The therapeutic effects of Panadol Extra are achieved through the combined actions of its two active ingredients:

1. Paracetamol:
   • Analgesic Effect: Inhibits prostaglandin synthesis in the central nervous system (CNS), reducing pain perception (BNF).
   • Antipyretic Effect: Acts on the hypothalamic heat-regulating center to reduce fever (Lippincott).
2. Caffeine:
   • Vasoconstrictor Effect: Reduces cerebral blood flow, alleviating headache pain (Lange).
   • Adjuvant Effect: Enhances the absorption and efficacy of paracetamol, providing faster and more effective pain relief (Lippincott).

Panadol Extra is indicated for:

1. Pain Relief:
   • Headaches, migraines, toothaches, and musculoskeletal pain.
2. Fever Reduction:
   • Mild to moderate fever associated with infections or other conditions.
3. Off-Label Uses:
   • May be used for tension headaches or menstrual pain.

Dosage varies by age and condition. Always follow the prescribing physician’s instructions.

Adults and Children Over 12 Years:

• Oral: 1–2 tablets every 4–6 hours as needed, not exceeding 8 tablets in 24 hours (BNF).

Children Under 12 Years:

• Not recommended without medical advice.

Administration Tips:

• Take with water, preferably after meals to reduce gastrointestinal irritation.
• Do not exceed the recommended dose to avoid liver damage from paracetamol overdose.

Panadol Extra is generally well-tolerated but may cause:

Common:

• Nausea or stomach discomfort.
• Mild headache or dizziness.

Rare but Serious:

• Liver Toxicity: With excessive paracetamol intake (BNF).
• Allergic Reactions: Rash, itching, or swelling (Lippincott).
• Caffeine-Related Effects: Insomnia, palpitations, or anxiety (Lange).

Before using Panadol Extra, inform your healthcare provider if you have:

• Liver or kidney disease.
• A history of alcohol abuse.
• Sensitivity to caffeine or paracetamol.
• Peptic ulcer disease or gastroesophageal reflux disease (GERD).

Special Populations:

• Pregnancy: Safe in recommended doses (BNF Category: A).
• Breastfeeding: Paracetamol and caffeine pass into breast milk; use with caution.
• Elderly: Increased risk of side effects; use lower doses if necessary.

Panadol Extra interacts with several medications:

1. Alcohol:
   • Increases the risk of liver damage with paracetamol (BNF).
2. Warfarin:
   • Paracetamol may enhance anticoagulant effects, increasing bleeding risk (Lippincott).
3. CYP450 Inducers (e.g., rifampicin):
   • Increase paracetamol metabolism, reducing efficacy and increasing toxicity risk (Lange).
4. Stimulants (e.g., amphetamines):
   • Additive CNS stimulation with caffeine.
5. Antidepressants (e.g., MAOIs):
   • May increase caffeine-related side effects.

Generic Names in Pharmacy

• Paracetamol + Caffeine (active ingredients)

Common brand names: Panadol Extra®, Tylenol Ultra®, Excedrin