Additive Effect of Combined Naproxen and Paracetamol in Rheumatoid Arthritis

Seideman, P

doi:10.1093/rheumatology/32.12.1077

Cited by 38 publications

(20 citation statements)

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“…ketoprofen, dexketoprofen (Miranda et al 2006(Miranda et al , 2007Luccarini et al 2006;Seideman 1993;Schug 2006;Qiu et al 2007). The synergic interaction was observed in the two nociceptive tests and, on the basis of the interaction indexes (Table 2), was stronger in Phase I of the formalin orofacial test.…”

Section: Discussionmentioning

confidence: 99%

Synergism between COX-3 inhibitors in two animal models of pain

et al. 2010

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These actions can be related to the differential selectivity of the drugs for inhibition of COX isoforms and also to the several additional antinociception mechanisms and pathways initiated by the analgesic drugs on pain transmission. Since the efficacy of the combination of metamizol with paracetamol has been demonstrated in the present study, this association could have a potential beneficial effect on the pharmacological treatment of clinical pain.

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Section: Discussionmentioning

confidence: 99%

Synergism between COX-3 inhibitors in two animal models of pain

et al. 2010

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“…At low doses and even with long administration, their role as DMARDs is gaining ground. Its beneWt is because of its anti-inXammatory eVect [7,56,57], NSAIDs due to their analgesic, anti-inXammatory and antipyretic eVect [7,[10][11][12][13], paracetamol due to its analgesic and antipyretic eVect [58,59] and amitriptyline due to its beneWt in depression and neuropathic pain [60,61] have all found a place in the treatment of rheumatoid arthritis as supportive drugs.…”

Section: Discussionmentioning

confidence: 99%

Causes of DMARD withdrawal following ADR within 6 months of initiation among Indian rheumatoid arthritis patients

et al. 2010

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The present study was conducted in Indian rheumatoid arthritis (RA) patients prescribed disease-modifying anti-rheumatic drugs (DMARDs) to determine the incidence and type of adverse drug reactions (ADRs) leading to their withdrawal in the initial 6 months of therapy. This was considered important as pharmacogenetic variations in the pattern of RA in different populations and genetic differences in efficacy and safety to drugs demand separate studies to be conducted in different populations. Hospital records were used to identify 1,000 consecutive patients with RA fulfilling the American College of Rheumatology criteria and having at least 6-month follow-up. Age, gender, duration of arthritis, drug usage and ADR-related drug withdrawal were recorded from the charts. Most of the patients were put on single DMARD. Combined use of DMARD was less frequent and non-use of DMARD was common; however, disease control was good. The commonest DMARD used in our hospital was hydroxychloroquine 444 (44%) and the commonest combination used was methotrexate with hydroxychloroquine by 55 (6%). Sulphasalazine use showed preference to young and males. Supportive drugs used were NSAIDs by 883 (88%), corticosteroids by 646 (65%), paracetamol by 594 (59%) and amitriptyline by 88 (9%). Incidence of ADR-related DMARD withdrawal was maximum with leflunomide 2/15 (13.33%) followed by methotrexate 9/116 (7.76%), sulphasalazine 6/185 (3.24%), chloroquine 3/131 (2.29%) and hydroxychloroquine 8/444 (1.8%). Severity and symptomatology of disease, genetic pattern of patients, financial status, previous experience of the clinicians and patients, availability of drugs, patient expectations and compliance were the main factors that lead to a difference in pattern of therapy in our patients compared to other population.

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“…Nonacidic analgesics such as paracetamol, propyphenazone and dipyrone are poor inhibitors of pros taglandin synthesis and do not accumulate in the mucosa, which probably accounts for their greater tolerability [9], In addition, paracetamol has proved to be effective in lowering the analgesic dose of NSAID required, even in rheumatoid arthritis, for patients with gastrointestinal disturbances [10], Dipyrone has been shown to be an effective analgesic for a wide variety of indications, but very few data are available concerning its gastrointestinal toxicity. Despite the epidemiological evidence for the good gastrointestinal tolerability of dipyrone, direct ef fects of dipyrone (metamizole) on the gastrointestinal tract in humans have not yet been investigated in detail even if it has been shown that the ulcerogenic activity of dipyrone in rats is similar to that of paracetamol [11].…”

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confidence: 99%

Endoscopic Assessment of the Effects of Dipyrone (Metamizol) in Comparison to Paracetamol and Placebo on the Gastric and Duodenal Mucosa of Healthy Adult Volunteers

Porro

Ardizzone²,

Petrillo³

et al. 1996

Digestion

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The potentially damaging gastric and duodenal effects of dipyrone, a nonnarcotic analgesic agent, were evaluated in three phases in comparison to placebo and paracetamol. Three groups of 12 healthy adult volunteers were treated in a double-blind study, according to a cross-over, randomization sequence, using the double-dummy technique, for two 15-day periods, with dipyrone 3 g/day and placebo (group I), dipyrone 1.5 g/day and placebo (group II), and dipyrone 1.5 g/day and paracetamol 1.5 g/day (group III). An esophagogastroduodenoscopy was performed at the beginning and end of each treatment period. In the first treatment group, grade-3 and 4 mucosal lesions were found after dipyrone administration (3 g/day) in 3 of 12 (25%) subjects (multiple antral erosions, gastric ulcer and duodenal ulcer, 1 case each), whereas grade-2 mucosal lesions (antral erosions) were detected in 1 of 12 cases (8%) after the corresponding placebo treatment. The difference between the two treatments, however, was not statistically significant (p > 0.05). Only in the gastric ulcer case were subjective symptoms reported (feeling of hunger). At the 1.5-g/day dose (groups II and III), dipyrone produced no gastroduodenal lesions, the endoscopic results showing no appreciable difference between dipyrone and either placebo (p = 0.54) or paracetamol (p = 0.99). No subjective symptoms were reported in any of these subjects. Dipyrone, administered for 2 weeks, has effects on the gastric and duodenal mucosa comparable to those of paracetamol and placebo, though noticeable damage is detectable at a dosage of 3 g/day.

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Additive Effect of Combined Naproxen and Paracetamol in Rheumatoid Arthritis

Cited by 38 publications

References 0 publications

Synergism between COX-3 inhibitors in two animal models of pain

Synergism between COX-3 inhibitors in two animal models of pain

Causes of DMARD withdrawal following ADR within 6 months of initiation among Indian rheumatoid arthritis patients

Endoscopic Assessment of the Effects of Dipyrone (Metamizol) in Comparison to Paracetamol and Placebo on the Gastric and Duodenal Mucosa of Healthy Adult Volunteers

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