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Components:
Caffeine, Acetaminophen
Method of action:
Analgesic, Antacid, Antipyretic, Pain Reliever
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Medically reviewed by Kovalenko Svetlana Olegovna, PharmD. Last updated on 2019.09.20

Name of the medicinal product

Acetamin Forte MK

Qualitative and quantitative composition

Caffeine; Acetaminophen

Therapeutic indications

The information provided in Therapeutic indications of Acetamin Forte MK is based on data of another medicine with exactly the same composition as the Acetamin Forte MK of the medicine (Caffeine, Acetaminophen). Be careful and be sure to specify the information on the section Therapeutic indications in the instructions to the drug Acetamin Forte MK directly from the package or from the pharmacist at the pharmacy.
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Acetamin Forte MK is a mild analgesic and antipyretic formulated to give extra pain relief. The soluble tablets are recommended for the treatment of most painful and febrile conditions, for example, headache including migraine, backache, toothache, colds and influenza, sore throat, rheumatic pain and dysmenorrhoea.

Dosage (Posology) and method of administration

The information provided in Dosage (Posology) and method of administration of Acetamin Forte MK is based on data of another medicine with exactly the same composition as the Acetamin Forte MK of the medicine (Caffeine, Acetaminophen). Be careful and be sure to specify the information on the section Dosage (Posology) and method of administration in the instructions to the drug Acetamin Forte MK directly from the package or from the pharmacist at the pharmacy.
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Acetamin Forte MK should be dissolved in at least half a tumblerful of water.

Adults (including the elderly) and children aged 16 years and over:

Two tablets up to four times daily.

Do not exceed 8 tablets in 24 hours.

Children aged 12-15 years:

One tablet up to four times daily.

Do not exceed 4 tablets in 24 hours.

Not recommended for children under 12 years.

Do not take more frequently than every 4 hours.

Do not take for longer than three days without consulting your doctor.

Method of Administration

Acetamin Forte MK Soluble Tablets are for oral administration only.

Contraindications

The information provided in Contraindications of Acetamin Forte MK is based on data of another medicine with exactly the same composition as the Acetamin Forte MK of the medicine (Caffeine, Acetaminophen). Be careful and be sure to specify the information on the section Contraindications in the instructions to the drug Acetamin Forte MK directly from the package or from the pharmacist at the pharmacy.
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Hypersensitivity to paracetamol, caffeine or any of the other constituents.

Special warnings and precautions for use

The information provided in Special warnings and precautions for use of Acetamin Forte MK is based on data of another medicine with exactly the same composition as the Acetamin Forte MK of the medicine (Caffeine, Acetaminophen). Be careful and be sure to specify the information on the section Special warnings and precautions for use in the instructions to the drug Acetamin Forte MK directly from the package or from the pharmacist at the pharmacy.
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Care is advised in the administration of paracetamol to patients with renal or hepatic impairment. The hazard of overdose is greater in those with non-cirrhotic alcoholic liver disease.

Excessive intake of caffeine (e.g. coffee, tea and some canned drinks) should be avoided while taking this product.

Do not exceed the stated dose.

Patients should be advised to consult their doctor if their headaches become persistent.

Patients should be advised not to take other paracetamol-containing products concurrently.

Each 2 tablet dose of Acetamin Forte MK Soluble Tablet contains 854 mg of sodium and should not be taken by patients on a low sodium diet.

Patients with rare hereditary problems of fructose intolerance should not take this medicine.

If symptoms persist consult your doctor.

Keep out of the reach and sight of children.

Pack Label:

Immediate medical advice should be sought in the event of an overdose, even if you feel well. Do not take with any other paracetamol-containing products.

Patient Information Leaflet:

Immediate medical advice should be sought in the event of an overdose, even if you feel well, because of the risk of delayed, serious liver damage.

Effects on ability to drive and use machines

The information provided in Effects on ability to drive and use machines of Acetamin Forte MK is based on data of another medicine with exactly the same composition as the Acetamin Forte MK of the medicine (Caffeine, Acetaminophen). Be careful and be sure to specify the information on the section Effects on ability to drive and use machines in the instructions to the drug Acetamin Forte MK directly from the package or from the pharmacist at the pharmacy.
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None.

Undesirable effects

The information provided in Undesirable effects of Acetamin Forte MK is based on data of another medicine with exactly the same composition as the Acetamin Forte MK of the medicine (Caffeine, Acetaminophen). Be careful and be sure to specify the information on the section Undesirable effects in the instructions to the drug Acetamin Forte MK directly from the package or from the pharmacist at the pharmacy.
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Adverse events from historical clinical trial data are both infrequent and from small patient exposure. Accordingly, events reported from extensive post-marketing experience at therapeutic/labelled dose and considered attributable are tabulated below by system class. Due to limited clinical trial data, the frequency of these adverse events is not known (cannot be estimated from available data), but post-marketing experience indicates that adverse reactions to paracetamol are rare and serious reactions are very rare.

Post marketing data

Body System

Undesirable effect

Blood and lymphatic system disorders

Thrombocytopenia

Agranulocytosis

Immune system disorders

Anaphylaxis

Cutaneous hypersensitivity reactions including skin rashes, angiodema and Stevens Johnson syndrome/toxic epidermal necrolysis

Respiratory, thoracic and mediastinal disorders

Bronchospasm*

Hepatobiliary disorders

Hepatic dysfunction

* There have been cases of bronchospasm with paracetamol, but these are more likely in asthmatics sensitive to aspirin or other NSAIDs.

Caffeine

Central Nervous system

Nervousness

Dizziness

When the recommended paracetamol-caffeine dosing regimen is combined with dietary caffeine intake, the resulting higher dose of caffeine may increase the potential for caffeine-related adverse effects such as insomnia, restlessness, anxiety, irritability, headaches, gastrointestinal disturbances and palpitations.

Overdose

The information provided in Overdose of Acetamin Forte MK is based on data of another medicine with exactly the same composition as the Acetamin Forte MK of the medicine (Caffeine, Acetaminophen). Be careful and be sure to specify the information on the section Overdose in the instructions to the drug Acetamin Forte MK directly from the package or from the pharmacist at the pharmacy.
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Paracetamol

Liver damage is possible in adults who have taken 10 g or more of paracetamol. Ingestion of 5 g or more of paracetamol may lead to liver damage if the patient has risk factors (see below).

Risk Factors:

If the patient

- Is on long term treatment with carbamazepine, phenobarbitone, phenytoin, primidone, rifampicin, St John's Wort or other drugs that induce liver enzymes.

Or

- Regularly consumes ethanol in excess of recommended amounts.

Or

- Is likely to be glutathione deplete e.g. eating disorders, cystic fibrosis, HIV infection, starvation, cachexia.

Symptoms

Symptoms of paracetamol overdose in the first 24 hours are pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage may become apparent 12 to 48 hours after ingestion. Abnormalities of glucose metabolism and metabolic acidosis may occur. In severe poisoning, hepatic failure may progress to encephalopathy, haemorrhage, hypoglycaemia, cerebral oedema and death. Acute renal failure with acute tubular necrosis, strongly suggested by loin pain, haematuria and proteinuria, may develop even in the absence of severe liver damage. Cardiac arrhythmias and pancreatitis have been reported.

Management

Immediate treatment is essential in the management of paracetamol overdose. Despite a lack of significant early symptoms, patients should be referred to hospital urgently for immediate medical attention. Symptoms may be limited to nausea or vomiting and may not reflect the severity of overdose or the risk of organ damage. Management should be in accordance with established treatment guidelines, see BNF overdose section.

Treatment with activated charcoal should be considered if the overdose has been taken within 1 hour. Plasma paracetamol concentration should be measured at 4 hours or later after ingestion (earlier concentrations are unreliable). Treatment with N-acetylcysteine may be used up to 24 hours after ingestion of paracetamol, however, the maximum protective effect is obtained up to 8 hours post-ingestion. The effectiveness of the antidote declines sharply after this time. If required the patient should be given intravenous N-acetylcysteine, in line with the established dosage schedule. If vomiting is not a problem, oral methionine may be a suitable alternative for remote areas, outside hospital. Management of patients who present with serious hepatic dysfunction beyond 24h from ingestion should be discussed with the NPIS or a liver unit.

Caffeine

Symptoms

Overdose of caffeine may result in epigastric pain, vomitting, diuresis, tachycardia or cardia arrhythmia, CNS stimulation (insomnia, restlessness, excitement, agitation, jitteriness, tremors and convulsions).

It must be noted that for clinically significant symptoms of caffeine overdose to occur with this product, the amount ingested would be associated with serious paracetamol-related toxicity.

Management

Patients should receive general supportive care (e.g. hydration and maintenance of vital signs). The administration of activated charcoal may be beneficial when performed within one hour of the overdose, but can be considered for up to four hours after the overdose. The CNS effects of overdose may be treated with intravenous sedatives.

Summary

Treatment of overdose with Cope Sachets requires assessment of plasma paracetamol levels for antidote treatment, with signs and symptoms of codeine and caffeine toxicity being managed symptomatically.

Sodium bicarbonate

High doses of sodium bicarbonate may be expected to induce gastrointestinal symptoms including belching and nausea. In addition, high doses of sodium bicarbonate may cause hypernatraemia; electrolytes should be monitored and patients managed accordingly.

Pharmacodynamic properties

The information provided in Pharmacodynamic properties of Acetamin Forte MK is based on data of another medicine with exactly the same composition as the Acetamin Forte MK of the medicine (Caffeine, Acetaminophen). Be careful and be sure to specify the information on the section Pharmacodynamic properties in the instructions to the drug Acetamin Forte MK directly from the package or from the pharmacist at the pharmacy.
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The combination of paracetamol and caffeine is a well established analgesic combination.

Pharmacokinetic properties

The information provided in Pharmacokinetic properties of Acetamin Forte MK is based on data of another medicine with exactly the same composition as the Acetamin Forte MK of the medicine (Caffeine, Acetaminophen). Be careful and be sure to specify the information on the section Pharmacokinetic properties in the instructions to the drug Acetamin Forte MK directly from the package or from the pharmacist at the pharmacy.
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Paracetamol is rapidly and almost completely absorbed from the gastro-intestinal tract. It is relatively uniformly distributed throughout most body fluids and exhibits variable protein binding. Excretion is almost exclusively renal, in the form of conjugated metabolites.

Caffeine is absorbed readily after oral administration, maximal plasma concentrations are achieved within one hour and the plasma half-life is about 3.5 hours. 65 - 80% of administered caffeine is excreted in the urine as 1-methyluric acid and 1-methylxanthine.

Preclinical safety data

The information provided in Preclinical safety data of Acetamin Forte MK is based on data of another medicine with exactly the same composition as the Acetamin Forte MK of the medicine (Caffeine, Acetaminophen). Be careful and be sure to specify the information on the section Preclinical safety data in the instructions to the drug Acetamin Forte MK directly from the package or from the pharmacist at the pharmacy.
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There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SPC.

Incompatibilities

The information provided in Incompatibilities of Acetamin Forte MK is based on data of another medicine with exactly the same composition as the Acetamin Forte MK of the medicine (Caffeine, Acetaminophen). Be careful and be sure to specify the information on the section Incompatibilities in the instructions to the drug Acetamin Forte MK directly from the package or from the pharmacist at the pharmacy.
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None.

Special precautions for disposal and other handling

The information provided in Special precautions for disposal and other handling of Acetamin Forte MK is based on data of another medicine with exactly the same composition as the Acetamin Forte MK of the medicine (Caffeine, Acetaminophen). Be careful and be sure to specify the information on the section Special precautions for disposal and other handling in the instructions to the drug Acetamin Forte MK directly from the package or from the pharmacist at the pharmacy.
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None.