title: A multiple dose comparison of combinations of ibuprofen and codeine and paracetamol, codeine and caffeine after third molar surgery.
abstract: In a randomised, double-blind, double-dummy, multiple dose, crossover study in 30 patients we compared an ibuprofen/codeine combination (400 mg ibuprofen/25.6 mg codeine phosphate) with a paracetamol/codeine/caffeine combination (1 g paracetamol/16 mg codeine phosphate/60 mg caffeine) for pain relief over 6 days after two-stage bilateral lower third molar removal. The ibuprofen combination produced significantly greater analgesia than the paracetamol combination, both on single-dose analysis of the first and second days and on multiple-dose measures for days 1, 2, 3 and 4. The mean incidence of adverse effects over the 6 days was 20% for both combinations. This trial design (crossover with multiple dosing in outpatients) is a sensitive way of testing for analgesia, and is potentially more predictive of adverse effect problems than single-dose studies. It confirms that multiple dosing may show increased efficacy.
authors.affiliation: Oxford Regional Pain Relief Unit, Churchill Hospital.
authors.forename: H J
authors.initials: HJ
authors.lastname: McQuay
authors.forename: D
authors.initials: D
authors.lastname: Carroll
authors.forename: P
authors.initials: P
authors.lastname: Guest
authors.forename: R P
authors.initials: RP
authors.lastname: Juniper
authors.forename: R A
authors.initials: RA
authors.lastname: Moore
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage* / Q000009:adverse effects; D000284:Administration, Oral; D000328:Adult; D002110:Caffeine / Q000008:administration & dosage*; D003061:Codeine / Q000008:administration & dosage*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D004338:Drug Combinations; D000082:Acetaminophen; D002110:Caffeine; D003061:Codeine; D007052:Ibuprofen