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Ibuprofen/paracetamol, sold under the brand name Combogesic among others, is a fixed-dose combination of two medications, ibuprofen, a non-steroidal anti-inflammatory drug (NSAID); and paracetamol (acetaminophen), an analgesic and antipyretic. [6] It is available as a generic medication. [9] [10] [11]
The WHO guidelines recommend prompt oral administration of drugs ("by the mouth") when pain occurs, starting, if the patient is not in severe pain, with non-opioid drugs such as paracetamol (acetaminophen) or aspirin, [1] with or without "adjuvants" such as non-steroidal anti-inflammatory drugs (NSAIDs) including COX-2 inhibitors.
Allowing sufficient time between doses of ibuprofen and immediate-release (IR) aspirin can avoid this problem. The recommended elapsed time between a dose of ibuprofen and a dose of aspirin depends on which is taken first. It would be 30 minutes or more for ibuprofen taken after IR aspirin, and 8 hours or more for ibuprofen taken before IR aspirin.
An equianalgesic chart is a conversion chart that lists equivalent doses of analgesics (drugs used to relieve pain). Equianalgesic charts are used for calculation of an equivalent dose (a dose which would offer an equal amount of analgesia) between different analgesics. [1]
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The brand first entered the American market in 1984 through Whitehall [3] (itself a division of Wyeth, which was purchased by Pfizer in 2009), [4] the same year ibuprofen gained Food and Drug Administration (FDA) approval for over-the-counter (OTC) sales in the United States (being available via prescription since 1974). [5]
Paracetamol's bioavailability is dose-dependent: it increases from 63 % for 500 mg dose to 89 % for 1000 mg dose. [6] Its plasma terminal elimination half-life is 1.9–2.5 hours, [ 6 ] and volume of distribution is roughly 50 L. [ 132 ] Protein binding is negligible, except under the conditions of overdose, when it may reach 15–21 %. [ 6 ]
Calpol also comes in a form containing ibuprofen, marketed under the name Calprofen. Calpol Night, a product containing paracetamol and an antihistamine, was listed for use from 2+ months. However, this was changed and it is now only considered suitable for children over the age of 6 years. [4]