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Codeine and Acetaminophen for Pain Relief: A Review of the Clinical Efficacy and Safety

Published on: April 12, 2012
Project Number: RC0344-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical efficacy of codeine for chronic pain relief?
  2. What is the clinical efficacy of codeine in combination with acetaminophen for chronic pain relief?
  3. What is the clinical evidence on patient safety associated with different doses of codeine?
  4. What is the clinical evidence on patient safety associated with different doses of acetaminophen?
  5. What is the clinical evidence on patient safety associated with different doses of codeine/acetaminophen combination products?

Key Message

Based on this review, both codeine and acetaminophen/codeine provide better chronic pain relief than placebo. Chronic use of acetaminophen at doses higher than 2000 mg per day may be associated with increased risk of gastrointestinal events, liver toxicity, and renal dysfunction or failure. This review found evidence of increased risk of adverse events for patients treated with codeine or acetaminophen/codeine combination products compared to placebo. Acetaminophen/codeine treatment for post-operative pain was found to be associated with a higher risk of adverse events compared to placebo. No evidence was found on relative safety of different doses of either codeine or acetaminophen/codeine combination products.

Tags

acetaminophen, chronic disease, codeine, paracetamol, tylenol, analgesia, analgesics, pain, pain management, anesthesia, Pain paracetamol, cocomadol, Tylenolcocomadol