Meds and you

Updated 27 September 2013

Aspirin, paracetamol, caffeine, codeine and meprobamate

The combination of aspirin, paracetamol, codeine, caffeine and meprobamate is a potent analgesic. An analgesic is a substance which reduces or eliminates pain.


The combination of aspirin, paracetamol, caffeine, codeine and meprobamate is the active ingredient of Tenston (Nappi code: 796649-009/017).

General information
The combination of aspirin, paracetamol, codeine, caffeine and meprobamate is a potent analgesic. An analgesic is a substance which reduces or eliminates pain.

In South Africa this combination is registered for the treatment of mild to moderate pain, and pain associated with tension. It is also effective in reducing fever.

Paracetamol is the analgesic of choice for mild to moderate pain and for reducing fever. It is suitable for both adults and children and, as it does not cause stomach irritation, it is safe to use by those who suffer from peptic ulcers and those who cannot take aspirin.

When taken by mouth it is rapidly absorbed into the body and will be effective within 30 minutes. Paracetamol is safe for occasional use by those being treated with anticoagulants.

Aspirin is used for the relief of mild to moderate pain, for reducing fever, and to reduce inflammation. It may cause indigestion, irritation of the stomach lining, gastric ulcers or even bleeding. This may be more common when combined with caffeine.

Codeine is most often prescribed to treat mild to severe pain, but is also effective in treating diarrhoea. For this reason, this combination may cause constipation in some. Codeine should be used with caution in those patients with a history of alcohol or drug abuse, as definitive risk of dependency does exist.

Meprobamate is effective in treating the symptoms of anxiety and tension and is commonly found as an ingredient of higher schedule painkillers, mainly due to its effectiveness in treating tension-related pain.

Caffeine appears to have analgesic effects for some types of pain. Caffeine alone or and in combination with other analgesics has been found to be effective in relieving mild to moderate tension and vascular headaches. It is also effective in reducing drowsiness and impaired mental alertness caused by some of the other ingredients in this combination.

It should be noted that pain is a symptom and not a disease, and although this combination may be useful for short-term pain management, long-term relief often requires treatment of the underlying cause. None of the ingredients in this combination cures the underlying condition responsible for pain or fever, but simply keeps the symptoms under control.

A combination product such as this is helpful in reducing the number of tablets taken for pain management.

How does this combination work?
Paracetamol and aspirin blocks the production of chemicals in the body that is responsible for pain, fever, swelling and inflammation, while codeine exerts its effect by acting on parts of the central nervous system which process pain signals. Meprobamate affects levels of chemicals in your brain, thereby reducing anxiety and tension. The combination of caffeine with these analgesics in this combination likely reinforces their use by causing a pleasant sense of general well-being.

Fast facts

Drug schedule: schedule 5
Available as: the combination of aspirin, paracetamol, caffeine, codeine and meprobamate is available as tablets
What does it do? this combination reduces or eliminates pain
Overdose risk: high
Dependence risk: high
Is this combination available as a generic? no
Is this combination available on prescription only? yes

User information

Dietary advice: this combination should best be taken with food to avoid gastric upset or irritation.
Stopping this medicine: treatment should not be stopped abruptly, especially if you have been taking this drug for a prolonged period of time. To prevent withdrawal symptoms you should decrease your dose gradually only as directed by your doctor.
Prolonged use: resistance may develop to this medication making it less effective with prolonged use. Your doctor should periodically review your treatment and the need to continue with this drug.

Special precautions
Consult your doctor before using this drug if:


  • you have a kidney or liver disease

  • you are epileptic

  • you have a respiratory disorder

  • you have a history of alcohol or substance abuse

  • you have porphyria

  • you have a head injury

  • you have a bleeding disorder

  • you have difficulty urinating

  • you have an obstructive bowel disorder

  • you have a thyroid disorder

  • you have a stomach ulcer or a history of stomach ulcers

  • you are dehydrated

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.
Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.
Infants and children: This medication is not intended for use in children.
The elderly: caution is advised in the elderly as adverse effects may occur more frequently.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication

Possible side effects

Side Effect
Consult your doctor
Only if severe
In all cases
drowsiness, dizziness
slurred speech
visual impairment
nausea, vomiting
fast, irregular heart rate
skin rash
difficulty breathing
change in mood
rash/itchy skin
yellow-tinged skin and eyes

Drug interactions

alcohol (and other suppressants of the cns) enhanced cns effects i.e. sedation
sedative drugs risk of masking the symptoms of aspirin overdose
oral contraceptives risk of potential contraceptive failure. an alternative method of contraception is advised.
atropine and related drugs increased risk of constipation, urinary retention, etc.
drugs of diarrhoea risk of severe constipation
carbamazepine increased risk of carbamazepine toxicity
monoamine oxidase inhibitors increase risk of low blood pressure
chlorpromazine increase painkilling effect

Disease interactions
Consult your doctor before using this drug if you have a kidney or liver disease, are epileptic, have a respiratory disorder, a history of alcohol or substance abuse, porphyria, a head injury, a bleeding disorder, difficulty urinating, an obstructive bowel disorder, a thyroid disorder, a stomach ulcer or a history of stomach ulcers or if you are dehydrated

Overdose action
An overdose of this medication can be fatal. Seek immediate emergency medical attention


This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

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