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Excedrin Side Effects

Generic name: acetaminophen / aspirin / caffeine

Medically reviewed by Last updated on Jan 6, 2024.

Note: This document contains side effect information about acetaminophen / aspirin / caffeine. Some dosage forms listed on this page may not apply to the brand name Excedrin.

Applies to acetaminophen / aspirin / caffeine: oral packet, oral tablet.

Serious side effects of Excedrin

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

Other side effects of Excedrin

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at

For Healthcare Professionals

Applies to acetaminophen/aspirin/caffeine: oral powder for reconstitution, oral tablet.


The more commonly reported adverse events may include nausea dyspepsia, nervousness, irritability, sleeplessness, and palpitations.[Ref]


Acetaminophen (paracetamol):

Frequency not reported: Liver failure


Frequency not reported: Hepatotoxicity, cholestatic hepatitis, aminotransferase elevations[Ref]


Acetaminophen (paracetamol):

Frequency not reported: Nausea, vomiting


Frequency not reported: Epigastric distress, abdominal discomfort, nausea, vomiting, hemorrhage, peptic ulcers, perforation, esophageal ulcerations, dyspepsia, gastritis[Ref]


Acetaminophen (paracetamol):

Postmarketing reports: Anaphylaxis, hypersensitivity reactions


Very common (10% or more): Hypersensitivity reactions in asthmatics who are aspirin-sensitive (e.g., with the clinical triad of aspirin sensitivity, bronchial asthma, and nasal polyps)

Frequency not reported: Hypersensitivity reactions include bronchospasm, rhinitis, conjunctivitis, urticaria, angioedema, skin reactions, and anaphylaxis[Ref]


Acetaminophen (paracetamol):

Very rare (less than 0.01%): Serious skin reactions including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP)


Frequency not reported: Stevens-Johnson syndrome, lichenoid eruption[Ref]



Frequency not reported: Renal dysfunction, renal failure, increased blood uric acid levels[Ref]


Acetaminophen (paracetamol):

Frequency not reported: Blood dyscrasias including thrombocytopenia, agranulocytosis


Frequency not reported: Predictable antiplatelet effects, hemorrhage, increased blood fibrinolytic activity, hypoprothrombinemia, thrombocytopenia, thrombocyturia, megaloblastic anemia, pancytopenia, aplastic anemia, ecchymosis[Ref]



Frequency not reported: Bronchospasm (in patients sensitive to aspirin and other NSAID)[Ref]


Acetaminophen (paracetamol):

Frequency not reported: Hypotension


Frequency not reported: Salicylate-induced variant angina, ventricular ectopy, conduction abnormalities, and hypotension, particularly during salicylate toxicity


Frequency not reported: Palpitations[Ref]


Acetaminophen (paracetamol):

Frequency not reported: Hypokalemia, hypoglycemia


Frequency not reported: Dehydration, hyperkalemia, hypoglycemia, sodium and fluid retention, respiratory alkalosis and metabolic acidosis (particularly during salicylate toxicity)[Ref]

Nervous system

Acetaminophen (paracetamol):

Frequency not reported: Headache, dizziness, dystonia


Frequency not reported: Dizziness, headache


Frequency not reported: Dizziness, tremor[Ref]


Acetaminophen (paracetamol):

Frequency not reported: Malaise, fatigue


Frequency not reported: Reye's syndrome, tinnitus, temporary hearing loss


Frequency not reported: Fibrocystic breast disease[Ref]

Frequently asked questions


1. "Multum Information Services, Inc. Expert Review Panel"

2. Lanas A, Serrano P, Bajador E, Esteva F, Benito R, Sainz R (1997) "Evidence of aspirin use in both upper and lower gastrointestinal perforation." Gastroenterology, 112, p. 683-9

3. Dickinson JP, Prentice CRM (1998) "Aspirin: benefit and risk in thromboprophylaxis." Qjm Mon J Assoc Physician, 91, p. 523-38

4. He J, Whelton PK, Vu B, Klag MJ (1998) "Aspirin and risk of hemorrhagic stroke: a meta-analysis of randomized controlled trials." JAMA, 280, p. 1930-35

5. "Product Information. Bayer Aspirin (acetylsalicylsyra)." Bayer

6. Clementz GL, Dailey JW (1988) "Psychotropic effects of caffeine." Am Fam Physician, 37, p. 167-72

7. Sawynok J (1995) "Pharmacological rationale for the clinical use of caffeine." Drugs, 49, p. 37-50

8. Cerner Multum, Inc. "UK Summary of Product Characteristics."

9. (2022) "Product Information. Pamprin Max (acetaminophen / aspirin / caffeine)." Chattem Consumer Products

10. Zimmerman HJ, Maddrey WC (1995) "Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: analysis of instances of therapeutic misadventure." Hepatology, 22, p. 767-73

11. Gursoy M, Haznedaroglu IC, Celik I, Sayinalp N, Ozcebe OI, Dundar SV (1996) "Agranulocytosis, plasmacytosis, and thrombocytosis followed by a leukemoid reaction due to acute acetaminophen toxicity." Ann Pharmacother, 30, p. 762-5

12. Lee WM (1995) "Medical progress: drug-induced hepatotoxicity." N Engl J Med, 333, p. 1118-27

13. Filipe PL, Freitas JP, Decastro JC, Silva R (1995) "Drug eruption induced by acetaminophen in infectious mononucleosis." Int J Dermatol, 34, p. 220-1

14. Perneger TV, Whelton PK, Klag MJ (1994) "Risk of kidney failure associated with the use of acetaminophen, aspirin, and nonsteroidal antiinflammatory drugs." N Engl J Med, 331, p. 1675-79

15. Shoenfeld Y, Shaklai M, Livni E, Pinkhas J (1980) "Thrombocytopenia from acetaminophen." N Engl J Med, 303, p. 47

16. Brown G (1996) "Acetaminophen-induced hypotension." Heart Lung, 25, p. 137-40

17. Boyle CA, Berkowitz GS, LiVolsi VA, Ort S, Merino MJ, White C, Kelsey JL (1984) "Caffeine consumption and fibrocystic breast disease: a case-control epidemiologic study." J Natl Cancer Inst, 72, p. 1015-9

Further information

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

Some side effects may not be reported. You may report them to the FDA.