Categories
Change Password!
Reset Password!
The fixed-dose combinations of Ibuprofen and Acetaminophen are effective, well-tolerated, and convenient alternatives to opioids for common acute pain conditions, with potential opioid-sparing benefits.
The shift toward opioid-sparing treatments highlights the requirement for effective nonopioid pain management. Fixed-dose combination (FDC) of Ibuprofen and Acetaminophen (IBU/APAP) has demonstrated potential as an opioid substitute. However, the available data are limited and cumbersome for comparison across studies. Hence, this study by Pam Kushner et al. sought to assess the evidence for IBU/APAP FDCs (IBU ≤1200 mg/day and APAP ≤4000 mg/day) as substitutes to opioids and their potential to curtail use of rescue opioids in tackling acute pain.
Researchers explored OVID Medline, EMBASE, and PubMed databases for published articles up to March 2023. Studies were incorporated if they were randomized, used oral treatments, had active comparators, and had IBU and APAP dosing in the FDC within the nonprescription range in at least one group. For this study, the FDC dosing range was IBU 75–400 mg per dose and ≤1200 mg/day, and APAP 250–1000 mg per dose and ≤4000 mg/day, in line with nonprescription limits in the U.S. and Canada.
The studies were segregated into two groups: those assessing opioids as direct comparators to FDC formulations and those with nonopioid FDC direct comparators, where reduced opioid use was evaluated as an endpoint. Across studies, IBU/APAP FDCs provided comparable or superior pain relief to opioid and nonopioid treatments, reduced the need for rescue opioids, and had fewer adverse events. The reviewed studies supported IBU/APAP FDCs as efficient, well-tolerated alternatives to opioids for common acute pain conditions, potentially offering an opioid-sparing effect.
Implementing FDC IBU/APAP could be a public health approach for addressing the opioid crisis. While FDC IBU/APAP cannot fully replace opioids, especially for certain clinical scenarios like postsurgical or late-stage oncology pain, it yields a safe and effective option that may improve opioid prescribing practices and patient safety. Therefore, FDC IBU/APAP could be considered a potential first-line therapy for acute pain.
Postgraduate Medicine
Ibuprofen/acetaminophen fixed-dose combination as an alternative to opioids in management of common pain types
Pam Kushner et al.
Comments (0)