aspirin + caffeine: clinical use

Prescribing considerations

• Confirm an analgesic aspirin–caffeine product is intended; it does not replace low-dose antiplatelet aspirin.
• Assess gastrointestinal bleeding, NSAID hypersensitivity, asthma, renal or hepatic impairment, hypertension, heart failure, dehydration, gout and bleeding risk.
• Review concurrent medicines and planned procedures.
• Consider total dietary and medicinal caffeine exposure.

Contraindications and cautions

• Hypersensitivity to aspirin, salicylates, caffeine or relevant excipients, or previous aspirin/NSAID-induced bronchospasm, angioedema, urticaria or rhinitis
• Active or previous peptic ulceration, or previous NSAID-associated gastrointestinal bleeding or perforation
• Severe renal or hepatic failure and specified clotting disorders
• Children under 16 unless specifically indicated and medically supervised
• Third-trimester pregnancy and breastfeeding as specified in the selected product information
• For Beechams powder, peanut or soya hypersensitivity because its flavouring contains soya protein

Monitoring

• Assess for bleeding and hypersensitivity symptoms.
• Monitor renal function, hydration and blood pressure when clinically relevant.
• Monitor phenytoin or valproate concentrations where co-administration cannot be avoided.
• Consider renal and toxicity monitoring with methotrexate and glucose monitoring with sulfonylureas.

Clinical pharmacology

Aspirin inhibits cyclo-oxygenase, reducing prostaglandin and thromboxane formation and impairing platelet aggregation. It is rapidly hydrolysed to salicylate. Caffeine is rapidly absorbed, centrally stimulating and used as an analgesic adjunct.

Formulation and product differences

• Beechams Powders is mixed with water and contains lactose and soya protein in its flavouring.
• Anadin Original is an oral tablet.
• Excipients and contraindications differ between products; check the selected product information and pack leaflet.