Combination hydrocodone and ibuprofen versus combination oxycodone and acetaminophen in the treatment of postoperative obstetric or gynecologic pain

Palangio, Mark; Wideman, Gilder L.; Keffer, Marie; Landau, Craig; Morns, Elena; Doyle, Ralph T.; Jiang, John; Damask, Michael; Padova, Anthony de

doi:10.1016/s0149-2918(00)80047-8

Cited by 34 publications

(30 citation statements)

References 23 publications

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“…It is well documented that analgesics containing a combination of opioid and nonopioid agents can provide effective pain relief. Combination opioid/nonopioid therapy with oxycodone (OC) and acetaminophen (APAP), for example, has been shown to provide effective analgesia in the treatment of low back pain,2–4 arthritis,2,5–8 cancer,2,9 and postoperative pain 2,10–13. In addition, combining analgesic agents with different mechanisms of action is intended to be additive or synergistic, such that lower doses of each agent may theoretically be used 2,14–17…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetics and bioavailability of oxycodone and acetaminophen following single-dose administration of MNK-795, a dual-layer biphasic IR/ER combination formulation, under fed and fasted conditions

Devarakonda¹,

Morton²,

Margulis³

et al. 2014

DDDT

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BackgroundXARTEMIS™ XR (formerly MNK-795) is a combination oxycodone (OC) and acetaminophen (APAP) analgesic with both immediate-release and extended-release (ER) components (ER OC/APAP). The tablets are designed with gastric-retentive ER oral delivery technology that releases the ER component at a controlled rate in the upper gastrointestinal tract. Because consumption of food has demonstrated an impact on the pharmacokinetics (PK) of some marketed products using gastric-retentive ER oral delivery technology, a characterization of the effects of fed (high- and low-fat diets) versus fasted conditions on the PK of ER OC/APAP was performed.MethodsThis Phase I study used an open-label randomized single-dose three-period six-sequence crossover single-center design. Healthy adult participants (n=48) were randomized to receive two tablets of ER OC/APAP under three conditions: following a high-fat meal; following a low-fat meal; and fasted. Plasma concentration versus time data from predose throughout designated times up to 48 hours postdose was used to estimate the PK parameters of oxycodone and APAP.ResultsThirty-one participants completed all three treatment periods. Both oxycodone and APAP were rapidly absorbed under fasted conditions. Total oxycodone and APAP exposures (area under the plasma drug concentration-time curve [AUC]) from ER OC/APAP were not significantly affected by food, and minimal changes to maximum observed plasma concentration for oxycodone and APAP were also noted. However, food marginally delayed the time to maximum observed plasma concentration of oxycodone and APAP. There was no indication that tolerability was affected by food.ConclusionThe findings from this study suggest that ER OC/APAP can be administered with or without food.

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Section: Introductionmentioning

confidence: 99%

Pharmacokinetics and bioavailability of oxycodone and acetaminophen following single-dose administration of MNK-795, a dual-layer biphasic IR/ER combination formulation, under fed and fasted conditions

Devarakonda¹,

Morton²,

Margulis³

et al. 2014

DDDT

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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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“…However, the use of ibuprofen with hydrocodone or oxycodone has provided an alternative with equal efficacy. 60 Oral opioid analgesic has its limitations. For example, factors such as slow gastric emptying after lower abdominal surgery and/or postoperative nausea and vomiting can significantly limit the potential usage of oral opioids.…”

Section: Analgesic Mechanisms Of Opioidsmentioning

confidence: 99%

Postoperative pain management in obstetric anesthesia–new challenges and solutions

Leung

2004

Journal of Clinical Anesthesia

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Combination hydrocodone and ibuprofen versus combination oxycodone and acetaminophen in the treatment of postoperative obstetric or gynecologic pain

Cited by 34 publications

References 23 publications

Pharmacokinetics and bioavailability of oxycodone and acetaminophen following single-dose administration of MNK-795, a dual-layer biphasic IR/ER combination formulation, under fed and fasted conditions

Pharmacokinetics and bioavailability of oxycodone and acetaminophen following single-dose administration of MNK-795, a dual-layer biphasic IR/ER combination formulation, under fed and fasted conditions

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

Postoperative pain management in obstetric anesthesia–new challenges and solutions

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