Thomapyrin® is a combination preparation consisting of the active ingredients paracetamol, acetylsalicylic acid (ASS) and caffeine. It is marketed by Boehringer Ingelheim Pharma GmbH & Co. KG (Vienna, Austria). It is one of the most widely used over-the-counter pain-relieving drugs in Germany. Thomapyrin® is mostly used to relieve mild to moderate pain.
Composition
Thomapyrin® is sold in the form of tablets with an active ingredient content of 250mg or 500mg. The distribution of the three active ingredients in a 500mg tablet looks like this. :
- ASS is with 250mg the highest concentrated
- Then follows paracetamol with 200mg
- Caffeine makes up a relatively small portion with 50mg.
Mode of action
The two analgesic active ingredients ASS and paracetamol are among the most frequently used pain-relieving preparations. Both belong to the group of non-opioid analgesics; this means that they are not active ingredients related to morphine. ASARs belong to the subgroup of NSAIDs (non-steroidal anti-inflammatory drugs/antiphlogistics) – i.e. analgesics that are not based on the active ingredient cortisone.
It inhibits the enzyme cyclooxygenase, which is responsible for the production of various inflammation-promoting and anti-inflammatory factors, the prostaglandins. By inhibiting cyclooxygenase, an attempt is made to shift the balance between the factors produced in the direction of anti-inflammatory. In addition to its anti-inflammatory effect, ASA has an antipyretic effect (antipyretic) and inhibits blood clotting (anticoagulatory).
In the course of the inhibition of COX, there is unfortunately also a lack of production of protective prostaglandins, e.g. in the stomach, which is one of the reasons why various side effects have been described. Within the group of non-opioid analgesics, paracetamol is counted among the “non-acid analgesics”. The name results from the fact that the NSAIDs, such as ASS, ibuprofen and diclofenac (Voltaren), are chemically speaking acids, whereas paracetamol is not.
The exact way paracetamol works has not yet been conclusively clarified. However, it is known that paracetamol has a fever-reducing and pain-relieving effect, but has no anti-inflammatory effect. The third active ingredient, caffeine, has no known anti-inflammatory effect.
The idea behind adding caffeine to Thomapyrin® is that the two pain-relieving active ingredients ASS and paracetamol act more quickly and the desired effect – pain relief – also occurs more quickly. In science and among pharmacologists, this effect is viewed critically and not confirmed by all sides. There is talk from various quarters of increased side effects due to the combination of the active ingredients, as well as an increased risk of dependence.
Other points of view note that the faster onset of action caused by the caffeine means that patients take additional tablets less frequently to achieve the desired effect. This would ultimately result in a lower dose of potentially harmful substances being taken. The addition of caffeine does not lead to a higher effect; the positive effect is that a lower dose of the analgesic together with 50mg of caffeine will have the same effect as a higher dose of the analgesic without caffeine. Some countries, such as Switzerland, do not see the combination of different analgesic active ingredients as a suitable starting point for today’s medicine and prohibit approval.
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