caffeine + codeine + paracetamol

Rokacet is a fixed-dose combination analgesic containing paracetamol (acetaminophen), caffeine, and codeine phosphate. Developed and manufactured by Taro Pharmaceuticals, it is marketed in Israel as an over-the-counter medication for the relief of mild-to-moderate pain (such as headache, migraine, and toothache), cough, and fever accompanied by pain. A stronger prescription-only formulation, Rokacet Plus, is also available. Paracetamol acts as an analgesic and antipyretic by weakly inhibiting cyclooxygenase (COX-1 and COX-2) pathways. Codeine is a centrally acting weak opioid analgesic that is metabolized in the liver by CYP2D6 to morphine, which then acts as an agonist at mu-type opioid receptors to impair pain transmission. Caffeine acts as a central nervous system stimulant and analgesic adjuvant by antagonizing adenosine receptors (primarily A1 and A2a), enhancing the pain-relieving effects of paracetamol. Rokacet has been evaluated in clinical settings, including a pilot trial in Israel as a rescue analgesic for postoperative pain following impacted wisdom tooth extraction.

Brand names

AnalgilasaCodasolveRatio-LenoltecRokacetRokacet PlusSolpadeine MaxSolpadeine PlusTeva-Lenoltec No 3Tylenol No. 1

Other names

acetaminophen + caffeine + codeineacetaminophen + caffeine + codeine phosphatecaffeine + codeine + paracetamolcaffeine + codeine phosphate + paracetamolparacetamol + caffeine + codeineparacetamol + caffeine + codeine phosphate