What is a white pill with E on it?

October 7, 2025 •

4 min read

With hundreds of thousands of different pills in circulation, a simple mark like an 'E' on a white pill is insufficient for proper identification and can be incredibly misleading. A white pill with E on it could be a common over-the-counter pain reliever, a prescription medication for a heart condition, or a dangerous counterfeit containing lethal substances like fentanyl. Safe and accurate identification is crucial for your health and safety.

Quick Summary

Several medications feature an 'E' imprint on a white pill, requiring additional markings like numbers and shape for accurate identification. Examples include Excedrin, Metoprolol, and the potent opioid Meperidine. Illicit counterfeit pills also exist, posing significant health risks, including overdose from contaminants like fentanyl. The only safe way to identify a pill is with a trusted pill identifier tool or through a pharmacist.

Key Points

Imprint Codes Are Crucial: A single letter 'E' is not enough for identification. The full imprint code, combined with shape and color, is required for accuracy.
Multiple Possibilities Exist: A white pill with 'E' could be Excedrin (an OTC pain reliever), Metoprolol (a prescription heart medication), or Meperidine (a prescription opioid), among other possibilities.
Counterfeit Pill Danger: Unidentified pills are a major public safety risk. Illicitly manufactured pills can contain lethal substances like fentanyl, and can be designed to mimic legitimate medications.
Never Self-Diagnose: Do not take a pill you find or that was not explicitly prescribed to you. Always confirm a medication's identity with a reliable source before use.
Use Professional Resources: For definitive identification, use reliable pill identifier websites (like Drugs.com or WebMD), or consult a pharmacist. For emergencies, contact poison control.

The Importance of Precise Pill Identification

Identifying a pill accurately is a critical step in ensuring safe medication use. A pill's appearance, including its color, shape, and imprint code, serves as a unique identifier required by the FDA for most over-the-counter and prescription drugs. However, relying on just one characteristic, like a single letter 'E' and a white color, is a dangerous oversimplification.

Different manufacturers produce a wide array of pills, and while the active ingredient may be the same, the appearance can vary. Even different dosages or formulations from the same company can look different. Without the complete imprint code, a white pill with 'E' is nothing more than an educated guess, with potentially life-threatening consequences.

Why a single letter isn't enough

Duplicate Markings: Multiple drugs, even with varying active ingredients, can have the same or similar imprints. For example, a white round pill with just an 'E' could be a variant of Excedrin, while a white round pill with 'e 71' is Metoprolol.
Illicit Drugs: Street drugs like MDMA are sometimes referred to as 'E', and counterfeit pills often carry imprints to mimic legitimate medications. These counterfeit pills can contain lethal doses of fentanyl or other dangerous substances.
Dosage and Formulation: Even within the same brand, different dosages or formulations can have distinct markings. The full imprint code, along with color and shape, is essential to determine the exact medication and its strength.

Common Medications That Are a White Pill with 'E'

Several legitimate medications, available both over-the-counter and by prescription, might be a white pill with 'E' on it. This list is not exhaustive and illustrates why further identification is required.

Over-the-Counter Options

Excedrin Extra Strength: A white, round, or oblong tablet with an 'E' imprint is often identified as Excedrin Extra Strength. It is an analgesic combination containing acetaminophen, aspirin, and caffeine, used for pain, fever, and migraine.
Excedrin Migraine: Also appearing as a white, oblong, or round pill with an 'E' imprint, this contains the same combination of ingredients and is specifically marketed for migraine relief.

Prescription Medications

Metoprolol Succinate ER (e 71): This is a white, round, 50mg tablet with the imprint 'e 71'. It is a cardioselective beta-blocker prescribed for heart conditions such as high blood pressure, angina, and heart failure.
Methenamine Hippurate (E 71): A white, capsule-shaped, 1 gram tablet with the imprint 'E 71' is used to treat and prevent urinary tract infections.
Meperidine Hydrochloride (E51): As a white, round, 100mg tablet with the imprint 'E51', this is a powerful prescription opioid used for moderate to severe pain. It is a controlled substance with a high potential for abuse.

The Critical Danger of Counterfeit Pills

In recent years, the Drug Enforcement Administration (DEA) has issued multiple warnings about the proliferation of counterfeit pills. These fake pills are often mass-produced to look identical to legitimate prescription medications, including opioids like oxycodone and stimulants like Adderall.

The danger lies in their composition: these illicit pills frequently contain lethal amounts of fentanyl, a synthetic opioid that is 50 to 100 times more potent than morphine. According to DEA lab testing, a significant percentage of counterfeit pills containing fentanyl have a potentially lethal dose. This makes identifying an unknown pill found outside a pharmacy a serious health risk.

For more information on the dangers of counterfeit medication, refer to the official DEA fact sheet: DEA Counterfeit Pills Fact Sheet.

How to Safely Identify an Unknown Pill

If you find an unknown pill, especially one resembling a white pill with 'E' on it, it's essential to follow a safe and methodical process. Never ingest an unidentified pill.

Use a Reliable Pill Identifier: Reputable online databases provided by sources like Drugs.com, WebMD, or the FDA are the safest tools for identification. Enter all available information, including the full imprint code, color, and shape.
Consult a Pharmacist: Your pharmacist is a trained professional who can help identify medications using their resources and expertise. If you have any doubts, a pharmacist is an excellent point of contact.
Contact Poison Control: If you suspect an accidental ingestion or have concerns about a pill, call a poison control center immediately. The national toll-free helpline in the U.S. is 1-800-222-1222.
Handle with Caution: If you need to dispose of an unknown or unneeded medication, consult FDA guidelines for safe disposal methods. Do not flush pills down the toilet unless specifically instructed.

Comparison of Common 'E' Imprints on White Pills


Pill Imprint	Color	Shape	Uses	Class	Potential Risks
E (Excedrin)	White	Round or Oblong	Migraine, Pain, Fever	Analgesic Combination	Overdose, liver/kidney damage with misuse
e 71 (Metoprolol)	White	Round	High Blood Pressure, Angina	Beta-blocker	Serious heart problems if stopped suddenly
E 71 (Methenamine)	White	Oblong (Capsule)	Urinary Tract Infections	Anti-infective	Allergic reactions, upset stomach
E51 (Meperidine)	White	Round	Moderate to Severe Pain	Opioid Analgesic	Addiction, neurotoxicity, respiratory depression
None (Counterfeit)	Various, incl. White	Various	Illicit use	N/A	Overdose, contamination with fentanyl

Conclusion

A white pill with E on it could be a number of different medications, ranging from harmless over-the-counter pain relievers to highly potent, regulated opioids. Without the full imprint code and other identifying characteristics, it is impossible and extremely dangerous to know for sure. The rise of counterfeit pills laced with deadly fentanyl adds a critical layer of risk to finding unidentified pills. Therefore, proper and safe identification is non-negotiable. Always use a reliable pill identifier, consult a pharmacist, or call poison control if you have any questions. Never assume you know what a pill is based on incomplete information.

Frequently Asked Questions

No, a white pill with 'E' is not always Excedrin. While Excedrin Extra Strength and Migraine often have this marking, other medications, including the prescription drugs Metoprolol and Meperidine, can also be white and have an imprint starting with 'E'.

It is virtually impossible to tell if a pill is counterfeit just by looking at it. Counterfeit pills are often made to look identical to legitimate ones. The only way to ensure a pill is safe is to obtain it from a licensed pharmacist with a valid prescription.

The main danger of counterfeit pills is that they often contain lethal amounts of fentanyl or other unknown, dangerous substances. This poses a severe risk of overdose and death, even in small doses.

If you find an unknown pill, do not take it. Use a reputable online pill identifier tool, ask a pharmacist for help, or contact a poison control center for guidance. Store it safely away from children and pets until you can dispose of it properly.

The full imprint code is essential because it distinguishes between different medications that may have similar colors and shapes. It helps confirm the exact drug, strength, and manufacturer, ensuring you don't confuse one medication for another.

Most prescription and over-the-counter drugs in the U.S. are required by the FDA to have an imprint code. However, some exceptions exist for certain products, and vitamins or supplements often do not have them. Illicit or foreign pills also lack proper imprints.

If your pill has additional numbers, it is crucial to include them when performing an identification search. For example, a white round pill with 'e 71' is Metoprolol, while a white round pill with 'E51' is Meperidine. These numbers are essential for accurate identification.