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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.
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.
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.
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]
Ibuprofen, an analgesic and non-steroidal anti-inflammatory drug (NSAID), [1] is sold under many brand-names around the world. The most common are Brufen (its earliest registered trademark), Advil, Motrin, and Nurofen .
One meta-analysis indicated that ibuprofen is more effective than acetaminophen in children at similar doses when both are given alone. [16] Due to concerns about Reye syndrome, it is recommended that aspirin and combination products that contain aspirin not be given to children or teenagers during episodes of fever-causing illnesses. [17] [18]
Codeine/paracetamol, also called codeine/acetaminophen and co-codamol, is a compound analgesic, comprising codeine phosphate and paracetamol (acetaminophen). Codeine/paracetamol is used for the relief of mild to moderate pain when paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs; such as ibuprofen, aspirin, and naproxen) alone do not sufficiently relieve symptoms.