Excedrin migraine vs advil migraine

How Excedrin® Migraine Works

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1. Silberstein, Stephen D. “Migraine – Neurologic Disorders.” Merck Manuals Professional Edition, www.merckmanuals.com/professional/neurologic-disorders/headache/migraine.

2. Diener, H C, et al. “The Fixed Combination of Acetylsalicylic Acid, Paracetamol and Caffeine Is More Effective than Single Substances and Dual Combination for the Treatment of Headache: a Multicentre, Randomized, Double-Blind, Single-Dose, Placebo-Controlled Parallel Group Study.” Cephalalgia : an International Journal of Headache., U.S. National Library of Medicine, Oct. 2005, www.ncbi.nlm.nih.gov/pubmed/16162254.

3. Lipton, Richard B. “Efficacy and Safety of Acetaminophen, Aspirin, and Caffeine in Alleviating Migraine Headache Pain.” Archives of Neurology, American Medical Association, 1 Feb. 1998, jamanetwork.com/journals/jamaneurology/fullarticle/1032899.

7. Foley, K A, et al. “Treating Early versus Treating Mild: Timing of Migraine Prescription Medications among Patients with Diagnosed Migraine.” Headache., U.S. National Library of Medicine, May 2005, www.ncbi.nlm.nih.gov/pubmed/15953272.

9 Steps to Surviving a Migraine {Excedrin Migraine}

June is Migraine Awareness Month. It’s also Home Safety Month. And I think there was a Donut Day in there too.

Migraines are the worst.

Being a mom, with little kids who aren’t gone at school all day…little kids who you still have to keep a close eye on or they’ll do something crazy like choke on glass…little kids who whine and cry and scream and get boooooored…the WORST.

I’ve had migraines my whole life. My grandma remembers me getting them as young as Kindergarten. And for as awful as they are under any conditions, they are especially terrible when you can’t just sleep them off in a dark room. We have no family nearby. I do not have the option of calling my mom and asking her to come take the kids for the afternoon. It stinks.

For those of you who don’t get migraines. I hate you. I hate you always, forever, until the ends of the earth, hate you.

And I mean that in the most loving way possible.

For the rest of us, the ones who feel like they are going to simultaneously puke, pass out, and their heads will explode in a giant mess that we’ll be stuck cleaning up later on…we need some survival tips for getting through the M word when we’re still responsible for a bunch of little kids who’s cute factor won’t get them through the afternoon.

Back when I was pregnant with the girls, nauseous, exhausted, and still in shock that I was having twins…. my wise friend Joy told me that it was okay to go into Survival Mode. It was okay to take care of yourself. Even if it meant letting your kids do things you would otherwise be horrified at. Survival Mode is temporary. Your kids won’t be permanently ruined because they were allowed to watch movies for hours on end one day. Or even one trimester. Once you’re better, you can go back to your normal house rules. I realize that sounds obvious…but I needed someone to give me permission to not be concerned with doing everything Just Right. I needed someone to tell me that I was allowed to be sick.

So, now I’m telling you. It’s okay to let it all go for a day or two. You’re allowed to feel puny.

Step 1: Ignore the house.

I’m one of those people who has a really hard time sitting down and relaxing when I know that the house is a mess. I’m not saying it has to be perfect, but obvious messes make me crazy. But when I have a migraine, I have to force myself to ignore the fact that the baby got into the dog food. Again.

Step 2: Barricade yourself in one room of your house.

My open floor plan is awesome for hosting parties and everyday life. But when I need to lie down and cover my eyes from evil sunlight, I need my littles to be nearby where I can keep a half open, squinty eye on them. It was much easier back when Owen wasn’t walking everywhere. Back then, I could lay him on my bed with a play gym. Back then was Nice.

Step 3: Institute a variety of quiet activities.

From your zombie like state, try to announce fun activities like Look At Books Quietly Time. Say it with as much enthusiasm as you can muster. Make it sound like a special activity. You know, because it’s summer and summertime comes with promises of special activities. Close the door behind you so no one can escape, and then lie on the floor motionless while the kids flip through books for exactly 12.4 seconds.

Step 4: Embrace the video babysitter.

I want to meet the inventor of Netflix. And upon meeting him or her, I want to kiss them. ON THE MOUTH. Because they are beautifully brilliant souls that save the likes of Migraine Moms like me. I don’t love it when my kids watch a lot of TV, but this is Survival Mode at its finest. Set up videos/DVDs/streaming on your tablet or laptop and lock them in a room with you. Put the volume on as low as possible. Partially because sounds makes the room spin, but also because it means the kids have to be REALLY quiet in order to hear it.

If your brain is on fire for an entire day, switch it up and let them watch on the big TV next. Then they can go to the laptop. And around again. I know. It’s gross to have your kids glued to a screen for hours. But less gross than you passing out on the floor because you just. can’t.

Step 6: Give the baby whatever will keep him as quiet as possible.

Hold him in your lap while you close your eyes. Let him sleep next to you. Nurse him all day long. Feed him two full sleeves of crackers. Just whatever, Man.

Step 7: Warn your husband.

This step is extremely important. First of all, because he needs to be emotionally prepared for the chaos he will walk into after having been at work all day. Remember, the house is a war zone. The dog food is still in ALL THE PLACES. The books the kids read are strewn all over the floor. Your bed is a crumpled mess. The kids will be all glassy eyed from cartoon watching. The baby’s diaper probably weighs as much as he does. And let’s not even talk about what YOU look like at this point.

Secondly, if he’s a Good One, and this isn’t his first rodeo, he will immediately know to suggest picking up some dinner on his way in. 99.999999% of the time I wholeheartedly agree to greasy food you don’t have to cook so that you can languish around in despair some more, but in this case, I had actually prepped dinner earlier in the day, pre-migraine. Which, is pretty much a Christmas Miracle in itself. Thinking About Dinner usually commences at about 4:56 pm.

Also, I married a Good One. I don’t know how. It just happened.

Also, I realize this is a sponsored post, but that Excedrin line in our text conversation wasn’t planned, planted, or faked. It’s just truth in These Parts.

Step 8: Hot Shower/Cold Soda

As soon as your husband steps one toe through that door, crawl your raggedy self upstairs and RETREAT, RETREAT, RETREAT! Just go. He will survive. Maybe give him a little wave on your way. Just so he knows you saw him.

Then take the hottest shower you can stand and let that hot water run all over your weary noggin. Just stand there. Don’t bother shaving your legs. After all, you have a headache. Like, actually.

While you’re in there, unclench your teeth. You’re doing it. I promise. You will be amazed at how much pressure that relieves.

Then drink an ice cold soda. I think the caffeine helps, but for me it’s really about my skin all hot and cozy and then icy bubbles in my tummy. Somehow this makes me feel somewhat better. I have no medical proof of this. Because, you know, I don’t think Google is accredited to give out medical degrees in exchange for lots of searching.

Step 9: Just hide. I don’t care if it’s only 6:15 p.m. Get in bed. Lie there. Take a nap. If your head can handle it, read a book. Whatever. Just rest. Last night, my migraine was fairly well knocked down, but it just drains my batteries. And I’ve learned (the hard way) that when I’ve just subdued a migraine, I’ve gotta keep taking it easy for a while longer or else it’ll be back in a flash. Swinging. With a vengeance. So don’t jump right back into life so quickly. Even if your head feels better. You need to let it go. And give yourself the space to fully recuperate. Trust me, it’s not worth it to soldier on. No one wins.

Besides, with the day you had, you deserve to just check out for the night.

* * *

Did you know that 36 million people in the US suffer from migraines, and three out of every four are women ages 18 to 35? I’d be curious how many of those are moms? There are many triggers like diet, hydration, weather changes, and even your monthly cycle. If you suffer from migraines, consider downloading the My Migraine Triggers app to help figure out what your triggers are, and potentially avoid future migraines.

Do you suffer from migraines? What is your Survival Mode method of choice? Any tips or tricks?

Leave a comment below answering the questions, and TWO people will be randomly selected and get an Excedrin Migraine gift pack of a water bottle, travel pillow, and eye mask!

(winners will be selected Monday, July 1.)

*Disclosure: I am a paid Excedrin® Migraine blog ambassador. Compensation has been provided by Novartis Consumer Health, Inc., the makers of Excedrin® Migraine; my journey for a migraine-free experience is my own.

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I’m a mom to four. A wife to one. I believe in story. I love telling you about mine and would love to hear yours. There’s really no sense in wasting our suffering and not sharing in each other’s joy. We’re all in this together…even if it doesn’t always feel like it.

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A Cherry Hill woman has filed a lawsuit in federal court accusing Novartis of consumer fraud for selling its Excedrin Migraine medicine at a higher price than Excedrin Extra Strength though both pain relievers have identical ingredients in the same quantities. In above photo, a Rite Aid in Newark is charging $17.49 for Excedrin Migraine and $16.49 for Extra Extra Strength in the 200-capsule bottles. It also charges more for the migraine medicine in 100-capsule bottles.

(Alexi Friedman/The Star-Ledger)

The two kinds of Excedrin have distinctly different looks.

Extra Strength comes in a green box and says it treats headaches, colds, muscle aches, sinusitis, toothaches and premenstrual cramps.

Excedrin Migraine, packaged in red, only treats migraines.

Even the lettering on the two boxes are in different positions so consumers can tell them apart. But because both pain medicines contain the same amount of the same active ingredients — acetaminophen, aspirin and caffeine — they are essentially identical.

One key ingredient is different: price.

Excedrin Migraine generally costs about 12 percent to 15 percent more than Excedrin Extra Strength for the 24-, 100-, 200- and 300-count bottles.

That means consumers can spend between 50 cents and $1.50 more per bottle for the migraine medicine, which ranges from $10 to $18.

The discrepancy was enough to give Kerri Yingst another headache, and led the Cherry Hill woman to file a federal lawsuit charging drugmaker Novartis with violating New Jersey consumer fraud law.

Filed earlier this month, the proposed class-action suit accuses the Swiss pharmaceutical company of selling Excedrin Migraine at a higher wholesale price than Extra Strength.

Novartis, whose U.S. base is in East Hanover, is “engaging in an unconscionable business practice” that violates the New Jersey Consumer Fraud Act, according to the complaint filed in Newark.

While it has not filed a response to the suit yet, Novartis spokeswoman Julie Masow said over-the-counter medications are regulated by the U.S. Food and Drug Administration, which reviewed Excedrin data to determine the appropriate doses.

“Excedrin Extra Strength and Excedrin Migraine are not considered the same based on their indications for use and clinical studies conducted to support these indications,” Masow said. Novartis doesn’t disclose pricing strategy, she said, but added, “several factors are taken into consideration in our pricing decisions, including cost of goods.”

The lawsuit will likely hinge on whether the plaintiff can prove Novartis misrepresented the way Excedrin was marketed and whether “a consumer relied on that perceived misleading statement to buy that product,” said David Noll, an assistant professor at Rutgers Law School in Newark who specializes in civil procedure.

Yingst has used Excedrin Migraine for eight years to relieve her acute headaches, said her attorney, Todd Muhlstock. Yingst noticed the price difference one day while walking through a drugstore and snapped a photo.

Muhlstock said his client “didn’t understand why she was paying more for the same product. It didn’t seem right.”

Muhlstock, who has used Excedrin in the past, said the suit wasn’t about the different labeling. “It’s about the charging more.”

The proposed class-action would include anyone who purchased Excedrin Migraine at a higher price than Excedrin Extra Strength on or after Aug. 1, 2005, essentially when Novartis took over the brand from Bristol-Myers Squibb. Muhlstock alleged that Bristol-Myers had sold the two medicines at identical prices.

Packages of Excedrin Migraine and Extra Strength are easily distinguishable by their red and green colors. Their suggested usages are also very different.

The complaint listed the proposed class as more than 100 people and damages at more than $5 million.

Muhlstock and another attorney on the case, Eric Gibbs of San Francisco, have filed identical suits in New York and California, and now have 48 plaintiffs. Muhlstock said he estimates a potential pool of 250,000, given Excedrin’s popularity. Novartis sells more than 1 billion Excedrin pills a year, according to Muhlstock’s estimates.

Novartis does not disclose sales for individual over-the-counter products, Masow said. But Excedrin Migraine remains a widely popular and by far the most-recommended migraine headache medicine by pharmacists, according to a recent survey by Pharmacy Times and U.S. News and World Report.

A similar class-action lawsuit was filed in state court against the chemical company, BASF, contending it had violated New Jersey consumer fraud law.

That case involved a group of farmers from Minnesota and other states who alleged BASF, whose North American headquarters is in Florham Park, deceptively marketed and sold two herbicides for different uses and prices, although they contained the same ingredients. In that 1997 filing, a jury awarded the plaintiffs $15 million, which was affirmed on appeal.

“On that case, the argument was when the company went to the regulators, they didn’t tell them it was the same product,” said Prentiss Cox, an associate professor at the University of Minnesota Law School, who saw strong parallels to the Novartis suit.

“So you had a scheme to create two different products out of one product, to make more money,” said Cox, who was head of consumer protection division at the Minnesota Attorney General’s Office during the BASF suit, and filed an accompanying brief on the case. “But if it’s the exact same thing and you convinced the regulators that you need two different labels without telling them it was the exact same thing, that’s deceptive.”

Muhlstock, a New York-based attorney, said that’s exactly what he alleges Novartis did.

“Part of the implication is that Excedrin is targeted for migraines and that somehow, it’s going to relieve the migraine better, quicker or differently than the Extra Strength,” he said.

That’s an alluring promise, he said, when “someone is at the mercy of a migraine and you can’t balance, you can’t have any light, and you’ll do anything to get relief.”

RELATED COVERAGE

• Novartis said to be in talks to trade animal health unit to Merck

• More enforcement and bigger fines may change illegal drug marketing, say Harvard researchers

Comparing Advil Migraine vs Excedrin Migraine

For Migraine: Like all medications I’ve ever taken, I followed the directions exactly (“take 2 caplets with a glass of water”) and the product worked great, with no side effects. With regard to those complaining that the product was ineffective or gave you bad side effects, PLEASE read the following. Although Excedrin Migraine and Excedrin Extra Strength are the exact same product, it is vitally important to follow the Excedrin Migraine directions if you are taking the pills for a migraine, NOT the directions for Extra Strength Excedrin! Here’s why. Many people have incorrectly assumed that because the two products are exactly the same, which they indeed are, that the directions are also the same. THIS IS COMPLETELY FALSE. The reason that there is a separate product solely for migraines, and the FDA approved it solely for migraine use only, is because the amount you take for migraines is completely different than for general pain relief, including “regular” headaches. The reason Excedrin Migraine instructs you to take only 2 pills in 24 hours (vs 8 pills in 24 hours for Extra Strength Excedrin) is because taking more than 2 pills in 24 hours (for a migraine) is likely to cause rebound migraines for many people. In other words, taking more pills than the directions tell you to will make your migraine problem worse! You will note on the Excedrin Migraine package that the ONLY use for the product is “treats migraines.” Think about that! The directions match that one usage and this is the reason the FDA approved the product. So if you have migraines and want to buy Extra Strength Excedrin, instead of Excedrin Migraine, that’s totally fine, but be sure to follow the Excedrin Migraine directions! If you’re taking the product for migraines and you take more than 2 pills in 24 hours, you can definitely except to experience the bad side effects that many people have talked about on this site! And keep in mind that although you should NEVER take more than 2 pills in 24 hours (if your using it for migraines), that doesn’t mean you can’t take just 1 pill in 24 hours. For some people, just 1 pill will get rid of your migraine. If 1 pill isn’t working for you, then you can always take another one during each 24 hours. So less is fine, but more is a huge mistake. I hope I’ve made my point. Review sites in general tend to attract people who have bad things to say about a product. People who have a good experience with a product are much less likely to post their comments on a site like this. Why? Because angry people want to vent. This is not to say that some people who complain are insincere or haven’t followed the directions of the product. There are always going to be people who a product just doesn’t work for. But most people who properly follow the directions will not have bad results. Also, for migraines specifically, finding a product that truly gets rid of them can be very difficult for many people. It’s trial and error. If one product doesn’t work, you try another until you hopefully find one that does the trick. So a product not getting rid of your migraines is one thing, but having painful or uncomfortable side effects is another. Follow the directions and you most likely will never have the bad side effects. Whether it works to get rid of your migraine is a coin toss, but at least you won’t have the bad side effects in most cases. I hope this helped. Good luck to all migraine sufferers. I know how awful they are.

8

Excedrin Migraine Now Comes with a Warning

Led by Jonathan Smith, MD, the group of physicians successfully petitioned the FDA to require combination OTC Migraine medications like Excedrin Migraine and Advil Migraine to come with a written warning. Now, the following message must be included on the drug fact label,

“Medication Overuse Headache Warning: Headaches may worsen if this product is used 10 or more days a month.”

In their petition, the doctors argued that the previous warning, “Stop use and consult with your doctor if migraine is not relieved or worsens after first dose,” did not portray the seriousness of the MOH risk. The FDA agreed with the doctors.

On February 23, 2017, the FDA updated their website informing consumers about the MOH risk with over the counter Migraine products like Excedrin Migraine. In their response letter granting the petition, the FDA wrote, “We recognize the evolving science in the area of MOH and are analyzing the broader impact of other drug products on MOH. Although there are other OTC general pain indication products with similar or the same ingredients as OTC Migraine products, the Agency has determined that consumers seeking OTC products indicated for migraine…are the critical population to target with the MOH warning.”

Don’t miss Dr. Rob Cowan, Dr. Robert Shapiro, and Dr. William Young at the Migraine World Summit – Claim your free ticket here

So, don’t expect to see a warning on that bottle of Advil or Tylenol – the new regulation only concerns drugs specifically targeting Migraine. It’s important to note that MOH can also be caused by triptans or even other OTC meds. If you find yourself reaching for the same Migraine med more than twice a week, it’s time to talk to your doctor about your other treatment options and options for prevention.

Comments? Were you aware of the MOH risks with Excedrin Migraine?

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Footnotes

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Over-the-counter Migraine Medications

Several reports have concluded that overusing over the counter migraine medication often results in rebound headaches. All of these medicines are recommended to be stored in an area where the temperature is between twenty to twenty-five degrees Celsius or sixty-eight and seventy-seven degrees Fahrenheit. If you live somewhere where this cant be accomplished be aware that the effectiveness of these medications can be compromised. Also of concern is if you receive your medication by mail. Leaving the medicine in your mailbox in temperatures outside the recommended range for even a few hours can seriously impair their effectiveness.

Most of these medications warn against the same type of side effects, but the frequency of complaints about those side effects vary tremendously from one user to another.

Excedrin Migraine

Active Ingredients: Acetaminophen 250g, Aspirin 250mg, Caffeine 65mg.

Forms: Geltabs, Tablets, Capsules.

The recommended dose of Excedrin Migraine is two tablets taken at six-hour intervals. Excedrin Migraine actually contains the exact same ingredient combination as Excedrin Extra Strength. In fact, the only difference between Excedrin Migraine and Excedrin Extra Strength is that Excedrin Migraine comes with instructions containing a warning about treating migraines. The instructions warns patients to consult with a physician if their headache is accompanied by vomiting or requires bed rest. Excedrin Extra Strength also does not specifically contain migraines under its use section.

Excedrin has established a fine reputation among consumers. Usually it ranks at or near the in customer satisfaction surveys.

Advil Migraine

Active Ingredients: Ibuprofen 200mg. Also contains 20mg of potassium.

Forms: Liquid filled capsule.

Important information: In the United States Advil Migraine is the only over the counter migraine medication available in liquid capsule form.

You should be aware that Advil Migraine contains the exact same ingredients as regular Advil. Customer satisfaction concerning this product varies. While many report that their recommended dosage often relieves their pain, many other complain that one must exceed dosage in order to get relief. Others complain that it upsets their stomach if they dont take it on a full stomach. Still others have complained about side effects such as nausea (see above), hives, swelling, etc. And yet others are simply unwilling to pay the extra price for this medication when they can buy the exact same medication under the regular Advil label.

Motrin Migraine Pain

Active Ingredient: Ibuprofen 200mg.

Forms: Caplets.

Contains the exact same ingredients as Motrin IB. You should be aware that Motrin Migraine pills are smaller than most other migraine pills. The advantage here is that they are easier to swallow, but at the same time because they are so small they could easily be mistaken for candy by a small child so be sure to keep them out of reach of the young ones. As with Advil, although perhaps even more, customer satisfaction truly runs the gamut when it comes to Motrin. Some migraine sufferers absolutely swear by it, while others say they will never take it again. There doesnt seem to be any pattern as to why it works so well one some patients and not at all on others. It is recommended that you at least try Motrin because it just may be the answer to your prayers. On the other hand it may no do you good at all. So therefore youve got all to gain and only a little bit of money to lose.

Naproxen

Naproxen is in a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) that work by reducing hormones that cause inflammation and pain in the body. Naproxen is sold under a wide variety of brand names across the world, including Aleve, Anaprox and Naprosyn.

TheraPatch Headache Cool Gel

One of the latest products to hit the markets are pads that can be placed on the forehead, temple or the back of the head which contain a gel that cools the skin for up to four hours. You can get the TheraPatch in two forms. One contains no medication whatever, while the other uses the patch as a device to deliver an analgesic. TheraPatch Cool contains menthol, camphor and methyl salicylate, while TheraPatch Warm contains capsaicin. LecTec is also offering medicinal patch products as a drug delivery alternative in the cough-cold and anti-itch sections.

Excedrin

Generic Name: acetaminophen, aspirin, and caffeine (ah SEET a MIN oh fen, ASP i rin, and KAF een)
Brand Names: Anacin Advanced Headache Formula, Arthriten, Backaid IPF, Excedrin, Goody’s Headache Powders, Pain Reliever Plus, Pamprin Max

Medically reviewed by Sanjai Sinha, MD Last updated on Apr 7, 2019.

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What is Excedrin?

Excedrin contains a combination of acetaminophen, aspirin, and caffeine. Acetaminophen is a pain reliever and a fever reducer. Aspirin is in a group of drugs called salicylates. It works by reducing substances in the body that cause pain, fever, and inflammation. Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow.

Excedrin is used to treat pain caused by tension headaches, migraine headaches, muscle aches, menstrual cramps, arthritis, toothaches, the common cold, or nasal congestion.

Excedrin may also be used for purposes not listed in this medication guide.

Important information

Do not give Excedrin to a child or teenager with a fever, flu symptoms, or chicken pox. Aspirin can cause Reye’s syndrome, a serious and sometimes fatal condition in children.

Do not take more Excedrin than is recommended. An overdose of acetaminophen can damage your liver or cause death. Call your doctor at once if you have nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of your skin or eyes).

Aspirin may cause stomach or intestinal bleeding, which can be fatal. Call your doctor at once if you have symptoms such as bloody or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

In rare cases, acetaminophen may cause a severe skin reaction. Stop taking Excedrin and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

Before taking this medicine

Do not give Excedrin to a child or teenager with a fever, flu symptoms, or chicken pox. Aspirin can cause Reye’s syndrome, a serious and sometimes fatal condition in children.

Aspirin may cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are taking Excedrin.

Ask a doctor or pharmacist if it is safe for you to take Excedrin if you have other medical conditions, especially:

  • liver disease, cirrhosis, a history of alcoholism, or if you drink more than 3 alcoholic beverages per day;

  • asthma or seasonal allergies;

  • fever with a stiff neck;

  • stomach ulcer, stomach or intestinal bleeding, ulcerative colitis;

  • a bleeding or blood clotting disorder such as hemophilia;

  • kidney disease; or

  • if you use medicine to treat glaucoma or prevent blood clots.

If you take Excedrin to treat headache pain, seek medical attention if you have:

  • a headache so bad you have to lie down;

  • a headache that causes vomiting;

  • what feels like the worst headache you’ve ever had;

  • a headache that seems different from your usual headaches;

  • a headache every day;

  • a headache after coughing, bending, exercising, or head injury;

  • if you have never had migraines diagnosed by a doctor; or

  • if you are having your first headache after age 50.

Aspirin may be harmful to an unborn baby’s heart, and may also reduce birth weight or have other dangerous effects. Tell your doctor if you are pregnant or plan to become pregnant while you are taking Excedrin.

Aspirin, acetaminophen, and caffeine can pass into breast milk and may harm a nursing baby. You should not breast-feed while using Excedrin.

How should I take Excedrin?

Use Excedrin exactly as directed on the label, or as it has been prescribed by your doctor. Do not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death.

Take Excedrin with food or milk if it makes your stomach upset.

Call your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever lasting longer than 3 days, or any swelling or pain lasting longer than 10 days.

This medication can cause unusual results with certain lab tests for glucose (sugar) in the urine. Tell any doctor who treats you that you are using Excedrin.

If you need surgery, tell the surgeon ahead of time that you are using Excedrin. You may need to stop using the medicine for a short time.

Store Excedrin at room temperature away from moisture and heat.

What happens if I miss a dose?

Since Excedrin is used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of acetaminophen can damage your liver or cause death.

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.

Overdose symptoms may also include ringing in your ears, headache, diarrhea, hallucinations, fast or slow heart rate, or seizure (convulsions).

What should I avoid?

Avoid drinking alcohol while you are taking Excedrin. Alcohol may increase your risk of stomach bleeding while taking aspirin, or liver damage while taking acetaminophen.

Ask a doctor or pharmacist before using any other cough, cold, allergy, pain, menstrual symptom, or fever medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Aspirin and caffeine are also contained in many combination medicines. Check the label to see if a medicine contains acetaminophen, APAP, aspirin, or caffeine.

Avoid coffee, tea, cola, energy drinks or other sources of caffeine while taking this medication. They can add to the side effects of the caffeine in the medication.

Excedrin side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Excedrin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. This could occur even if you have taken acetaminophen in the past and had no reaction. Stop taking Excedrin and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling. If you have this type of reaction, you should never again take any medicine that contains acetaminophen.

Stop using Excedrin and call your doctor at once if you have:

  • severe anxiety, agitation, confusion, panic;

  • easy bruising or bleeding;

  • a light-headed feeling, like you might pass out;

  • if you feel very thirsty or hot, are unable to urinate, and have heavy sweating or hot and dry skin;

  • symptoms of stomach bleeding–bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • high potassium–slow heart rate, weak pulse, muscle weakness, tingly feeling; or

  • liver problems–nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common Excedrin side effects may include:

  • upset stomach, heartburn;

  • depressed mood, feeling anxious or restless; or

  • sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Excedrin?

Other drugs may interact with Excedrin, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Excedrin only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2020 Cerner Multum, Inc. Version: 7.02.

Medical Disclaimer

More about Excedrin (acetaminophen / aspirin / caffeine)

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  • 32 Reviews
  • Drug class: analgesic combinations
  • FDA Alerts (4)

Consumer resources

  • Excedrin

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Professional resources

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Related treatment guides

  • Migraine
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The Side Effects of Excedrin®

Stop use and ask a doctor if:

  • an allergic reaction occurs. Seek medical help right away.
  • you experience any of the following signs of stomach
    bleeding:
    • feel faint
    • vomit blood
    • have bloody or black stools
    • have stomach pain that does not get better
  • ringing in the ears or loss of hearing occurs
  • painful area is red or swollen
  • pain gets worse or lasts for more than 10 days
  • fever gets worse or lasts for more than 3 days
  • any new symptoms occur

These could be signs of a serious condition.

EXCEDRIN® MIGRAINE

Excedrin® Migraine treats migraines and is intended for those who have been diagnosed by a doctor. If your migraine is not relieved or worsens after first dose, talk to your doctor.

The warnings and side effects of Excedrin® Migraine are:

Reye’s syndrome: Children and teenagers who have or are recovering from chicken pox or flu-like symptoms should not use this product. When using this product, if changes in behavior with nausea and vomiting occur, consult a doctor because these symptoms could be an early sign of Reye’s syndrome, a rare but serious illness.

Allergy alert: Acetaminophen may cause severe skin reactions. Symptoms may include:

  • skin reddening
  • blisters
  • rash

If a skin reaction occurs, stop use and seek medical help right away.

Allergy alert: Aspirin may cause a severe allergic reaction which may include:

  • hives
  • facial swelling
  • asthma (wheezing)
  • shock

Liver warning: This product contains acetaminophen. Severe liver damage may occur if you take

  • more than 2 caplets in 24 hours, which is the maximum daily amount
  • with other drugs containing acetaminophen
  • 3 or more alcoholic drinks every day while using this product

Stomach bleeding warning: This product contains an NSAID, which may cause severe stomach bleeding. The chance is higher if you

  • are age 60 or older
  • have had stomach ulcers or bleeding problems
  • take a blood thinning (anticoagulant) or steroid drug
  • take other drugs containing prescription or nonprescription NSAIDs (aspirin, ibuprofen, naproxen, or others)
  • have 3 or more alcoholic drinks every day while using this product
  • take more or for a longer time than directed

Medication overuse headache warning: Headaches may worsen if this product is used for 10 or more days per month.

Caffeine warning: The recommended dose of this product contains about as much caffeine as a cup of coffee. Limit the use of caffeine-containing medications, foods, or beverages while taking this product because too much caffeine may cause nervousness, irritability, sleeplessness, and, occasionally, rapid heart beat.

Do not use

  • if you have ever had an allergic reaction to acetaminophen, aspirin or any other pain reliever/fever reducer
  • with any other drug containing acetaminophen (prescription or nonprescription). If you are not sure whether a drug contains acetaminophen, ask a doctor or pharmacist.

Ask a doctor before use if

  • you have never had migraines diagnosed by a health professional
  • you have a headache that is different from your usual migraines
  • you have the worst headache of your life
  • you have fever and stiff neck
  • you have headaches beginning after or caused by head injury, exertion, coughing or bending
  • you experienced your first headache after the age of 50
  • you have daily headaches
  • you have a migraine so severe as to require bed rest
  • you have liver disease
  • stomach bleeding warning applies to you
  • you have a history of stomach problems, such as heartburn
  • you have high blood pressure, heart disease, liver cirrhosis, or kidney disease
  • you are taking a diuretic
  • you have asthma
  • you have problems or serious side effects from taking pain relievers or fever reducers
  • you have vomiting with your migraine headache

Ask a doctor or pharmacist before use if you are

  • taking a prescription drug for:
    • diabete
    • gout
    • arthritis
  • under a doctor’s care for any serious condition
  • taking any other drug
  • taking any other product that contains aspirin, acetaminophen, or any other pain reliever/fever reducer

In 1966, other investigators began using radioactive substances to measure gastric emptying. With refinements over the years, this technique has become the standard for assessing the rate of gastric emptying.

Standards for such testing have been set by the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. They state that a normal stomach should be 90 percent empty after four hours. The difference between this standard and the earlier study probably reflects differences in foods. Solids take longer to digest than liquids; fats take longer to digest than protein or carbohydrates.

The Food and Drug Administration incorporates these data, standards and thousands of drug-food studies into actionable recommendations. The F.D.A. defines an empty stomach as “one hour before eating, or two hours after eating.” The F.D.A.’s two-hour rule is just a rule of thumb; the stomach will probably not be completely empty.

The specific definition of an empty stomach varies from drug to drug. The popular anti-osteoporosis drug Fosamax, for example, should be taken “at least one-half hour before the first food, beverage, or medication of the day.” This promotes its absorption and reflects the need to stay upright after taking Fosamax, which lessens its potential to cause esophageal irritation. The same recommendation applies to the related drug Actonel, but a full hour is recommended for the related drug Boniva.

Similarly, the thyroid drug levothyroxine should be taken “on an empty stomach, one-half to one hour before breakfast.” But one should not assume that an empty stomach always implies that a medication should be taken first thing in the morning. Some medications should be taken on an empty stomach at bedtime. This is the case with the H.I.V. drug Sustiva. Taking Sustiva on an empty stomach regulates its absorption. And, taking it at bedtime makes the dizziness and drowsiness that it causes more tolerable.

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