Caffeine is one of three active ingredients
Each caplet of Excedrin Extra Strength combines acetaminophen (250 mg), aspirin (250 mg) and caffeine (65 mg), according to its drug label, which lists caffeine’s purpose as a pain reliever aid. The dose is two caplets, so each dose carries 130 mg of caffeine, a little more than an 8 oz cup of drip coffee at USDA’s reference strength (95 mg). The label’s own caffeine warning says the recommended dose contains about as much caffeine as a cup of coffee.
The daily maximum is over the daily limit
The label allows two caplets every 6 hours, up to 8 caplets in 24 hours. At that maximum, Excedrin alone supplies 520 mg of caffeine, more than the 400 mg a day the FDA cites for healthy adults, before any coffee, tea or soda. The label accordingly says to limit caffeine-containing medicines, foods and drinks while taking it, because too much caffeine may cause nervousness, irritability, sleeplessness and occasionally a rapid heartbeat.
Excedrin Migraine and Tension Headache
The other caffeinated Excedrin products use the same 65 mg per caplet, but their labels set different limits. Excedrin Migraine has the same three ingredients at the same strengths; its label says to take two caplets and not more than two in 24 hours unless directed by a doctor, so at most 130 mg of caffeine a day. Excedrin Tension Headache drops the aspirin and pairs 500 mg of acetaminophen with 65 mg of caffeine; its label allows up to six caplets in 24 hours, 390 mg of caffeine.
Before a second dose
Because the caffeine comes with acetaminophen and aspirin, the limits on those ingredients matter as much as the caffeine. The Extra Strength label warns against taking it with any other drug containing acetaminophen, and says to ask a doctor first if you have liver disease, high blood pressure or heart disease, among other conditions.
The caffeine is easy to forget when you are counting drinks. A dose of Excedrin with a Grande Starbucks Caffè Latte is 280 mg; add a second dose in the afternoon and the day reaches 410 mg.