What is megaphone?

This drug is a combination of acetaminophen, ibuprofen and caffeine. This drug is used in the treatment of mild to moderate pain caused by headache (nervous and migraine), toothache, neuro-muscular pain, joint pain .

Mechanism of action

Caffeine is a mild stimulant of the central nervous system and constricts the blood vessels of the brain, and this effect may help relieve headaches. The analgesic and antipyretic effects of this drug are related to acetaminophen and ibuprofen.


Caffeine is well absorbed from the digestive tract and its half-life is 3-4 hours. Its binding to plasma proteins is low and its metabolism is mainly hepatic. Acetaminophen and ibuprofen are well absorbed from the gastrointestinal tract and both are metabolized by the liver. A small amount of acetaminophen and 99% of ibuprofen are bound to plasma proteins.


If you have a history of severe allergies such as anaphylaxis or angioedema caused by non-steroidal anti-inflammatory drugs, it is contraindicated.

side effects

Skin rashes, allergic dermatitis, blood disorders, acute pancreatitis are side effects of long-term use of acetaminophen. Nausea, diarrhea, and sometimes bleeding and ulcers may be caused by the use of ibuprofen.

Drug interactions

    • Taking ibuprofen with angiotensin enzyme inhibitors can reverse their antihypertensive effect and cause kidney failure and increase blood potassium.
    • Cyclosporine, lithium, methotrexate, triamterene, aspirin and valproic acid interact with ibuprofen contained in this medicine.
    • Medicines that make liver enzymes more active reduce the effect of acetaminophen. For example: carbamazepine (Tegretol), isoniazid, barbiturates such as phenobarbitol, rifampin.
    • Cholestyramine reduces the absorption of acetaminophen from the intestine, so acetaminophen should be used one hour before or 3-4 hours after taking cholestyramine.
    • Warfarin: Taking acetaminophen with a dose of more than 2 grams per day can increase the blood thinning effect of warfarin.
    • The risk of bleeding due to the use of oral anticoagulants increases during treatment with this drug.
    • Simultaneous use of this drug with antibiotics, corticosteroids and NSAIDs increases the possibility of gastrointestinal side effects.
    • Following the simultaneous use of this drug with furosemide, aminoglycosides, cisplatin, capromycin, erythromycin, vancomycin, there is a possibility of worsening ototoxicity, and in this regard, the patient should be checked.


Overuse of this drug may increase the risk of liver necrosis.

Acetaminophen should be used with caution in the following cases:

Active alcoholism, liver disease and viral hepatitis.

Medication recommendations

In case of any visual disturbances, a doctor should be consulted.

Due to the possibility of liver or kidney damage, this drug should not be taken more than the recommended amount.

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