(1.01 to 1.6) (moderate dose) had insufficient data quality evidence). to analyse on its own. In two studies (159 The McQuay study was participants) ibuprofen included in the plus codeine appeared to commissioned review. be better than the same This paper does not provide dose of codeine alone additional evidence for the (69% versus 33%), but no incremental analgesia analysis was done. There effectiveness of low-dose was no difference between codeine in combination the combination and products. placebo in the reporting of adverse events in these The review does not provide acute studies (moderate detailed safety information. quality evidence). Authors’ conclusions: The combin-ation of ibuprofen 400 mg plus codeine 25.6 mg to 60 mg demonstrates good analgesic efficacy. Very limited data suggest that the combination is better than the same dose of either drug alone, and that similar numbers of people experience adverse events with the combination as with placebo. Graudins A, Meek R, Initial analgesia in adult Primary outcome: Single-dose of oral DBRCT three arm Conference abstract only. – D, Parkinson J, emergency department change in visual paracetamol + 182 adult patients from 18 Abstract submitted to the Meyer A. (2015) A double patients with moderate analog ibuprofen + to 75 years with isolated 31st Annual Scientific blind, randomised controlled pain from limb injury rating (VAS) from thiamine limb injury and moderate Meeting of the Australasian comparing single-dose baseline to 30 pain (VAS greater than 3 College for Emergency
(1.01 to 1.6) (moderate quality evidence). In two studies (159 participants) ibuprofen plus codeine appeared to be better than the same dose of codeine alone (69% versus 33%), but no analysis was done. There was no difference between the combination and placebo in the reporting of adverse events in these acute studies (moderate quality evidence). Authors’ conclusions: The combin-ation of ibuprofen 400 mg plus codeine 25.6 mg to 60 mg demonstrates good analgesic efficacy. Very limited data suggest that the combination is better than the same dose of either drug alone, and that similar numbers of people experience adverse events with the combination as with placebo. dose) had insufficient data to analyse on its own. The McQuay study was included in the commissioned review. This paper does not provide additional evidence for the incremental analgesia effectiveness of low-dose codeine in combination products. The review does not provide detailed safety information. Graudins A, Meek R, D, Parkinson J, Meyer A. (2015) A double blind, randomised controlled comparing single-dose Initial analgesia in adult emergency department patients with moderate pain from limb injury Primary outcome: change in visual analog rating (VAS) from baseline to 30 Single-dose of oral paracetamol + ibuprofen + thiamine DBRCT – three arm 182 adult patients from 18 to 75 years with isolated limb injury and moderate pain (VAS greater than 3 Conference abstract only. Abstract submitted to the 31st Annual Scientific Meeting of the Australasian College for Emergency
update-codeine-safety-and-efficacy-review.docx