Codeine, alone and with paracetamol (acetaminophen), for cancer pain

Straube, Carmen; Derry, Sheena; Jackson, Kenneth C.; Wiffen, Philip J; Bell, Rae Frances; Strassels, Scott A.; Straube, Sebastian

doi:10.1002/14651858.cd006601.pub4

Cited by 44 publications

(47 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This scoring will help the physician´s management of pain. Codeine (3-methoxymorphina) is a mild opioid with low affinity for the opioidergic receptors and is one of the main opium-derived alkaloids, with analgesic potency ranging from 5 to 10% as compared to morphine 10,11 . Which means that a 30mg dose of codeine phosphate is equivalent to approximately 3mg of morphine.…”

Section: Discussionmentioning

confidence: 99%

“…Which means that a 30mg dose of codeine phosphate is equivalent to approximately 3mg of morphine. This natural opioid is considered a "prodrug" that must be first metabolized in the liver to become active in morphine and morphine-6-glucuronide via the CYP2D enzyme, a member of the cytochrome P450 10,11 . However, codeine capacity to metabolize codeine into active metabolites varies in the population at large 10,11 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of viminol in acute pain management after third molars extraction. Case report

Hummig

Grossmann

2018

Brazilian Journal of Pain

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES: Acute postoperative pain of the third molars requires not only the ability of the dental surgeon in removing them but also the correct pharmacological control of this incidental pain that will install after the effect of the anesthetic blockade has ceased. The objective of this study was to report a case of moderate pain after third molar removal procedure, where the adverse effects of the prescribed medication were determinant for the abandonment of pharmacological treatment and consequently the maintenance of the pain. CASE REPORT: A 22-year-old male patient, student, from the city of Curitiba, sought outpatient care for acute moderate-intensity pain after 48 hours of removal of the third molars. He was experiencing some adverse effects due to the prescription of the combination of oral codeine (30mg) and paracetamol (325mg) at every 6 hours. In view of this, we opted for the prescription of viminol hydroxybenzoate (70mg) orally, every 6 hours. CONCLUSION: The prescription of the viminol hydroxybenzoate analgesic resulted in complete, rapid and effective postoperative analgesia, with excellent tolerability.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of viminol in acute pain management after third molars extraction. Case report

Hummig

Grossmann

2018

Brazilian Journal of Pain

View full text Add to dashboard Cite

show abstract

“…In the second study by Noyes et al, two different THC doses of 10 and 20 mg were compared to placebo and 60 mg codeine (14). A 60 mg dose of codeine is a standard daily opioid analgesic regimen used in the management of many pain types, including cancer pain (20). A significant difference in pain reduction was observed with the administration of 20 mg THC when compared to placebo (P<0.05).…”

Section: Dosagementioning

confidence: 99%

A selective review of medical cannabis in cancer pain management

Blake¹,

et al. 2017

View full text Add to dashboard Cite

Insufficient management of cancer-associated chronic and neuropathic pain adversely affects patient quality of life. Patients who do not respond well to opioid analgesics, or have severe side effects from the use of traditional analgesics are in need of alternative therapeutic options. Anecdotal evidence suggests that medical cannabis has potential to effectively manage pain in this patient population. This review presents a selection of representative clinical studies, from small pilot studies conducted in 1975, to double-blind placebo-controlled trials conducted in 2014 that evaluated the efficacy of cannabinoid-based therapies containing tetrahydrocannabinol (THC) and cannabidiol (CBD) for reducing cancer-associated pain. A review of literature published on Medline between 1975 and 2017 identified five clinical studies that evaluated the effect of THC or CBD on controlling cancer pain, which have been reviewed and summarised. Five studies that evaluated THC oil capsules, THC:CBD oromucosal spray (nabiximols), or THC oromucosal sprays found some evidence of cancer pain reduction associated with these therapies. A variety of doses ranging from 2.7-43.2 mg/day THC and 0-40 mg/day CBD were administered. Higher doses of THC were correlated with increased pain relief in some studies. One study found that significant pain relief was achieved in doses as low as 2.7-10.8 mg THC in combination with 2.5-10.0 mg CBD, but there was conflicting evidence on whether higher doses provide superior pain relief. Some reported side effects include drowsiness, hypotension, mental clouding, and nausea and vomiting. There is evidence suggesting that medical cannabis reduces chronic or neuropathic pain in advanced cancer patients. However, the results of many studies lacked statistical power, in some cases due to limited number of study subjects. Therefore, there is a need for the conduct of further double-blind, placebo-controlled clinical trials with large sample sizes in order to establish the optimal dosage and efficacy of different cannabis-based therapies.

show abstract

“…27 There is low-quality evidence that some people (26% and 51%) with moderate or severe cancer pain can obtain substantial benefits within 1 or 2 weeks. 27 There is evidence supporting the use of codeine, 28 but there is only weak evidence supporting the use of tramadol for cancer pain. A Cochrane review on tramadol with or without paracetamol for cancer pain in 2017 29 mentioned limited, low-quality evidence from RCTs that tramadol relieved cancer pain.…”

Section: Evidence-based Pain Managementmentioning

confidence: 99%

Palliative care: the need of the modern era

Chan

2018

Hong Kong Med J

View full text Add to dashboard Cite

There is a great need for palliative care in the modern era of medicine. Despite medical advances, patients with life-limiting illnesses still suffer significantly. Palliative care emerged a half century ago as an ethos based on compassion and care for patients and their families to relieve their suffering. It entails a paradigm shift from the biomedical model to the biopsychospiritual model. Palliative care is recognised by the World Health Organization as an essential part of the continuum of universal health coverage. In 2014, the World Health Assembly approved a resolution on "Strengthening of palliative care as a component of comprehensive care throughout the life course". Despite Hong Kong's relatively good local palliative care service coverage for patients who died of cancer and end-stage renal failure, service gaps for palliative care do exist among our ageing population with non-malignant life-limiting illnesses. We strongly urge the Hong Kong Government to develop our local palliative care policy in response to the World Health Assembly's resolution. Growing international and local evidence demonstrates the impacts of palliative care on patient outcomes, caregivers, and health care. Such outcomes can be service-based, disease-based, or symptom/suffering-based. The goal of palliative care is to relieve health-related suffering. Evidence-based management of pain, breathlessness, and psychospiritual suffering are discussed. Care in the end-of-life phase should be an integral part of palliative care, promoting patient choice, advance care planning, and good death.

show abstract

Codeine, alone and with paracetamol (acetaminophen), for cancer pain

Cited by 44 publications

References 57 publications

Use of viminol in acute pain management after third molars extraction. Case report

Use of viminol in acute pain management after third molars extraction. Case report

A selective review of medical cannabis in cancer pain management

Palliative care: the need of the modern era

Contact Info

Product

Resources

About