Phenacetin

Phenacetin is a synthetic analgesic and antipyretic drug first introduced in 1887 by Bayer. It was one of the earliest non-opioid pain relievers and fever reducers available for clinical use. Phenacetin acts primarily by inhibiting cyclooxygenase (COX), thereby reducing prostaglandin synthesis in the brain and peripheral tissues, which leads to decreased pain perception and fever reduction. Its analgesic effects are also attributed to actions on sensory tracts of the spinal cord and a depressant effect on cardiac contractility (negative inotropy). In vivo, phenacetin is metabolized mainly to paracetamol (acetaminophen), which is responsible for most of its therapeutic effects[2][3][6]. Due to serious adverse effects—including nephrotoxicity, carcinogenicity (notably kidney and bladder cancer), hemolytic anemia, methemoglobinemia, agranulocytosis, gastrointestinal bleeding, hemorrhagic stroke, Stevens-Johnson syndrome—and its potential for abuse due to mild sedative/euphoric properties[5][6], phenacetin has been withdrawn from medical use in most countries since the late 1970s–1980s[1][3][4]. It remains available as an adulterant in illicit drugs.

Brand names

AntineuralgicaDolor

Other names

acetophenetidinacetophenetidineN-(4-ethoxyphenyl)acetamide