The recommended dosing has a low risk profile when taken occasionally in a well hydrated state. As with all medications containing paracetamol (acetaminophen), concomitant use with alcohol carries a significant risk of hepatotoxicity. The combination of paracetamol with aspirin also creates the risk of renal papillary necrosis if large doses are taken chronically. This is due to the fact that paracetamol yields a toxic metabolite that can accumulate in the kidney while aspirin works to deplete the glutathione stores necessary to oxidize it. Additionally, chronic aspirin usage is associated with increased risk of gastrointestinal bleeding.
In Germany, this combination is sold as Chephapyrin, dolomo, Dolopyrin, HA-Tabletten N, Melabon, Neuralgin, Novo Petrin, ratiopyrin, Thomapyrin CLASSIC, Thomapyrin INTENSIV, TITRALGAN, in Austria as Thomapyrin, InfluASS, Irocophan, and in Russia as Citramon.