Combination hydrocodone and ibuprofen versus combination oxycodone and acetaminophen in the treatment of moderate or severe acute low back pain

Palangio, Mark; Morris, E. W. T.; Doyle, Ralph T.; Dornseif, Bruce E.; Valente, Thomas J.

doi:10.1016/s0149-2918(02)85007-x

Cited by 49 publications

(30 citation statements)

References 16 publications

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“…Several small randomized trials have addressed the combined analgesic efficacy of paracetamol and opioids in patients with pain in general, 8 acute low back pain, 9 soft tissue strains and sprains, 10-12 and postarthroscopy analgesia, 13 but few have compared it with nonsteroidal antiinflammatory drugs. Of these studies, only 1 recruited more than 100 participants.…”

Section: Discussionmentioning

confidence: 99%

Randomized Double-Blind Trial Comparing Oral Paracetamol and Oral Nonsteroidal Antiinflammatory Drugs for Treating Pain After Musculoskeletal Injury

Woo

Man

Lam

et al. 2005

Annals of Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

Randomized Double-Blind Trial Comparing Oral Paracetamol and Oral Nonsteroidal Antiinflammatory Drugs for Treating Pain After Musculoskeletal Injury

Woo

Man

Lam

et al. 2005

Annals of Emergency Medicine

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“…2 The popularity of hydrocodone/acetaminophen postdischarge is supported by two small clinical trials, 3,4 and several other studies that compare the efficacy of commonly prescribed oral opioids in different settings. [5][6][7][8][9] There has been increasing concern about the abuse of oral opioids in patients discharged from the ED. 10,11 The efficacy of hydrocodone versus codeine has not been adequately studied among discharged adult ED patients with acute pain.…”

mentioning

confidence: 99%

Randomized Clinical Trial of Hydrocodone/Acetaminophen Versus Codeine/Acetaminophen in the Treatment of Acute Extremity Pain After Emergency Department Discharge

Chang

Bijur

Munjal

et al. 2014

Academic Emergency Medicine

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ObjectivesThe objective was to test the hypothesis that hydrocodone/acetaminophen (Vicodin [5/500]) provides more efficacious analgesia than codeine/acetaminophen (Tylenol #3 [30/300]) in patients discharged from the emergency department (ED). Both are currently Drug Enforcement Administration (DEA) Schedule III narcotics.MethodsThis was a prospective, randomized, double‐blind, clinical trial of patients with acute extremity pain who were discharged home from the ED, comparing a 3‐day supply of oral hydrocodone/acetaminophen (5 mg/500 mg) to oral codeine/acetaminophen (30 mg/300 mg). Pain was measured on a valid and reproducible verbal numeric rating scale (NRS) ranging from 0 to 10, and patients were contacted by telephone approximately 24 hours after being discharged. The primary outcome was the between‐group difference in improvement in pain at 2 hours following the most recent ingestion of the study drug, relative to the time of phone contact after ED discharge. Secondary outcomes compared side‐effect profiles and patient satisfaction.ResultsThe median time from ED discharge to follow‐up was 26 hours (interquartile range [IQR] = 24 to 39 hours). The mean NRS pain score before the most recent dose of pain medication after ED discharge was 7.6 NRS units for both groups. The mean decrease in pain scores 2 hours after pain medications were taken were 3.9 NRS units in the hydrocodone/acetaminophen group versus 3.5 NRS units in the codeine/acetaminophen group, for a difference of 0.4 NRS units (95% confidence interval [CI] = –0.3 to 1.2 NRS units). No differences were found in side effects or patient satisfaction.ConclusionsBoth medications decreased NRS pain scores by approximately 50%. However, the oral hydrocodone/acetaminophen failed to provide clinically or statistically superior pain relief compared to oral codeine/acetaminophen when prescribed to patients discharged from the ED with acute extremity pain. Similarly, there were no clinically or statistically important differences in side‐effect profiles or patient satisfaction. If the DEA reclassifies hydrocodone as a Schedule II narcotic, as recently recommended by its advisory board, our data suggest that the codeine/acetaminophen may be a clinically reasonable Schedule III substitute for hydrocodone/acetaminophen at ED discharge. These findings should be regarded as tentative and require independent validation in similar and other acute pain models.

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“…2 For a wide range of patients who do not achieve control of CNCP with standard therapies, the combination of oxycodone/paracetamol at low doses has been efficacious and well tolerated in the short-to medium-term. [7][8][9][10][11][12][13][14][15][16][17] The current study investigates whether this efficacy and tolerability also extends to medium-tolong-term use by analyzing clinical charts from consecutive outpatients remaining in treatment with oxycodone/paracetamol. All patients were still in treatment at the last available follow-upappointment.…”

Section: But Itmentioning

confidence: 99%

Adherence and long-term effect of oxycodone/paracetamol in chronic noncancer pain: a retrospective study

et al. 2011

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The results of this study support the hypothesis that an opiate-based combination at low doses improves tolerability and adherence and results in patients obtaining long-term efficacy. Larger studies of the use of opiates in this setting and clinical monitoring on the regional and national level may convince clinicians to view opiates as efficacious analgesics and not as dangerous substances of abuse.

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Combination hydrocodone and ibuprofen versus combination oxycodone and acetaminophen in the treatment of moderate or severe acute low back pain

Cited by 49 publications

References 16 publications

Randomized Double-Blind Trial Comparing Oral Paracetamol and Oral Nonsteroidal Antiinflammatory Drugs for Treating Pain After Musculoskeletal Injury

Randomized Double-Blind Trial Comparing Oral Paracetamol and Oral Nonsteroidal Antiinflammatory Drugs for Treating Pain After Musculoskeletal Injury

Randomized Clinical Trial of Hydrocodone/Acetaminophen Versus Codeine/Acetaminophen in the Treatment of Acute Extremity Pain After Emergency Department Discharge

Adherence and long-term effect of oxycodone/paracetamol in chronic noncancer pain: a retrospective study

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