic anticonvulsants. Consider therapy modification
Iomeprol: Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iomeprol. Specifically, the risk for seizures may be increased. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iomeprol. Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic anticonvulsants. Consider therapy modification
Iopamidol: Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iopamidol. Specifically, the risk for seizures may be increased. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iopamidol. Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic anticonvulsants. Consider therapy modification
Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. Consider therapy modification
Lithium: Caffeine anhydrous and Caffeine anhydrous Containing Products may decrease the serum concentration of Lithium. Monitor therapy
Norfloxacin: May increase the serum concentration of Caffeine anhydrous and Caffeine anhydrous Containing Products. Monitor therapy
Olodaterol: Caffeine anhydrous and Caffeine anhydrous Containing Products may enhance the adverse/toxic effect of Olodaterol. Caffeine anhydrous and Caffeine anhydrous Containing Products may enhance the hypokalemic effect of Olodaterol. Monitor therapy
Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Management: Concomitant use of ozanimod with sympathomimetic agents is not recommended. If combined, monitor patients closely for the development of hypertension, including hypertensive crises. Consider therapy modification
Pipemidic Acid: May increase the serum concentration of Caffeine anhydrous and Caffeine anhydrous Containing Products. Monitor therapy
Regadenoson: Caffeine anhydrous and Caffeine anhydrous Containing Products may diminish the vasodilatory effect of Regadenoson. Management: Avoiding using Caffeine anhydrous or other methylxanthine containing products (e.g., theophylline) for at least 12 hours prior to the administration of regadenoson. Consider therapy modification
Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Monitor therapy
Solriamfetol: CNS Stimulants may enhance the hypertensive effect of Solriamfetol. CNS Stimulants may enhance the tachycardic effect of Solriamfetol. Monitor therapy
Stiripentol: May increase the serum concentration of Caffeine anhydrous and Caffeine anhydrous Containing Products. Avoid combination
Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Monitor therapy
Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Monitor therapy
Theophylline Derivatives: CYP1A2 Inhibitors (Weak) may increase the serum concentration of Theophylline Derivatives. Exceptions: Dyphylline. Monitor therapy
TiZANidine: CYP1A2 Inhibitors (Weak) may increase the serum concentration of TiZANidine. Management: Avoid these combinations when possible. If combined use is necessary, initiate tizanidine at an adult dose of 2 mg and increase in 2 to 4 mg increments based on patient response. Monitor for increased effects of tizanidine, including adverse reactions. Consider therapy modification
Tobacco (Smoked): May decrease the serum concentration of Caffeine anhydrous and Caffeine anhydrous Containing Products. Monitor therapy
Caffeine anhydrous side effects
See also:
What are the possible side effects of Caffeine anhydrous?
Overall, the reported number of adverse events in the double-blind period of the controlled trial was similar for the Caffeine anhydrous citrate and placebo groups. The following table shows adverse events that occurred in the double-blind period of the controlled trial and that were more frequent in Caffeine anhydrous citrate treated patients than placebo.
| Adverse Event (AE) | Caffeine anhydrous Citrate N=46 n(%) | Placebo N=39 n(%) |
| BODY AS A WHOLE Accidental Injury Feeding Intolerance Sepsis | 1 (2.2) 4 (8.7) 2 (4.3) | 0 (0.0) 2 (5.1) 0 (0.0) |
| CARDIOVASCULAR SYSTEM Hemorrhage | 1 (2.2) | 0 (0.0) |
| DIGESTIVE SYSTEM Necrotizing Enterocolitis Gastritis Gastrointestinal Hemorrhage | 2 (4.3) 1 (2.2) 1 (2.2) | 1 (2.6) 0 (0.0) 0 (0.0) |
| HEMIC AND LYMPHATIC SYSTEM Disseminated Intravascular Coagulation | 1 (2.2) | 0 (0.0) |
| METABOLIC AND NUTRITIVE DISORDERS Acidosis Healing Abnormal | 1 (2.2) 1 (2.2) | 0 (0.0) 0 (0.0) |
| NERVOUS SYSTEM Cerebral Hemorrhage | 1 (2.2) | 0 (0.0) |
| RESPIRATORY SYSTEM Dyspnea Lung Edema | 1 (2.2) 1 (2.2) | 0 (0.0) 0 (0.0) |
| SKIN AND APPENDAGES Dry Skin Rash Skin Breakdown | 1 (2.2) 4 (8.7) 1 (2.2) | 0 (0.0) 3 (7.7) 0 (0.0) |
| SPECIAL SENSES Retinopathy of Prematurity | 1 (2.2) | 0 (0.0) |
| UROGENITAL SYSTEM Kidney Failure | 1 (2.2) | 0 (0.0) |
In addition to the cases above, three cases of necrotizing enterocolitis were diagnosed in patients receiving Caffeine anhydrous citrate during the open-label phase of the study.
Three of the infants who developed necrotizing enterocolitis during the trial died. All had been exposed to Caffeine anhydrous. Two were randomized to Caffeine anhydrous, and one placebo patient was “rescued” with open-label Caffeine anhydrous for uncontrolled apnea.
Adverse events described in the published literature include: central nervous system stimulation (i.e., irritability, restlessness, jitteriness), cardiovascular effects (i.e., tachycardia, increased left ventricular output, and increased stroke volume), gastrointestinal effects (i.e., increased gastric aspirate, gastrointestinal intolerance), alterations in serum glucose (hypoglycemia and hyperglycemia) and renal effects (increased urine flow rate, increased creatinine clearance, and increased sodium and calcium excretion). Published long-term follow-up studies have not shown Caffeine anhydrous to adversely affect neurological development or growth parameters.
Caffeine anhydrous contraindications
See also:
What is the most important information I should know about Caffeine anhydrous?
Caffeine anhydrous citrate injection and Caffeine anhydrous Citrate
Oral Solution are contraindicated in patients who have demonstrated hypersensitivity to any of its components.
What is Paracetamol?
Paracetamol (acetaminophen) is a pain reliever and a fever reducer. The exact mechanism of Paracetamol of is not known.
Paracetamol is used to treat many conditions such as headache, muscle aches, arthritis, backache, toothaches, colds, and fevers. It relieves pain in mild arthritis but has no effect on the underlying inflammation and swelling of the joint.
Paracetamol may also be used for other purposes not listed in this medication guide.
Paracetamol indications
For systemic use of Paracetamol Sante Naturelle: prevention and treatment of hypo- and avitaminosis of vitamin C; providing increased need for vitamin C during growth, pregnancy, lactation, with heavy loads, fatigue and during recovery after prolonged severe illness; in winter with an increased risk of infectious diseases.
For intravaginal use: chronic or recurrent vaginitis (bacterial vaginosis, nonspecific vaginitis) caused by the anaerobic flora (due to changes in pH of the vagina) in order to normalize disturbed vaginal microflora.
How should I use Paracetamol?
Use paracetamol exactly as directed on the label, or as prescribed by your doctor.
Do not use more of this medication than is recommended. An overdose of paracetamol 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 paracetamol could cause damage to your liver. If you drink more than three alcoholic beverages per day, talk to your doctor before taking paracetamol and never use more than 2 grams (2000 mg) per day. If you are treating a child, use a pediatric form of paracetamol. Carefully follow the dosing directions on the medicine label. Do not give the medication to a child younger than 2 years old without the advice of a doctor.
Measure the liquid form of paracetamol with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. You may need to shake the liquid before each use. Follow the directions on the medicine label.
The paracetamol chewable tablet must be chewed thoroughly before you swallow it.
Make sure your hands are dry when handling the paracetamol disintegrating tablet. Place the tablet on your tongue. It will begin to dissolve right away. Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.
To use the paracetamol effervescent granules, dissolve one packet of the granules in at least 4 ounces of water. Stir this mixture and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.
Do not take a paracetamol rectal suppository by mouth. It is for use only in your rectum. Wash your hands before and after inserting the suppository.
Try to empty your bowel and bladder just before using the paracetamol suppository. Remove the outer wrapper from the suppository before inserting it. Avoid handling the suppository too long or it will melt in your hands.
For best results from the suppository, lie down and insert the suppository pointed tip first into the rectum. Hold in the suppository for a few minutes. It will melt quickly once inserted and you should feel little or no discomfort while holding it in. Avoid using the bathroom just after inserting the suppository.
Stop using paracetamol and call your doctor if:
-
you still have a fever after 3 days of use;
-
you still have pain after 7 days of use (or 5 days if treating a child);
-
you have a skin rash, ongoing headache, or any redness or swelling; or
-
if your symptoms get worse, or if you have any new symptoms.
Urine glucose tests may produce false results while you are taking paracetamol. Talk to your doctor if you are diabetic and you notice changes in your glucose levels during treatment.
Store paracetamol at room temperature away from heat and moisture. The rectal suppositories can be stored at room temperature or in the refrigerator.
Uses of Paracetamol in details
This drug is used to treat mild to moderate pain (from headaches, menstrual periods, toothaches, backaches, osteoarthritis, or cold/flu aches and pains) and to reduce fever.
How to use Paracetamol
Take this product by mouth as directed. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist.
There are many brands and forms of acetaminophen available. Read the dosing instructions carefully for each product because the amount of acetaminophen may be different between products. Do not take more acetaminophen than recommended.
If you are giving acetaminophen to a child, be sure you use a product that is meant for children. Use your child's weight to find the right dose on the product package. If you don't know your child's weight, you can use their age.
For suspensions, shake the medication well before each dose. Some liquids do not need to be shaken before use. Follow all directions on the product package. Measure the liquid medication with the provided dose-measuring spoon/dropper/syringe to make sure you have the correct dose. Do not use a household spoon.
For rapidly-dissolving tablets, chew or allow to dissolve on the tongue, then swallow with or without water. For chewable tablets, chew thoroughly before swallowing.
Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.
For effervescent tablets, dissolve the dose in the recommended amount of water, then drink.
Pain medications work best if they are used as the first signs of pain occur. If you wait until the symptoms have worsened, the medication may not work as well.
Do not take this medication for fever for more than 3 days unless directed by your doctor. For adults, do not take this product for pain for more than 10 days (5 days in children) unless directed by your doctor. If the child has a sore throat (especially with high fever, headache, or nausea/vomiting), consult the doctor promptly.
Tell your doctor if your condition persists or worsens or if you develop new symptoms. If you think you may have a serious medical problem, get medical help right away.
Paracetamol description
Paracetamol is an organic compound that consists of a six-membered ring containing two opposing nitrogen atoms. Paracetamol exists as small alkaline deliquescent crystals with a saline tasteacinol was introduced to medicine as a solvent for uric acid. When taken into the body the drug is partly oxidized and partly eliminated unchanged. Outside the body, piperazine has a remarkable power to dissolve uric acid and producing a soluble urate, but in clinical experience it has not proved equally successfulacinol was first introduced as an anthelmintic in 1953. A large number of piperazine compounds have anthelmintic Paracetamol. Their mode of Paracetamol is generally by paralysing parasites, which allows the host body to easily remove or expel the invading organism.
Paracetamol dosage
Usual Adult Paracetamol Dose for Fever:
General Dosing Guidelines: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours orally or rectally.
Paracetamol 500mg tablets: Two 500 mg tablets orally every 4 to 6 hours
Usual Adult Paracetamol Dose for Pain:
General Dosing Guidelines: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours orally or rectally.
Paracetamol 500mg tablets: Two 500 mg tablets orally every 4 to 6 hours
Usual Pediatric Dose for Fever:
Oral or Rectal:
<=1 month: 10 to 15 mg/kg/dose every 6 to 8 hours as needed.
>1 month to 12 years: 10 to 15 mg/kg/dose every 4 to 6 hours as needed (Maximum: 5 doses in 24 hours)
Fever: 4 months to 9 years: Initial Dose: 30 mg/kg (Reported by one study (n=121) to be more effective in reducing fever than a 15 mg/kg maintenance dose with no difference regarding clinical tolerance.)
>=12 years: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours.
Usual Pediatric Dose for Pain:
Oral or Rectal:
<=1 month: 10 to 15 mg/kg/dose every 6 to 8 hours as needed.
>1 month to 12 years: 10 to 15 mg/kg/dose every 4 to 6 hours as needed (Maximum: 5 doses in 24 hours)
Fever: 4 months to 9 years: Initial Dose: 30 mg/kg (Reported by one study (n=121) to be more effective in reducing fever than a 15 mg/kg maintenance dose with no difference regarding clinical tolerance.)
>=12 years: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours.
Paracetamol interactions
See also:
What other drugs will affect Paracetamol?
With the simultaneous use with inducers of microsomal liver enzymes, means having hepatotoxic effect, increasing the risk of hepatotoxic Paracetamol of paracetamol.
With the simultaneous use of anticoagulants may be slight to moderate increase in prothrombin time.
With the simultaneous use of anticholinergics may decrease absorption of paracetamol.
With the simultaneous use of oral contraceptives accelerated excretion of paracetamol from the body and may reduce its analgesic Paracetamol.
With the simultaneous use with urological means reduced their effectiveness.
With the simultaneous use of activated charcoal reduced bioavailability of paracetamol.
When Paracetamol applied simultaneously with diazepam may decrease excretion of diazepam.
There have been reports about the possibility of enhancing mielodepression effect of zidovudine while applying with paracetamol. A case of severe toxic liver injury.
Described cases of toxic effects of paracetamol, while the use of isoniazid.
When applied simultaneously with carbamazepine, phenytoin, phenobarbital, primidonom decreases the effectiveness of paracetamol, which is caused by an increase in its metabolism and excretion from the body. Cases of hepatotoxicity, while the use of paracetamol and phenobarbital.
In applying cholestyramine a period of less than 1 h after administration of paracetamol may decrease of its absorption.
At simultaneous application with lamotrigine moderately increased excretion of lamotrigine from the body.
With the simultaneous use of metoclopramide may increase absorption of paracetamol and its increased concentration in blood plasma.
When applied simultaneously with probenecid may decrease clearance of paracetamol, with rifampicin, sulfinpyrazone - may increase clearance of paracetamol due to increasing its metabolism in the liver.
At simultaneous application of Paracetamol with ethinylestradiol increases absorption of paracetamol from the gut.
Enhances the effect of indirect anticoagulants (coumarin derivatives and indandione). Antipyretic and analgesic activity of Paracetamol increases, reduce - rifampicin, phenobarbital and alcohol (accelerated biotransformation, inducing microsomal liver enzymes).
Paracetamol side effects
See also:
What are the possible side effects of Paracetamol?
Effects due to the presence of acetylsalicylic acid.
Accidents awareness with respiratory or skin reactions (angioedema, urticaria, asthma, anaphylactic shock);
Cross hypersensitivity reactions with NSAIDs and with tartrazine;
At low doses recommended for the use of Paracetamol, side effects of aspirin are generally limited to some irritation of the gastro-intestinal tract.
At higher doses, side effects include gastrointestinal mucosal erosions, gastric ulcer or duodenal ulcer, occult blood loss, melena.
Acetylsalicylic acid may also increase the tendency to bleeding and bleeding time (the lengthening of bleeding continues 4-6 days after stopping the drug).
It may also worsen renal function including cases of pre-existing condition (the long-term use can cause chronic kidney disease).
The signs of salicylic overdose described under.
Effects due to the presence of paracetamol.
At the doses and duration of recommended treatment, side effects are usually negligible, but the prolonged use of paracetamol in therapeutic doses large (2-4 g per day, or 10-20 tablets Paracetamol) may cause the appearance chronic hepatitis. This justifies the recommendations of caution especially in patients with liver disease prior.
Very rarely, it can produce thrombocytopenia.
The acute liver toxicity in overdose massive (doses greater than 8 g of paracetamol) is described in paragraph overdose.
Paracetamol contraindications
See also:
What is the most important information I should know about Paracetamol?
Paracetamol should not be used in patients who have previously exhibited hypersensitivity to aspirin and/or nonsteroidal antiinflammatory agents. Paracetamol should not be given to patients with a recent history of gastrointestinal bleeding or in patients with bleeding disorders (e.g., hemophilia).
What is Phenylephrine HCl?
Phenylephrine HCl (Phenylephrine HCl) is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).
Phenylephrine HCl is used to treat nasal and sinus congestion, or congestion of the tubes that drain fluid from your inner ears, called the eustachian (yoo-STAY-shun) tubes.
Phenylephrine HCl may also be used for purposes not listed in this medication guide.
Phenylephrine HCl indications
Phenylephrine HCl is used for the temporary relief of stuffy nose, sinus, and ear symptoms caused by the common cold, flu, allergies, or other breathing illnesses (e.g., sinusitis, bronchitis). This medication works by decreasing swelling in the nose and ears, thereby lessening discomfort and making it easier to breathe.
Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Some products (such as long-acting tablets/capsules) are not recommended for use in children younger than 12 years. Ask your doctor or pharmacist for more details about using your product safely.
How should I use Phenylephrine HCl?
Use Phenylephrine HCl as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Phenylephrine HCl is for use in the eye only. Avoid contact with the nose or mouth.
- To use Phenylephrine HCl, first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.
- To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including your eye. Keep the container tightly closed.
- Do not wear contact lenses while you are using Phenylephrine HCl. Sterilize contact lenses according to the manufacturer's directions and check with your doctor before using them.
- Do not use Phenylephrine HCl if it is brown or contains particles.
- If you miss a dose of Phenylephrine HCl, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Phenylephrine HCl.
Uses of Phenylephrine HCl in details
This medication is used for temporary relief of congestion in the nose caused by various conditions including the common cold, sinusitis, hay fever, and allergies. It works by narrowing the blood vessels in the nose area, reducing swelling and congestion.
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This drug may also be used to relieve "plugged ears" and to reduce swelling in the nose before certain surgery or procedures.
How to use Phenylephrine HCl nasal
Use this medication in the nose as directed. Follow all directions on the product package, or use as directed by your doctor. If you are uncertain about any of the information, consult your doctor or pharmacist.
Gently blow your nose before using this drug. Use your finger to close the nostril on the side not receiving the medication. While keeping your head upright, place the spray tip into the open nostril. Spray the medication into the open nostril as you breathe in through your nose. Sniff hard a few times to be sure the medication reaches deep into the nose. Repeat these steps for the other nostril if needed.
Avoid spraying the medication into your eyes or onto the middle of the inside of your nose (nasal septum).
Rinse the spray tip with hot water or wipe with a clean tissue after each use. Make sure that water does not get inside the container. Replace cap after each use.
This medication provides only temporary relief. Do not use more often, use more sprays, or use longer than directed because doing so may increase the risk of side effects. Also, do not use this medication for more than 3 days or it may cause a condition called rebound congestion. Symptoms of rebound congestion include long-term redness and swelling inside the nose and increased runny nose. If this occurs, stop using this medication and consult your doctor or pharmacist.
Inform your doctor if your condition worsens or persists after 3 days.
Phenylephrine HCl description
Phenylephrine HCl is a sympathomimetic amine that acts predominantly on α-adrenergic receptors. It is mainly used to treat nasal congestion, but may also be useful in treating hypotension and shock, hypotension during spinal anaesthesia, prolongation of spinal anaesthesia, paroxysmal supraventricular tachycardia, symptomatic relief of external or internal hemorrhoids, and to increase blood pressure as an aid in the diagnosis of heart murmurs.
Phenylephrine HCl dosage
Usual Adult Dose for Hypotension:
IM or subcutaneous: 2 to 5 mg every 1 to 2 hours as needed.
IV bolus: 0.2 mg/dose (range: 0.1 to 0.5 mg/dose) every 10 to 15 minutes as needed (initial dose should not exceed 0.5 mg)
IV infusion: 100 to 180 mcg/min initially. The usual maintenance dose is 40 to 60 mcg/min.
Alternatively, 0.5 mcg/kg/minute; titrate to desired response. Dosing ranges between 0.4 to 9.1 mcg/kg/minute have been reported.
Usual Adult Dose for Shock:
IM or subcutaneous: 2 to 5 mg every 1 to 2 hours as needed.
IV bolus: 0.2 mg/dose (range: 0.1 to 0.5 mg/dose) every 10 to 15 minutes as needed (initial dose should not exceed 0.5 mg)
IV infusion: 100 to 180 mcg/min initially. The usual maintenance dose is 40 to 60 mcg/min.
Alternatively, 0.5 mcg/kg/minute; titrate to desired response. Dosing ranges between 0.4 to 9.1 mcg/kg/minute have been reported.
Usual Adult Dose for Supraventricular Tachycardia:
0.25 to 0.5 mg IV over 30 seconds.
Usual Adult Dose for Nasal Congestion:
Tablets or oral liquid: 10 to 20 mg orally every 4 hours as needed.
Phenylephrine HCl 7.5 mg/5 mL oral liquid:
15 mg orally every 6 hours not to exceed 60 mg daily.
Phenylephrine HCl 10 mg oral tablet:
10 mg orally every 4 to 6 hours not to exceed 4 doses daily.
Phenylephrine HCl 10 mg oral disintegrating strip:
10 mg orally every 4 hours not to exceed 6 doses daily.
Phenylephrine HCl 10 mg/5 mL oral suspension, extended release:
10 to 20 mg orally every 12 hours.
Phenylephrine HCl tannate 10 mg oral tablet, chewable, extended release:
10 to 20 mg orally every 12 hours.
Phenylephrine HCl tannate 7.5 mg/5 mL oral suspension, extended release
7.5 to 15 mg orally every 12 hours.
Usual Pediatric Dose for Hypotension:
IM or subcutaneous: 0.1 mg/kg every 1 to 2 hours as needed. Maximum dose: 5 mg.
IV bolus: 5 to 20 mcg/kg/dose every 10 to 15 minutes as needed.
IV: 0.1 to 0.5 mcg/kg/min titrated to effect.
Usual Pediatric Dose for Shock:
IM or subcutaneous: 0.1 mg/kg every 1 to 2 hours as needed. Maximum dose: 5 mg.
IV bolus: 5 to 20 mcg/kg/dose every 10 to 15 minutes as needed.
IV: 0.1 to 0.5 mcg/kg/min titrated to effect.
Usual Pediatric Dose for Supraventricular Tachycardia:
5 to 10 mcg/kg IV over 30 seconds.
Usual Pediatric Dose for Nasal Congestion:
Phenylephrine HCl 1.25 mg/0.8 mL oral liquid:
2 years to 5 years: 1.6 mL orally every 4 hours not to exceed 6 doses daily.
Chewable tablets or oral liquid:
6 years to 11 years: 10 mg orally every 4 hours as needed.
12 years or older: 10 to 20 mg orally every 4 hours as needed.
Phenylephrine HCl 7.5 mg/5 mL oral liquid:
2 years to 5 years: 3.75 mg orally every 6 hours not to exceed 15 mg daily.
6 years to 11 years: 7.5 mg orally every 6 hours not to exceed 30 mg daily.
12 years or older: 15 mg orally every 6 hours not to exceed 60 mg daily.
Phenylephrine HCl 10 mg oral tablet:
12 years or older: 10 mg orally every 4 to 6 hours not to exceed 4 doses daily.
Phenylephrine HCl 10 mg oral tablet, disintegrating:
2 years to 5 years: 5 mg orally every 4 hours as needed.
6 years to 11 years: 10 mg orally every 4 hours as needed.
12 years or older: 10 to 20 mg orally every 4 hours as needed.
Phenylephrine HCl 10 mg/5 mL oral suspension, extended release:
12 years or older: 10 to 20 mg orally every 12 hours.
6 years to 11 years: 5 to 10 mg orally every 12 hours.
Phenylephrine HCl 10 mg oral disintegrating strip:
12 years or older: 10 mg orally every 4 hours not to exceed 6 doses daily.
Phenylephrine HCl tannate 10 mg oral tablet, chewable, extended release:
6 years to 11 years: 5 to 10 mg orally every 12 hours.
12 years or older: 10 to 20 mg orally every 12 hours.
Phenylephrine HCl tannate 7.5 mg/5 mL oral suspension, extended release
2 years to 5 years: 1.25 to 2.5 mL orally every 12 hours.
6 years to 11 years: 2.5 to 5 mL orally every 12 hours.
12 years or older: 5 to 10 mL orally every 12 hours.
Phenylephrine HCl 1.25 mg oral disintegrating strip:
2 years to 3 years: 2.5 mg orally every 4 hours, not to exceed 15 mg in 24 hours.
Phenylephrine HCl 2.5 mg oral disintegrating strip:
2 years to 5 years: 2.5 mg orally every 4 hours, not to exceed 15 mg in 24 hours.
6 years to 11 years: 5 mg orally every 4 hours, not to exceed 30 mg in 24 hours.
Phenylephrine HCl 1.25 mg oral tablet, chewable:
12 years or older: 5 mg orally every 4 hours not to exceed 6 doses daily.
Phenylephrine HCl 2.5 mg/5 mL oral liquid:
4 years to 5 years: 5 mL orally every 4 hours, not to exceed 6 doses in 24 hours.
6 years to 11 years: 10 mL orally every 4 hours, not to exceed 6 doses in 24 hours.
Phenylephrine HCl interactions
See also:
What other drugs will affect Phenylephrine HCl?
If this product has been prescribed, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.
Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: blood pressure medications (especially reserpine, guanethidine, methyldopa, beta blockers such as atenolol, or calcium channel blockers such as nifedipine), other decongestants (taken by mouth or applied in the nose), digoxin, tricyclic antidepressants (e.g., amitriptyline, imipramine).
This medication may worsen the serious side effects of some medications used for migraine headaches (e.g., sumatriptan, naratriptan, zolmitriptan, ergotamine). Consult your pharmacist or doctor for more details.
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
Phenylephrine HCl side effects
See also:
What are the possible side effects of Phenylephrine HCl?
Temporary burning, stinging, dryness in the nose, runny nose, and sneezing may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
If your doctor has prescribed this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if any of these unlikely but serious side effects occur: slow/fast/pounding heartbeat, dizziness, nausea, headache, mental/mood changes, trouble sleeping, shaking (tremors), unusual sweating, unusual weakness.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Phenylephrine HCl contraindications
See also:
What is the most important information I should know about Phenylephrine HCl?
Hypersensitivity to any component of the products, potassium guaiacolsulfonate, or to sympathomimetic amines; severe hypertension; ventricular tachycardia; pheochromocytoma; ophthalmic 10% solution contraindicated in infants and patients with aneurysms; low birth weight infants; anatomically narrow angles or narrow-angle glaucoma; during intraocular procedures when the corneal epithelial barrier has been disrupted; elderly patients with severe arteriosclerotic CV or cerebrovascular disease; MAOI use or 14 days after stopping an MAOI; severe coronary artery disease.
Active ingredient matches for Caffeine anhydrous/Paracetamol/phenylephrine HCl:
Caffeine anhydrous/Paracetamol/phenylephrine HCl
List of Caffeine anhydrous/Paracetamol/phenylephrine HCl substitutes (brand and generic names) | Sort by popularity |
| Unit description / dosage (Manufacturer) | Price, USD |
| Beacons 500 (Singapore) | |
| Beacons 500 1000's | |
References
- DailyMed. "CAFFEINE; ERGOTAMINE TARTRATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubChem. "phenylephrine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- PubChem. "caffeine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
