Paracetamol/Cafeine/Codeine Arrow (Paracetamol, Codeine Phosphate Hemihydrate, Anhydrous Caffeine)

Paracetamol/Caffeine/Codeine Arrow is a combination analgesic that acts on several pain‑related pathways.

• Headache: provides relief of tension‑type and migraine‑associated pain.
• Dental pain: reduces discomfort after dental procedures.
• Musculoskeletal pain: alleviates pain from strains, sprains and low‑back discomfort.
• Fever: lowers elevated body temperature in adults.
• Post‑operative pain: helps manage pain following minor surgical procedures.

• Paracetamol inhibits central cyclooxygenase enzymes, reducing prostaglandin synthesis and lowering the pain threshold. Codeine, a weak opioid agonist, binds to μ‑opioid receptors in the central nervous system, producing analgesia and mild sedation. Caffeine acts as an adenosine‑receptor antagonist, enhancing analgesic potency and counteracting drowsiness. The three components work synergistically to provide combined pain relief and antipyretic effects.

Paracetamol/Caffeine/Codeine Arrow may cause a range of adverse reactions.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Drowsiness: transient sleepiness.
• Constipation: reduced bowel movements.
• Dizziness: light‑headed sensation.
• Insomnia: difficulty falling or staying asleep.

Serious or Rare Side Effects

• Respiratory depression: slowed breathing, especially at higher opioid doses.
• Hepatotoxicity: liver injury from excessive paracetamol exposure.
• Allergic reactions: rash, itching, swelling or anaphylaxis.
• Seizures: rare occurrence, often linked to high caffeine intake.
• Dependence or misuse: potential for opioid‑related dependence with prolonged use.

Paracetamol/Caffeine/Codeine Arrow should be used with caution in specific situations.

• Liver disease: avoid or adjust use in patients with hepatic impairment.
• Renal impairment: monitor kidney function in patients with reduced renal clearance.
• Alcohol use: limit intake as combined use may increase liver toxicity.
• Pregnancy and lactation: consult a healthcare professional before use.
• Concomitant CNS depressants: may enhance sedative effects.
• Store below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Paracetamol/Caffeine/Codeine Arrow can interact with several medicines.

Major Interactions (Avoid)

• Other opioid analgesics: additive risk of respiratory depression and sedation.
• Benzodiazepines: heightened central nervous system depression.
• MAO inhibitors: increased risk of serotonin syndrome.

Moderate Interactions (Monitor Closely)

• Anticoagulants (e.g., warfarin): potential alteration of bleeding risk.
• Antihistamines: may increase drowsiness.
• CYP2D6 inhibitors: can affect codeine metabolism and analgesic effectiveness.