Risk of Hepatotoxicity-Related Hospitalizations among Patients Treated with Opioid/Acetaminophen Combination Prescription Pain Medications

Abstract

There is no population data-based evidence supporting elevated risk of hepatotoxicity-related hospitalization associated with opioid/acetaminophen combinations.

Risk of hospital admission for liver injury in users of NSAIDs and nonoverdose paracetamol: Preliminary results from the EPIHAM study

“…Epidemiologic studies of hospitalisation for ALI are limited: A case‐crossover study by Lee et al demonstrated that nimesulide, diclofenac, ibuprofen, and other NSAIDs are associated with an increased risk of hospitalisation for acute hepatitis . On the other hand, the pre‐post study by Duh et al, aiming to determine the risk of serious hepatotoxicity resulting in hospitalizations among patients prescribed opioid/acetaminophen combinations, could not find an association between hepatotoxicity‐related hospitalisation and opioid‐paracetamol combination medications …”

Removal of Opioid/Acetaminophen Combination Prescription Pain Medications: Assessing the Evidence for Hepatotoxicity and Consequences of Removal of These Medications

“…Eliminating opioid/acetaminophen combination products will have a very significant impact on pain management. In one analysis of claims data for hydrocodone or short‐acting oxycodone pain medications, one in six claimants received an opioid/acetaminophen combination medication at some time over an 8‐year period [21]. The actual consequences on patient care of removing the most commonly prescribed pain medications for patients with moderate to moderately‐severe pain are unknown.…”

A multicenter, randomized, double-blind, placebo-controlled trial to assess the efficacy and safety of single-entity, once-daily hydrocodone tablets in patients with uncontrolled moderate to severe chronic low back pain

“…significant number of unintentional overdose cases which often lead to acute liver failure and death [6][7][8][9][10][11]. As a result, the potential of APAP toxicity has created a dosage ceiling for those hydrocodone combination analgesics [10].…”