CETAL® Family (EIPICO – Egypt): Complete Medical Guide to Paracetamol & Combinations

MEDICAL INFORMATION: Some CETAL® products are available over the counter, but incorrect use can be harmful. This content is for educational purposes only and does not replace professional medical advice. Always follow the leaflet, never exceed the recommended dose, and consult your doctor or pharmacist if you have any questions or medical conditions.

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The Complete Medical Guide to the CETAL® Family (EIPICO – Egypt)

1) Summary

CETAL® is one of Egypt’s leading brands for managing pain and fever, manufactured by EIPICO. The family includes a core line of paracetamol-only products and several combination products (with caffeine, pseudoephedrine, and/or chlorpheniramine) tailored for headaches, sinus symptoms, and cold & flu relief.

2) Manufacturer

EIPICO – Egyptian International Pharmaceutical Industries Co.
Tenth of Ramadan City, Egypt.

3) Category

• Analgesic & Antipyretic (Paracetamol core line)
• Cold & Flu Combination Products (with decongestant and/or antihistamine ± caffeine)

4) Active Ingredient(s)

• Paracetamol (Acetaminophen) – all core CETAL® products
• Caffeine – CETAL Extra®
• Pseudoephedrine – CETAL Sinus®; CETAL Cold & Flu®
• Chlorpheniramine – CETAL Cold & Flu®

5) Mechanism of Action

• Paracetamol: Inhibits central prostaglandin synthesis → analgesic & antipyretic effects with minimal peripheral anti-inflammatory action.
• Caffeine: CNS stimulant that can enhance the analgesic effect of paracetamol (useful in tension headache/migraine).
• Pseudoephedrine: Sympathomimetic nasal decongestant → vasoconstriction of nasal mucosa → reduced congestion & sinus pressure.
• Chlorpheniramine: H1-antihistamine → reduces sneezing, rhinorrhea, and watery eyes; may cause sedation.

6) Available Forms & Strengths

Formulation	Strength	Typical Use
Tablets (CETAL®)	500 mg; 1000 mg (1 g)	Adults & ≥12 years (pain, fever)
Oral Drops	100 mg/ml (15 ml)	Infants & young children
Oral Suspension	250 mg/5 ml (60 ml)	Children
Suppositories	120 mg; 300 mg	Infants & children (when oral route not feasible)
CETAL Extra® (Tabs)	Paracetamol + Caffeine	Tension headache/migraine; enhanced analgesia
CETAL Sinus® (Caplets)	Paracetamol + Pseudoephedrine	Sinus pain & congestion
CETAL Cold & Flu® (Caplets)	Paracetamol + Pseudoephedrine + Chlorpheniramine	Multi-symptom cold & flu relief

For deeper background on Paracetamol, see the Paracetamol Hub Post.

7) Indications

• Fever of various causes
• Mild to moderate pain (headache, toothache, musculoskeletal pain)
• Sinus pain & nasal congestion (CETAL Sinus®)
• Cold & flu symptoms (CETAL Cold & Flu®)
• Headache/migraine requiring enhanced analgesia (CETAL Extra®)

8) Dosage & Administration

• Adults & ≥12 years (Paracetamol core): 500–1000 mg every 4–6 hours as needed; do not exceed 4 g/24 h from all sources.
• Children: 10–15 mg/kg/dose every 4–6 hours; typical max 60 mg/kg/day (use pediatric formulations and dosing devices).
• Combination products: Follow pack leaflet. Do not co-administer multiple Paracetamol-containing products.

9) Contraindications

• Hypersensitivity to paracetamol or any component.
• Severe hepatic impairment.
• Pseudoephedrine-containing products: Severe/uncontrolled hypertension, significant coronary artery disease, hyperthyroidism, severe arrhythmias, concomitant or recent (within 14 days) MAOI use.
• Chlorpheniramine-containing products: Narrow-angle glaucoma, severe urinary retention/prostatic hypertrophy; caution or avoid in children <6 years unless physician-directed.

10) Warnings & Precautions

• Hepatotoxicity: Risk rises with overdosing, chronic alcohol use, fasting/malnutrition, or liver disease.
• Alcohol: Avoid or limit; increases liver toxicity with paracetamol.
• Caffeine: May cause insomnia, palpitations, nervousness—avoid near bedtime.
• Pseudoephedrine: May elevate BP/HR; use cautiously in cardiovascular disease and diabetes.
• Chlorpheniramine: Sedating—caution with driving/machinery; additive CNS depression with alcohol/sedatives.

11) Side Effects

• Paracetamol: Generally well tolerated; rare rash or hypersensitivity; serious liver injury in overdose.
• Caffeine: Jitteriness, insomnia, palpitations, GI upset (dose-related).
• Pseudoephedrine: Restlessness, increased BP/HR, insomnia; rarely urinary retention.
• Chlorpheniramine: Drowsiness, dry mouth, blurred vision, constipation.

12) Drug Interactions

• Paracetamol: Chronic co-use with warfarin may raise INR; hepatotoxic risk increases with alcohol or enzyme inducers.
• Pseudoephedrine: Contraindicated with MAOIs (hypertensive crisis); caution with other sympathomimetics.
• Caffeine: Additive effects with other stimulants; may interact with certain CYP1A2 substrates.
• Chlorpheniramine: Additive sedation with alcohol, benzodiazepines, opioids, or other sedating antihistamines.

13) Overdose

• Paracetamol overdose: Can cause delayed but severe acute liver failure.
• Early symptoms: nausea, vomiting, diaphoresis, malaise; serious hepatotoxicity may appear 24–72 h later.
• Antidote: N-acetylcysteine (NAC) as early as possible per emergency protocols; urgent hospital evaluation required.

14) Use in Pregnancy & Lactation

• Paracetamol: Generally considered the analgesic/antipyretic of choice at recommended doses.
• Caffeine: Limit total daily intake; avoid high doses.
• Pseudoephedrine & Chlorpheniramine: Use only if the potential benefit justifies potential risk; seek physician advice.

15) Pediatric & Geriatric Use

• Pediatrics: Use weight-based dosing and pediatric formulations; avoid decongestants/antihistamines in children <6 years unless prescribed.
• Geriatrics: Consider comorbidities and polypharmacy; monitor BP/HR with pseudoephedrine; watch CNS effects with antihistamines.

16) Storage

• Store below 30°C, in a dry place away from direct heat.
• Keep out of reach of children.
• Do not use after the expiry date printed on the pack.

17) Packaging

• Tablets: Strips of 10; common retail boxes of 20; institutional packs may exist.
• Oral Drops: 15 ml bottle with plastic dropper.
• Suspension: 60 ml bottle; dosing spoon/cup as supplied.
• Suppositories: Packs of 5; larger institutional packs may exist.
• Combination products (caplets/tablets): Typically boxes of 20.

18) References

1. Paracetamol educational background post (overview of dosing & safety).
2. MedlinePlus – Cold and Cough Medicines (combination product guidance).
3. EIPICO official product leaflets (local Egyptian presentations and packs).
4. Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 13th ed. (mechanisms & pharmacology).

⚠ CRITICAL SAFETY REMINDER

Never take more than one Paracetamol-containing product at the same time. This can easily exceed the safe daily limit and cause severe, potentially fatal liver injury. Always check the active ingredients on every pack.