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Analgesic combinations

Medically reviewed by Carmen Pope, BPharm. Last updated on April 17, 2023.

What are Analgesic combinations?

Analgesic combinations contain at least one analgesic in combination with another medicine or medicines. An analgesic is the name given to a medicine that relieves pain without putting you to sleep or making you lose consciousness. Analgesics may also be known as painkillers or pain relievers.

If an analgesic combination product contains two analgesics, these generally have different ways of working to relieve pain.

Analgesic combination products tend to either have acetaminophen, an NSAID (such as ibuprofen or naproxen), or an opioid (such as codeine) as one of their ingredients.

What are analgesic combinations used for?

Analgesic combinations may be taken to relieve pain that arises from a wide range of conditions, such as:

It is important to note that not all analgesic combinations are appropriate for all these conditions.

What are the differences between the different analgesic combinations?

Analgesic combinations differ in the ingredients they contain which means there are vast differences in the way they work, their potency, (how strong they are), and in the way they are absorbed, distributed, metabolized, and excreted within the body.

Some analgesic combinations contain NSAIDs, whereas others contain opioids (narcotics). Other ingredients may include caffeine, which enhances the pain-relieving effect of an analgesic, and diphenhydramine, which is used for its sleep-inducing properties.

Analgesic combinations that contain opioids should only be used if other analgesics or analgesic combinations have proved ineffective as they are potentially addictive.

Common Analgesic combinations available in the U.S.

Generic name Brand name examples
acetaminophen + aspirin Generic
acetaminophen + aspirin + caffeine ArthritenExcedrin, Goody's Extra-Strength
acetaminophen + butalbital AllzitalBupap
acetaminophen + butalbital + caffeine Capacet, Fioricet
acetaminophen + caffeine Excedrin Quick Tab, Excedrin Tension Headache
acetaminophen +caffeine + isometheptene mucate Discontinued
Acetaminophen + caffeine + magnesium salicylate Generic
Acetaminophen + diphenhydramine Midol PM
acetaminophen + phenyltoloxamine CR Discontinued
aspirin + butalbital + caffeine Fiorinal
codeine + acetaminophen Generic
codeine + acetaminophen + butalbital + caffeine Fioricet with codeine
codeine + aspirin + butalbital + caffeine Ascomp with codeine, Fiorinal with codeine
dihydrocodeine + acetaminophen + caffeine Trezix
hydrocodone + acetaminophen Generic
hydrocodone + ibuprofen Generic
ibuprofen + diphenhydramine Advil PM
naproxen + diphenhydramine Aleve PM, Excedrin PM, Tylenol PM
oxycodone + acetaminophen NalocetPrimlev
tramadol + acetaminophen Ultracet

Are analgesic combinations safe?

Most analgesic combinations are considered safe when taken for short periods of time and exactly as directed on the packaging or by a doctor. Some analgesic combinations, such as those containing acetaminophen or ibuprofen, may be considered safer than others.

Narcotic analgesic combinations have been associated with some serious risks such as respiratory depression (unusually slow and shallow breathing), opioid-use disorder, and potentially fatal overdose. They are potentially addictive and should only be used for certain conditions and under strict monitoring.

What are the side effects of analgesic combinations?

All medicines have side effects but how vulnerable a person is to them depends on several different factors such as age, genetics, kidney function and gender (see Managing Common Drug Side Effects)

Narcotic analgesic combinations have many side effects, although people with cancer or a terminal illness taking narcotic analgesic combinations for long periods of time may become tolerant to some of these side effects.

Drowsiness, sleepiness, or dizziness are common with most narcotic analgesic combinations. These side effects may affect driving or a person's ability to operate machinery and perform other hazardous tasks. Alcohol may potentiate these effects

Combination analgesics containing NSAIDs may also cause side effects, especially when used at higher than recommended dosages for long periods of time. Gastrointestinal side effects that may occur include bloating, diarrhea, constipation, irritation of the lining of the stomach, nausea or vomiting. Combination products containing NSAIDs may also affect kidney function and reduce how quickly blood flows through the kidneys. They may cause retention of sodium and water which can lead to edema and high potassium levels. Occasionally, they may cause more serious damage to the kidneys. NSAIDs have also been associated with a higher risk of cardiovascular disease.

Combination products that contain agents that enhance sleep such as diphenhydramine may also cause drowsiness and affect a person’s ability to drive, operate machinery, or perform other hazardous tasks.

Please refer to each combination product for a full list of side effects.

List of Analgesic combinations

View by  Generic | Brand
Drug Name Avg. Rating Reviews
acetaminophen / aspirin / caffeine systemic
Brand names: Anacin Advanced Headache Formula, Arthriten, Backaid Inflammatory Pain Formula, Excedrin, Excedrin Extra Strength, Excedrin Migraine, Genace, Goody's Extra Strength, Goody's Extra-Strength Headache Powders, Goody's Headache Powders, Vanquish
6.7
387 reviews
aspirin / caffeine systemic
Brand names: Alka-Seltzer Hangover Relief, Alka-Seltzer Wake-Up Call!, Anacin, Anacin Max Strength, Back & Body Extra Strength, BC Arthritis, BC Original, Cope, P-A-C, P-A-C Analgesic
5.0
311 reviews
acetaminophen / butalbital / caffeine systemic (Pro)
Brand names: Anolor 300, Fioricet, Phrenilin Forte, Vanatol LQ, Vanatol S, Vtol LQ, Zebutal
8.7
262 reviews
aspirin / butalbital / caffeine systemic (Pro)
Brand names: Fiorinal, Fortabs
8.9
128 reviews
acetaminophen / diphenhydramine systemic
Brand names: Headache Relief PM, Legatrin PM, Midol PM, Night Time Pain, Percogesic Extra Strength, Percogesic Original Strength, Tylenol PM, Unisom PM Pain
7.1
69 reviews
diphenhydramine / naproxen systemic
Brand name: Aleve PM
6.6
43 reviews
diphenhydramine / ibuprofen systemic (Pro)
Brand names: Advil PM, Ibuprofen PM, Motrin PM
7.1
23 reviews
acetaminophen / butalbital systemic (Pro)
Brand names: Allzital, Bupap, Cephadyn
9.3
18 reviews
acetaminophen / caffeine systemic
Brand names: Excedrin Quick Tab, Excedrin Tension Headache
9.5
8 reviews
acetaminophen / caffeine / pyrilamine systemic
Brand name: Midol Complete
8.0
4 reviews
acetaminophen / caffeine / magnesium salicylate systemic
10
2 reviews
bupivacaine / meloxicam systemic (Pro)
Brand name: Zynrelef
8.0
1 review
diphenhydramine / magnesium salicylate systemic
Brand name: Doans PM
No reviews
acetaminophen / magnesium salicylate / pamabrom systemic
Brand name: Pamprin Cramp Menstrual Pain Relief
No reviews
acetaminophen / ibuprofen systemic
Brand names: Combogesic, Combogesic IV
No reviews
For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).

Further information

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