A white caplet debossed with 44-390 (or 44 390) is an over-the-counter (OTC) multi-symptom menstrual pain relief formulation. Manufactured primarily as a generic store-brand equivalent to Midol® Complete, it is distributed by major retailers such as Equate (Walmart), Walgreens, CVS, and Family Wellness.
Each single caplet contains a fixed combination of three active ingredients:
- Acetaminophen (500 mg): Pain Reliever / Fever Reducer
- Caffeine (60 mg): Central Nervous System Stimulant / Diuretic
- Pyrilamine Maleate (15 mg): First-Generation Antihistamine
Physical Identification
- Imprint:
44 390or44-390printed on one side. - Shape: Oval / Capsule-shaped (Caplet).
- Color: White
- Size: Approximately 17 mm.
- Score Line: Unscored (intended to be taken whole).
- Regulatory Status: Over-the-counter (OTC) medication.
Mechanism of Action
The three active components work synergistically to target different aspects of menstrual distress (cramps, bloating, fatigue, headache, and backache):
- Acetaminophen (Analgesic): Inhibits prostaglandin synthesis in the central nervous system, raising the body’s overall pain threshold to relieve abdominal cramps, backaches, and headaches.
- Caffeine (Diuretic & Analgesic Adjuvant): Acts as a central adenosine receptor antagonist. It reduces fluid retention/water-weight gain (acting as a mild diuretic) and constricts dilated cerebral blood vessels, enhancing the pain-relieving efficacy of acetaminophen by up to 40%.
- Pyrilamine Maleate (Antihistamine): Blocks H1 histamine receptors. In menstrual formulations, its primary action is relaxing uterine smooth muscle to ease painful spasms and reducing fluid retention caused by histamine responses.
Recommended Dosage & Directions
- Always adhere to package instructions or a healthcare provider’s guidance:
- Adults and Children 12 Years and Older:
- Take 2 caplets with water every 6 hours as needed.
- Maximum Daily Dose: Do not exceed 6 caplets within 24 hours (which provides 3,000 mg of acetaminophen, 360 mg of caffeine, and 90 mg of pyrilamine maleate).
- Children Under 12 Years: Ask a doctor before use.
- Administration: Swallow caplets whole with a full glass of water. May be taken with or without food, though taking it with food can help prevent mild stomach upset.
Side Effects
Because this is a three-drug combination product, side effects can stem from any of the individual active ingredients.
Common Side Effects
- Drowsiness or Fatigue: Pyrilamine maleate is a sedating first-generation antihistamine that can cause somnolence, reduced reaction times, or dry mouth/throat.
- Nervousness or Jitteriness: Caffeine can cause restlessness, anxiety, difficulty sleeping (insomnia), or a fast heart rate (tachycardia), especially in caffeine-sensitive individuals.
- Gastrointestinal: Mild nausea, heartburn, or upset stomach.
- Paradoxical Excitability: Children or older adults may occasionally experience restlessness or excitability rather than sedation.
Serious Reactions (Seek Immediate Medical Care)
- Severe Skin Reactions (Acetaminophen Alert): Reddening of the skin, blisters, or widespread rash (signs of rare conditions like Stevens-Johnson Syndrome).
- Signs of Liver Toxicity: Yellowing of the eyes or skin (jaundice), severe upper abdominal pain, dark urine, or extreme fatigue.
- Hypersensitivity / Anaphylaxis: Swelling of the face, tongue, or throat; hives; severe dizziness; or difficulty breathing.
Precautions & Critical Warnings
Severe Liver Damage Warning (Acetaminophen)
This product contains 500 mg of acetaminophen per caplet. Severe liver damage may occur if you:
- Take more than 4,000 mg of acetaminophen in 24 hours from all combined sources.
- Take it concurrently with other medications containing acetaminophen (e.g., Tylenol, NyQuil, Percocet, or cold/sinus products).
- Consume 3 or more alcoholic drinks every day while using this product.
Pre-existing Conditions
Consult a healthcare provider before use if you have:
- Liver disease or chronic alcohol dependence.
- Glaucoma (pyrilamine can increase intraocular pressure).
- Breathing problems such as chronic bronchitis, emphysema, or asthma.
- Urinary retention or difficulty urinating due to prostate enlargement.
Drug Interactions
- Sedatives & Tranquilizers: Alcohol, sleeping pills, or anti-anxiety drugs will significantly worsen drowsiness when combined with pyrilamine maleate.
- Warfarin: Frequent, long-term use of acetaminophen can potentiate blood-thinning effects and increase bleeding risk.
- Other Caffeine Sources: Limit coffee, tea, energy drinks, or caffeine-containing foods/medications to avoid severe jitteriness or elevated heart rate.
Special Populations
- Driving / Machinery: Use caution when driving or operating machinery, as drowsiness can impair alertness.
- Pregnancy & Breastfeeding: Consult a physician before use. (Caffeine and pyrilamine cross the placenta and pass into breast milk).