Fever and Pain? And you want to get rid of it within minutes?? Go through what we have here and share the information with people. We will give you clinical experimental information performed on how efficacious this miraculous combination can be. Indeed, sometime we want to get over with fever to face most worthy and precious moments of our life.
- Getting Started
- Mechanism of Combination therapy
- Effect of Combination
- What doses can I take?
- Adverse effects
- The Original Trial
“Increased intensity of action of drugs that are activated by metabolism. Acute paracetamol toxicity is due to one of its metabolites-toxicity occurs at lower doses in patients receiving enzyme inducers.”- K.D tripathi pharmacology
Mechanism of Combination therapy
Paracetamol metabolism is increased 2-4 folds by microsomal enzyme induction through cytochrome p450.
Effect of Combination
Increased Anti-pyretic and Analgesic effect (Mainly nociceptive). Inappropriate or higher dosages may cause paracetamol toxicity.
What doses can I take?
500mg of paracetamol+100mg of caffeine
100mg= roughly one mug of coffee
Box 1. Caffeine content of commonly consumed items compared with paracetamol with caffeine tablets.
|Beverage/item||Container/size||Typical caffeine content|
|250 mL cup||60–80 mg
|Tea||250 mL cup||10–50 mg|
|Coca Cola||375 mL can||48.75 mg|
|Energy drink||250 mL can||80 mg|
|Chocolate bar||100 g bar||20 mg|
|Paracetamol with caffeine||1 dose (= 2 tablets)||130 mg|
Most problematic can be Paracetamol toxicity, though it is rare (occurs with genetic or overdose).
Treatment of Overuse
It includes headache as the most prominent sign of withdrawal.
Contraindicated in Pregnant and Breast
Feeding women and pregnant women should not consume more than 200 mg caffeine per day, as this may increase the risk of spontaneous miscarriage. Consuming > 300 mg per day may also increase the risk of preterm delivery and fetal growth retardation.
Caffeine is readily transferred to breast milk and young infants are poor metabolizers of caffeine. Infants who are breastfed by mothers consuming > 300 mg caffeine per day may become jittery and restless, and may experience sleep difficulties.
K.D Tripathi: Page 27-28
The Original Trial
So does caffeine added to painkillers make them work better?
In the light of a new Cochrane review, the simple answer seems to be yes. The reviewers looked for studies comparing the pain-relieving effect of common painkillers with and without added caffeine. As well as searching key databases the authors contacted drug companies known to have carried out trials that have not been published.
19 randomized controlled trials (RCTs) of 7238 people were included, assessing several acute pain conditions including headache, post-dental pain, postoperative pain following childbirth, and period pain. Most studies used paracetamol (500 mg to 1500 mg) or ibuprofen (100 mg to 400 mg), with two using aspirin (650 mg and 800 mg), one aspirin (500 mg) plus paracetamol (400 mg), one diclofenac (100 mg), and one tolfenamic acid (200 mg). Caffeine was added at doses of 50 mg to 260 mg, with most studies using between 100 mg and 200 mg. In most studies participants were not allowed to have any caffeine in food, drink or other medicines for a specified time within the trial.
There was a small but statistically significant benefit with caffeine used at doses of 100 mg or more for all pain conditions and painkillers. About 5% to 10% more people achieve a good level of pain relief with the addition of caffeine.
There was only one serious health event in one person treated with caffeine plus painkiller and this was not considered related to the study medication.
Most of the studies were old, with only three (in headache) published since 2000, but they were generally of good methodological quality.
There are 20 more studies with over 9000 participants for which data for analysis were not obtainable. However, even if all the missing data showed no effect of caffeine, the additional effect of caffeine would still be statistically significant.
The authors concluded that the existing evidence is probably sufficient to support the use of caffeine with analgesics, with the addition of ≥ 100 mg caffeine to a standard dose of commonly used analgesics providing a small but important increase in the proportion of people who experience a good level of pain relief.
100mg of caffeine is roughly equivalent to the caffeine in a mug of coffee. So if you’ve got a headache and have standard painkillers in the cupboard, you may do well to wash them down with a coffee.
Swallow down the PCM with coffee and feel the effects much faster than taking paracetamol with water.
This was all about the Paracetamol-Caffeine Combination for Fever.