Do you often get headaches and body aches? Maybe it's a severe headache like a migraine. At times like these, many of us are used to taking a quick-relief painkiller from the pharmacy. These pills, which come with names like Excedrin, Panadeine, and Panadol Extra, provide quick relief, right? The reason is that this is not a regular painkiller, but a combination of three medications. So, today we will talk about some important things that we need to know when using this medicine.
Why is this called a 'three-in-one' medicine?
It contains three main ingredients: Acetaminophen, Aspirin, and Caffeine. Let's take a look at what each of these ingredients does.
- Acetaminophen: This is the main ingredient in Panadol, which we all know. It controls fever and pain.
- Aspirin: This is a pain reliever and anti-inflammatory drug. To be precise, it belongs to the group called ``NSAIDs''.
- Caffeine: This is also found in tea and coffee. Caffeine is added to this medicine to boost the effectiveness of the two painkillers mentioned above. Also, in some types of headaches, caffeine constricts blood vessels and provides pain relief.
The combination of these three is why this medicine provides faster relief than a regular painkiller.
Things you need to tell your doctor before taking this medicine
Although this is easily available from a pharmacy, it is not suitable for everyone. If you have any of the health conditions listed below, you should definitely talk to your doctor before using this medicine.
- Anemia
- Frequent anxiety or panic attacks
- Asthma
- Bleeding problems (e.g., poor blood clotting)
- Diabetes
- If you are a frequent drinker
- Gout
- Heart disease or high blood pressure
- Kidney disease
- Liver diseases
- Vitamin K deficiency
- Immune system diseases such as lupus
- Stomach ulcers or other gastrointestinal problems
- If you are a smoker
- If you are trying to get pregnant or are pregnant
- If a mother is breastfeeding her child
- If you have previously had an allergic reaction to acetaminophen, aspirin, caffeine, or another NSAID (e.g., ibuprofen, diclofenac)
Taking medication while hiding these facts will put your health at unnecessary risk. So discuss these things honestly with your doctor.
The correct way to use the medicine
When using this medicine, follow the instructions on the package exactly.
- Swallow the tablet/capsule with a glass of water.
- If it feels like stomach upset, take it with food.
- Never take more than the prescribed dose.
- Do not give this medicine to children under 12 years of age without medical advice, as aspirin can cause a dangerous complication (`Reye's Syndrome`) in some pediatric conditions.
- People over the age of 65 may be more sensitive to this medication and may need a lower dose. Ask your doctor about that as well.
What to do if you take too much medicine? (Overdose)
This is very important. If you think you have taken too much of this medicine, do not wait until symptoms appear. Go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital . The serious effects of an overdose of acetaminophen may not be apparent for several days. Therefore, it is very important to take quick action.
Things to avoid and things to be careful about with this medicine
This medicine may interact with other medications, so tell your doctor about all the medications you are taking.
| Things that may interact with this medicine | |
|---|---|
| Don't mess with these. | |
| Antidepressants from the MAOI group | (e.g. Carbex, Marplan, Nardil) |
| Methotrexate | A drug for cancer and rheumatoid arthritis |
| Other acetaminophen-containing medications | (e.g. separate Panadol tablets) |
| Be very careful if you take these with you (ask your doctor) | |
| Alcohol | Increases damage to the liver and stomach |
| Other types of NSAIDs | Painkillers like Ibuprofen, Naproxen, Diclofenac |
| Blood thinners | Such as Warfarin, Heparin, Clopidogrel |
| Some medications for diabetes | Blood sugar levels may fluctuate. |
| Some herbal products | Such as ginger, garlic, ginkgo biloba |
Things to be careful about when taking medicine
- Liver protection: This is the most important thing. When taking this medicine, do not take any other medicine that contains acetaminophen, such as Panadol. Some cold packs may also contain acetaminophen. Read the label carefully. If too much acetaminophen enters the body, it is very dangerous for the liver.
- Stomach protection: The aspirin in this medicine can cause stomach irritation, gastritis, and possibly even bleeding from stomach ulcers. So avoid alcohol and smoking. Do not lie down for 30 minutes after taking the medicine.
- About pain: If your pain lasts more than 10 days, if the pain is getting worse, or if you have a new type of pain, tell your doctor about it.
- Use for migraines: If you use this medicine for migraines for more than 10 days a month, it may make your headaches worse. This is called ``Medication Overuse Headache''. Keep a record of how many days you take the medicine. If your headaches become more frequent, talk to your doctor.
Possible side effects of the medicine
| Serious side effects that require immediate medical attention | |
|---|---|
| Allergic Reactions | Skin rash, itching, swelling of the face, lips, tongue, difficulty breathing. |
| Symptoms of bleeding | Black or tarry stools, vomiting blood, dark brown/red urine, red/purple spots on the skin. |
| Symptoms of liver damage | Pain in the upper right abdomen, loss of appetite, nausea, yellowing of the skin or eyes, unusual tiredness. |
| Symptoms of kidney damage | Decreased urine output, swelling of the ankles, hands, and feet. |
| Hearing loss | Hearing a "ringing" sound in the ears or hearing loss. |
| Side effects that occur commonly, but should be reported to the doctor if they persist | |
| Stomach pain or discomfort | Nausea |
| Insomnia | May be caused by caffeine. Avoid taking at night. |
| Restlessness, tremors | Effects of caffeine |
Take-Home Message
- This is a combination of acetaminophen, aspirin, and caffeine, so it's stronger than a typical painkiller.
- When taking this medicine, do not take any medicine containing acetaminophen, such as Panadol, separately. It can be very harmful to the liver.
- If you have stomach, liver, or kidney disease, are taking blood thinners, or are pregnant, be sure to talk to your doctor before taking this medication.
- If you overdose, even if you have no symptoms, consider it an emergency and go to the hospital's Emergency Treatment Unit (ETU) immediately.
- The solution to pain isn't always to swallow pills. If you have persistent pain, it's best to seek medical advice to find the underlying cause.
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