What is Phenacetin?

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  • Written By: M. Gardner
  • Edited By: A. Joseph
  • Last Modified Date: 08 February 2020
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The painkiller phenacetin was the world's first synthetic pharmaceutical drug. It was developed by an American chemist and began distribution in 1887. Phenacetin was often accompanied by aspirin and caffeine in what were called APC pills, which were widely distributed during and after World War II. The use of phenacetin in the U.S. was discontinued in the 1980s because of links to cancer and other adverse side effects, but it remains available in some countries.

Phenacetin is a white crystalline powder with the chemical composition C10H13NO2. It was first developed by Harmon Northrop Morse in 1878. In addition to its pain-reducing properties, it also has been used as a fever-reducer, a treatment for rheumatoid arthritis and a treatment for intercostal neuralgia, a rare disorder that causes pain in the nerves around the ribs. It was one of the first painkillers that was not derived from opium while at the same time being absent of anti-inflammatory qualities.

In 1983, the U.S. Food and Drug Administration (FDA) banned phenacetin in the U.S. because of its discovered carcinogenic properties and its link to kidney failure. The FDA stated that phenacetin alone is reasonably believed to be a human carcinogen, or cancer-causing agent, and that painkiller mixtures containing the drug are known human carcinogens. There has been little evidence found that phenacetin alone is a human carcinogen because it usually has been administered in combination with other drugs.


Those who have taken drugs that contain phenacetin are more likely to develop cardiovascular disease, high blood pressure, anemia and cancer, and they are at a higher risk of death because of renal failure or diseases of the urinary system, according to various studies. A 1989 study showed that daily users of phenacetin were 5.1 times more likely to develop kidney disease than people who used the drug infrequently. The drug, which was also used in veterinary medicine, was shown to cause benign and malignant tumors in both mice and rats during experimental laboratory studies.

Some over-the-counter painkiller manufacturers replaced phenacetin with paracetamol, a similar drug that has not been shown to be a carcinogen. Paracetamol is also known as acetaminophen. Studies have shown that acetaminophen also can cause damage to the kidneys, but its side effects are not as serious as those of phenacetin.

Phenacetin is still available as a prescription medication in some countries, particularly in Europe. It has drawn attention for its use by gangs in the United Kingdom to dilute cocaine. The two drugs have a close physical resemblance.


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Post 8

I have had migraine headaches for over 38 years since age 16, and I took APC for them at bedtime. It works great but only at bedtime for me. In 1983 the FDA took it off the market in the USA.

I panicked, but found I could buy 1,000 APC pills at a pharmacy warehouse. I bought 2000 and froze the pills. I still have some, and I even took one last night and they still work. I only take them at night though, for a headache. Otherwise, during the day I take Excedrin Migraine for a headache and that works great too.

Taking Excedrin does not work at bedtime since it keeps me awake. I have not had any health problems at all taking the small amount of Phenacetin. But I used to take it all the time for the headaches when I was younger. I am 63 years old now, and in very good health.

Post 7

The reality of it is all drugs will give you side effects, depending on how long you take it. Even antibiotics can actually cause you bigger problems by destroying both good and bad bacteria and weakening your immune system, creating a condition for you to get more drugs! This is something the doctors and the pharmaceutical industry will not tell people. So long as the money is coming in, why should they? That's it in a nutshell.

Post 6

I live in the UK and for many years. I am not proud of it, but I have been a user of mostly crack cocaine on a daily basis. Lately I have noticed that either the quality is low or my tolerance is very high, which has prompted me to look into what else is in the stuff I am spending vast amounts on.

I really wish I could kick the habit! Does anyone know how I could see what the crack I buy is made of? I would certainly like to know what exactly I am buying but have no scientific experience. Thanks.

Post 5

Often times I wonder how long a drug is on the market, how many studies have been done, and how many people have suffered bad sad effects before they are removed from the market.

I have struggled with headaches for most of my life. I have tried almost every remedy you can think of to help them, but the only thing that seems to work on a consistent basis is Tylenol or Ibuprofen. I am thankful they work, but always worry about the long term side effects.

I had to quit taking Ibuprofen because I began having stomach issues so now use Tylenol (which has acetaminophen as the active ingredient).

Every time I take one I think

of how this can be damaging my kidneys, but also know that I have to function at work and can't do that when I have a headache all the time.

Reading about Phenacetin really makes me wonder - especially when it is still on the market in some countries. Will they someday remove Tylenol from the market? I think about how many hospitals use this medication on a daily basis, but still wonder how safe it really is.

Post 4

I try not to take over the counter pain killers or prescription medications unless it is absolutely necessary. When I do take something, I try to make it as short term as possible.

I find it interesting that Phenacetin and Tylenol are closely related. It seems that there are more studies all the time revealing the potential side effects of Tylenol for the liver and kidneys.

Many people rely on these drugs every day for relief from pain. This can be a frustrating situation because you want to have a good quality of life that is pain free, but yet you worry about the long term side effects of them.

Post 3

I did a little bit of research, and it looks like doctors now recommend non-steroidal anti-inflammatory drugs as treatment for intercostal neuralgia. NSAIDs can treat a lot of the other thing phenacetin used to treat as well.

I guess what I'm trying to say is that it doesn't sound like a very big deal that this drug was taken off the market. There are plenty of other drugs that can do what phenacetin do. And they're safer, from what we know currently.

Post 2

@ceilingcat - Keep in mind that phenacetin was invented in 1887. I'm pretty sure we have much more sophisticated testing for new drugs than they had back then.

I'm a little disturbed by the fact that some other countries still use this stuff! I mean, why would you want to use a drug that has all these possible side effects? I sure wouldn't. Also, if this drug was taken off the market it couldn't be used to dilute cocaine for sale, which I think would be a bonus.

Post 1

The fact that this drug was used for years before anyone realized it was carcinogenic really makes me question our public health system in this country. I feel like the fact that phenacetin is carcinogenic should have been discovered when it was first tested, as well as its potential to cause kidney damage.

I feel horrible for people who were prescribed this drug by their doctors, and later suffered ill effects. Most people trust their doctors to prescribe them medicine that is going to help them, not cause them more problems later.

I swear, I hate to sound paranoid, but I don't like to take prescription or over the counter drugs very much. How are we supposed to know they are safe?

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