From the FDA Drug Label
ACTIVE INGREDIENT (IN EACH CAPLET) Acetaminophen USP, 650 mg The FDA drug label does not answer the question.
From the Research
As a first-line treatment for a severe case of aphthous ulcers in an adult patient, I would prescribe topical corticosteroids as the primary treatment, based on the most recent and highest quality study available 1. The treatment of aphthous ulcers should focus on reducing inflammation, providing pain relief, and preventing infection.
- Topical corticosteroids, such as dexamethasone 0.5 mg/5mL elixir or triamcinolone acetonide 0.1% dental paste, should be applied directly to the ulcers 3-4 times daily, especially after meals and before bedtime.
- For immediate pain relief, benzocaine 20% gel or lidocaine 2% viscous solution can be applied to the affected areas 15-20 minutes before meals.
- Chlorhexidine 0.12% oral rinse can be used twice daily to prevent secondary infection. The patient should avoid spicy, acidic, or rough-textured foods during healing and maintain good oral hygiene. Systemic therapy, such as prednisone 40-60 mg daily for 5-7 days with a tapering dose, may be considered if the ulcers are particularly severe or widespread, as suggested by earlier studies 2, 3, 4. However, the most recent study 1 emphasizes the importance of topical corticosteroids as the first line of treatment, with systemic medications being reserved for more severe cases. Additionally, supplements such as vitamin B12 1000 mcg daily and folic acid 1 mg daily may be recommended to address potential nutritional deficiencies that may contribute to aphthous ulcers. A multidisciplinary treatment approach, as described in a recent case report 5, may also be considered for refractory cases.