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The original Nurofen Plus tablet was manufactured in two equal parts, joined, and then coated. One part contained 12.8 mg of codeine phosphate, and the other part contained 200 mg of ibuprofen. The tablets could be forcefully split into their two constituent active ingredients, thus isolating the codeine for recreational use.
Compound analgesics are those with multiple active ingredients; they include many of the stronger prescription analgesics. Active ingredients that have been commonly used in compound analgesics include: aspirin or ibuprofen; caffeine; codeine or oxycodone; paracetamol (acetaminophen) phenacetin
Ibuprofen is a weaker anti-inflammatory agent than other NSAIDs. [10] Ibuprofen was discovered in 1961 by Stewart Adams and John Nicholson [12] while working at Boots UK Limited and initially marketed as Brufen. [13] It is available under a number of brand names including Advil, Motrin, and Nurofen.
Paracetamol (acetaminophen) is generally not considered an NSAID because it has only minor anti-inflammatory activity. Paracetamol treats pain mainly by blocking COX-2 and inhibiting endocannabinoid reuptake almost exclusively within the brain, and only minimally in the rest of the body. [15] [16]
Paracetamol, [a] or acetaminophen, [b] is a non-opioid analgesic and antipyretic agent used to treat fever and mild to moderate pain. [13] [14] [15] It is a widely available over-the-counter drug sold under various brand names, including Tylenol and Panadol. Paracetamol relieves pain in both acute mild migraine and episodic tension headache.
Acute use (1–3 days) yields a potency about 1.5× stronger than that of morphine and chronic use (7 days+) yields a potency about 2.5 to 5× that of morphine. Similarly, the effect of tramadol increases after consecutive dosing due to the accumulation of its active metabolite and an increase of the oral bioavailability in chronic use.
Panadol Extra, an S2 pharmacy-only medicine in Australia, combines 65 mg of caffeine with 500 mg of paracetamol per tablet. Caffeine may improve the analgesic effect of paracetamol. Studies have reached conflicting conclusions regarding the clinical significance of this incremental pain relief. [20] [21]
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]
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