Skip to main content
Erschienen in: Advances in Therapy 6/2016

03.05.2016 | Original Research

Retrospective Evaluation of a Fixed-Dose Combination of Oxycodone and Acetaminophen to Manage Moderate Pain: The Lower the Better

verfasst von: Silvia Natoli, Marzia Lazzari, Roberta Carpenedo, Elisa Palombo, Maria Beatrice Silvi, Massimo Mammucari, Mario Dauri

Erschienen in: Advances in Therapy | Ausgabe 6/2016

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Oxycodone is one of the most commonly used opioid analgesics in the clinical management of pain. The present retrospective analysis aimed to determine the dose of oxycodone that could achieve effective control of moderate pain when combined with a fixed dose of acetaminophen, and the time required to reach a clinically relevant reduction in intensity of pain.

Methods

Data of patients treated with a combination of oxycodone (5, 10, and 20 mg) and acetaminophen (325 mg) were evaluated for gender, current disease condition, basal pain intensity, total daily dose, days of controlled pain at the initial low dose, and pain intensity after treatment using a numeric pain rating scale.

Results

Data from a total of 491 patients were assessed; of these 93.5% of patients experienced persistent non-cancer pain and had an average baseline pain score of 5.68 ± 1.35. For the overall population, the pain score was reduced to 2.49 ± 1.71 with a mean dose of 8.68 ± 4.96 mg oxycodone after 21.60 ± 6.12 days of treatment with the combination. Almost 97% of the patients who reported relief of pain received 1.61 ± 0.67 doses of oxycodone 5 mg combined with 325 mg of acetaminophen.

Conclusion

A low-dose combination of oxycodone with acetaminophen can be effective in the management of moderate pain and may help in reducing the treatment-associated adverse reactions and drug dependence.

Funding

Sponsorship for article processing charges was provided by Molteni Farmaceutici, Florence, Italy.
Literatur
1.
Zurück zum Zitat Molton IR, Terrill AL. Overview of persistent pain in older adults. Am Psychol. 2014;69(2):197–207.CrossRefPubMed Molton IR, Terrill AL. Overview of persistent pain in older adults. Am Psychol. 2014;69(2):197–207.CrossRefPubMed
2.
Zurück zum Zitat Helm R, Gibson S. Pain in older people. Epidemiology of pain. Seattle: IASP; 1999. p. 103–12. Helm R, Gibson S. Pain in older people. Epidemiology of pain. Seattle: IASP; 1999. p. 103–12.
3.
Zurück zum Zitat Chou R, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113–30.CrossRefPubMedPubMedCentral Chou R, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113–30.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Caraceni A, Hanks G, Kaasa S, et al. Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncol. 2012;13(2):e58–68.CrossRefPubMed Caraceni A, Hanks G, Kaasa S, et al. Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncol. 2012;13(2):e58–68.CrossRefPubMed
5.
Zurück zum Zitat Schug SA, Goddard C. Recent advances in the pharmacological management of acute and chronic pain. Ann Palliat Med. 2014;3(4):263–75.PubMed Schug SA, Goddard C. Recent advances in the pharmacological management of acute and chronic pain. Ann Palliat Med. 2014;3(4):263–75.PubMed
6.
Zurück zum Zitat Davis MP, Varga J, Dickerson D, et al. Normal-release and controlled-release oxycodone: pharmacokinetics, pharmacodynamics, and controversy. Support Care Cancer. 2003;11(2):84–92.PubMed Davis MP, Varga J, Dickerson D, et al. Normal-release and controlled-release oxycodone: pharmacokinetics, pharmacodynamics, and controversy. Support Care Cancer. 2003;11(2):84–92.PubMed
7.
Zurück zum Zitat World Health Organization. Cancer pain relief: with a guide to opioid availability. 2nd ed. Geneva, Switzerland: World Health Organization; 1996. World Health Organization. Cancer pain relief: with a guide to opioid availability. 2nd ed. Geneva, Switzerland: World Health Organization; 1996.
8.
Zurück zum Zitat Leow KP, Smith MT, Williams B, Cramond T. Single-dose and steady-state pharmacokinetics and pharmacodynamics of oxycodone in patients with cancer. Clin Pharmacol Ther. 1992;52(5):487–95.CrossRefPubMed Leow KP, Smith MT, Williams B, Cramond T. Single-dose and steady-state pharmacokinetics and pharmacodynamics of oxycodone in patients with cancer. Clin Pharmacol Ther. 1992;52(5):487–95.CrossRefPubMed
9.
Zurück zum Zitat Lalovic B, Kharasch E, Hoffer C, et al. Pharmacokinetics and pharmacodynamics of oral oxycodone in healthy human subjects: role of circulating active metabolites. Clin Pharmacol Ther. 2006;79(5):461–79.CrossRefPubMed Lalovic B, Kharasch E, Hoffer C, et al. Pharmacokinetics and pharmacodynamics of oral oxycodone in healthy human subjects: role of circulating active metabolites. Clin Pharmacol Ther. 2006;79(5):461–79.CrossRefPubMed
10.
Zurück zum Zitat Andreassen TN, Klepstad P, Davies A, et al. Influences on the pharmacokinetics of oxycodone: a multicentre cross-sectional study in 439 adult cancer patients. Eur J Clin Pharmacol. 2011;67(5):493–506.CrossRefPubMed Andreassen TN, Klepstad P, Davies A, et al. Influences on the pharmacokinetics of oxycodone: a multicentre cross-sectional study in 439 adult cancer patients. Eur J Clin Pharmacol. 2011;67(5):493–506.CrossRefPubMed
11.
Zurück zum Zitat Panerai AE. Oxycodone/acetaminophen fixed-dose combination in chronic non malignant pain treatment. Trends Med. 2009;9(1):27–35. Panerai AE. Oxycodone/acetaminophen fixed-dose combination in chronic non malignant pain treatment. Trends Med. 2009;9(1):27–35.
12.
Zurück zum Zitat Gatti A, Sabato E, Di Paolo AR, Mammucari M, Sabato AF. Oxycodone/paracetamol: a low-dose synergic combination useful in different types of pain. Clin Drug Investig. 2010;30(Suppl 2):3–14.CrossRefPubMed Gatti A, Sabato E, Di Paolo AR, Mammucari M, Sabato AF. Oxycodone/paracetamol: a low-dose synergic combination useful in different types of pain. Clin Drug Investig. 2010;30(Suppl 2):3–14.CrossRefPubMed
13.
Zurück zum Zitat Labianca R, Sarzi-Puttini P, Zuccaro SM, et al. Adverse effects associated with non-opioid and opioid treatment in patients with chronic pain. Clin Drug Investig. 2012;32(Suppl 1):53–63.CrossRef Labianca R, Sarzi-Puttini P, Zuccaro SM, et al. Adverse effects associated with non-opioid and opioid treatment in patients with chronic pain. Clin Drug Investig. 2012;32(Suppl 1):53–63.CrossRef
14.
Zurück zum Zitat Gatti A, Mammucari M, Sabato E, et al. Adherence and long-term effect of oxycodone/paracetamol in chronic noncancer pain: a retrospective study. Adv Ther. 2011;28(5):418–26.CrossRefPubMed Gatti A, Mammucari M, Sabato E, et al. Adherence and long-term effect of oxycodone/paracetamol in chronic noncancer pain: a retrospective study. Adv Ther. 2011;28(5):418–26.CrossRefPubMed
17.
Zurück zum Zitat Geppetti P, Benemei S. Pain treatment with opioids: achieving the minimal effective and the minimal interacting dose. Clin Drug Investig. 2009;29(Suppl 1):3–16.CrossRefPubMed Geppetti P, Benemei S. Pain treatment with opioids: achieving the minimal effective and the minimal interacting dose. Clin Drug Investig. 2009;29(Suppl 1):3–16.CrossRefPubMed
18.
Zurück zum Zitat Ripamonti CI, Santini D, Maranzano E, Berti M, Roila F. Management of cancer pain: ESMO clinical practice guidelines. Ann Oncol. 2012;23(Suppl 7):vii139–54.CrossRefPubMed Ripamonti CI, Santini D, Maranzano E, Berti M, Roila F. Management of cancer pain: ESMO clinical practice guidelines. Ann Oncol. 2012;23(Suppl 7):vii139–54.CrossRefPubMed
20.
Zurück zum Zitat Gatti A, Sabato AF, Carucci A, Bertini L, Mammucari M, Occhioni R. Adequacy assessment of oxycodone/paracetamol (acetaminophen) in multimodal chronic pain: a prospective observational study. Clin Drug Investig. 2009;29(1):31–40.CrossRefPubMed Gatti A, Sabato AF, Carucci A, Bertini L, Mammucari M, Occhioni R. Adequacy assessment of oxycodone/paracetamol (acetaminophen) in multimodal chronic pain: a prospective observational study. Clin Drug Investig. 2009;29(1):31–40.CrossRefPubMed
21.
Zurück zum Zitat Corsinovi L, Martinelli E, Fonte G, et al. Efficacy of oxycodone/acetaminophen and codeine/acetaminophen vs. conventional therapy in elderly women with persistent, moderate to severe osteoarthritis-related pain. Arch Gerontol Geriatr. 2009;49:378–82.CrossRefPubMed Corsinovi L, Martinelli E, Fonte G, et al. Efficacy of oxycodone/acetaminophen and codeine/acetaminophen vs. conventional therapy in elderly women with persistent, moderate to severe osteoarthritis-related pain. Arch Gerontol Geriatr. 2009;49:378–82.CrossRefPubMed
22.
Zurück zum Zitat Raffaeli W, Pari C, Corvetta A, et al. Oxycodone/acetaminophen at low dosage: an alternative pain treatment for patients with rheumatoid arthritis. J Opioid Manag. 2010;6:40–6.CrossRefPubMed Raffaeli W, Pari C, Corvetta A, et al. Oxycodone/acetaminophen at low dosage: an alternative pain treatment for patients with rheumatoid arthritis. J Opioid Manag. 2010;6:40–6.CrossRefPubMed
23.
Zurück zum Zitat Raffa RB. Pharmacology of oral combination analgesics: rational therapy for pain. J Clin Pharm Ther. 2001;26(4):257–64.CrossRefPubMed Raffa RB. Pharmacology of oral combination analgesics: rational therapy for pain. J Clin Pharm Ther. 2001;26(4):257–64.CrossRefPubMed
24.
Zurück zum Zitat Gammaitoni AR, Galer BS, Lacouture P, Domingos J, Schlagheck T. Effectiveness and safety of new oxycodone/acetaminophen formulations with reduced acetaminophen for the treatment of low back pain. Pain Med. 2003;4(1):21–30.CrossRefPubMed Gammaitoni AR, Galer BS, Lacouture P, Domingos J, Schlagheck T. Effectiveness and safety of new oxycodone/acetaminophen formulations with reduced acetaminophen for the treatment of low back pain. Pain Med. 2003;4(1):21–30.CrossRefPubMed
26.
Zurück zum Zitat Corsinovi L, Martinelli E, Fonte G, et al. Efficacy of oxycodone/acetaminophen and codeine/acetaminophen vs. conventional therapy in elderly women with persistent, moderate to severe osteoarthritis-related pain. Arch Gerontol Geriatr. 2009;49(3):378–82.CrossRefPubMed Corsinovi L, Martinelli E, Fonte G, et al. Efficacy of oxycodone/acetaminophen and codeine/acetaminophen vs. conventional therapy in elderly women with persistent, moderate to severe osteoarthritis-related pain. Arch Gerontol Geriatr. 2009;49(3):378–82.CrossRefPubMed
27.
Zurück zum Zitat Rosenblum A, Marsch LA, Joseph H, Portenoy RK. Opioids and the treatment of chronic pain: controversies, current status, and future directions. Exp Clin Psychopharmacol. 2008;16(5):405–16.CrossRefPubMedPubMedCentral Rosenblum A, Marsch LA, Joseph H, Portenoy RK. Opioids and the treatment of chronic pain: controversies, current status, and future directions. Exp Clin Psychopharmacol. 2008;16(5):405–16.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Coxib and traditional NSAID Trialists’ (CNT) Collaboration, Bhala N, Emberson J, Merhi A, et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013;382(9894):769–79.CrossRef Coxib and traditional NSAID Trialists’ (CNT) Collaboration, Bhala N, Emberson J, Merhi A, et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013;382(9894):769–79.CrossRef
Metadaten
Titel
Retrospective Evaluation of a Fixed-Dose Combination of Oxycodone and Acetaminophen to Manage Moderate Pain: The Lower the Better
verfasst von
Silvia Natoli
Marzia Lazzari
Roberta Carpenedo
Elisa Palombo
Maria Beatrice Silvi
Massimo Mammucari
Mario Dauri
Publikationsdatum
03.05.2016
Verlag
Springer Healthcare
Erschienen in
Advances in Therapy / Ausgabe 6/2016
Print ISSN: 0741-238X
Elektronische ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-016-0339-0

Weitere Artikel der Ausgabe 6/2016

Advances in Therapy 6/2016 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.