SUMMARY
ACETAMINOPHEN, ASPIRIN, AND CODEINE* PHOSPHATE CAPSULES
Acetaminophen, aspirin, and codeine phosphate capsules are available in three different strengths and colors:
150 mg/180 mg/15 mg 150 mg/180 mg/30 mg 150 mg/180 mg/60 mg
(grey/green) (grey/black) (grey/red)
Acetaminophen 150 mg 150 mg 150 mg
Aspirin 180 mg 180 mg 180 mg
Codeine* Phosphate 15 mg 30 mg 60 mg
(*WARNING: May be habit forming)
Acetaminophen, 4-hydroxyacetanilide, is a non-opiate, non-salicylate analgesic and antipyretic which occurs as a white, odorless, crystalline powder, possessing a slightly bitter taste.
Aspirin, salicylic acid acetate, is a non-opiate analgesic, anti-inflammatory and antipyretic agent. It occurs as a white, crystalline tabular or needle-like powder and is odorless or has a faint odor, Its structure is as follows:
Codeine is an alkaloid, obtained from opium or prepared from morphine by methylation.
Acetaminophen, aspirin, and codeine phosphate capsules are indicated for the relief of mild to moderately severe pain.
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NEWS HIGHLIGHTSMedia Articles Related to Acetaminophen, Aspirin and Codeine (Acetaminophen / Aspirin / Codeine)
Erectile Dysfunction Tied To Long Term Painkiller Use
Source: Erectile Dysfunction / Premature Ejaculation News From Medical News Today [2013.05.16]
A new study suggests that long term use of opioid prescription painkillers for back pain is tied to a higher risk of erectile dysfunction (ED). The findings are published in the 15 May online issue of the journal Spine. Lead author Richard A...
Painkillers Increase Risk of Erectile Dysfunction
Source: Erectile Dysfunction / Premature Ejaculation News From Medical News Today [2013.05.15]
Regularly taking prescription painkillers, commonly called opioids, is linked to a greater risk of erectile dysfunction (ED) in men, according to a new study published in Spine. Over 11,000 men suffering from back pain were involved in the research...
Retooling Pain Assessment for Older Adults
Source: Medscape Emergency Medicine Headlines [2013.05.14]
Current pain assessment tools for older adults are inadequate, and education for healthcare professionals falls short in meeting the unique challenges posed by pain management for elderly patients.
Medscape Medical News
Tanezumab Makes Good in Chronic Back Pain (CME/CE)
Source: MedPage Today Neurology [2013.05.14]
NEW ORLEANS (MedPage Today) -- The controversial agent tanezumab, which was once put on an FDA regulatory hold, offered durable reduction of chronic low back pain, a long-term safety and efficacy study showed.
Persistent Pain After Sexual Assault Often Untreated
Source: Medscape Nurses Headlines [2013.05.13]
Although pain is common after sexual assault, more than 50% of women don't seek appropriate medical care 6 weeks after presenting to the ED.
Medscape Medical News
Published Studies Related to Acetaminophen, Aspirin and Codeine (Acetaminophen / Aspirin / Codeine)
Double-blind comparison of an acetaminophen 400 mg-codeine 25 mg combination versus aspirin 1000 mg and placebo in acute migraine attack. [1994.04]
The purpose of this study was to compare the efficacy and tolerance of a single dose of the acetaminophen 400 mg-codeine 25 mg combination (ACC) aspirin 1000 mg (A) and a placebo (P) for the treatment of acute migraine attack. The study design was randomized, multicentre, double-blind and double dummy with cross-over on three periods...
Evaluation of ketorolac, ibuprofen, acetaminophen, and an acetaminophen-codeine combination in postoperative oral surgery pain. [1990]
Two-hundred six outpatients with postoperative pain after the surgical removal of impacted third molars were randomly assigned on a double-blind basis to receive oral doses of ketorolac tromethamine 10 and 20 mg, ibuprofen 400 mg, acetaminophen 600 mg, a combination of acetaminophen 600 mg plus codeine 60 mg, or placebo...
Acetaminophen, aspirin, or Ibuprofen in combination analgesic products. [2001.11]
Pain of multiple etiologies remains a substantial problem for many patients presenting in the clinical setting...
Clinical Trials Related to Acetaminophen, Aspirin and Codeine (Acetaminophen / Aspirin / Codeine)
Acetaminophen for Cancer Pain [Recruiting]
Many patients with cancer pain have pain not fully controlled on opioids (eg. morphine).
The addition of acetaminophen (Tylenol) to opioids in a small study in cancer patients
demonstrated better pain control without an increase in side effects. This study will
determine if regular acetaminophen improves pain control when added to strong opioids in
patients with cancer pain.
Effect of Imatinib Mesylate and the Pharmacokinetics of Acetaminophen/Paracetamol in Patients With Newly Diagnosed, Previously Untreated Chronic Myeloid Leukemia in Chronic Phase (CML-CP) [Recruiting]
A non-randomized, open-label study to investigate the effects of imatinib mesylate on the
pharmacokinetics of acetaminophen/paracetamol in patients with newly diagnosed, previously
untreated chronic myeloid leukemia in chronic phase (CML-CP)
A Study of the Efficacy and Safety of Tramadol HCl/Acetaminophen, Hydrocodone Bitartrate/Acetaminophen and Placebo in Patients With Pain From an Ankle Sprain With a Partial Torn Ligament [Completed]
The purpose of this study is to explore the pain-relieving effects and safety of two
analgesic treatment regimens as compared to placebo in patients experiencing acute
musculoskeletal pain. Patients who are experiencing at least moderate acute musculoskeletal
pain from an ankle sprain severe enough to require prescription pain relief medication will
be randomized to receive either tramadol HCl/acetaminophen, hydrocodone
bitartrate/acetaminophen or placebo.
AVIS - Acetaminophen Before Vaccines for Infants Study [Recruiting]
The purpose of this study is to see whether giving acetaminophen (the medicine in Tylenol)
for routine infant vaccinations is helpful in preventing fever or other symptoms.
A Trial Comparing Combination Therapy of Acetaminophen Plus Ibuprofen Versus Tylenol #3 for the Treatment of Pain After Outpatient Surgery [Completed]
Increasingly in general surgery, the investigators are conducting outpatient day surgery.
Ambulatory surgery currently comprises 60 to 70% of surgeries performed in North America.
These patients all require some form of analgesia which can be taken at home in the first few
days after the surgery. The current standard at the investigators' centre and many others in
the maritime provinces is to provide a prescription for oral acetaminophen plus codeine or
oxycodone (Tylenol #3®, Percocet ®). Some patients may receive more potent opioids such as
oral hydromorphone (Dilaudid®). Unfortunately, the most commonly prescribed medication
(Tylenol #3®) is often poorly tolerated by patients, has several undesirable side effects,
and may not provide effective pain relief. In the investigators' experience, non-steroidal
anti-inflammatory drugs (NSAIDs) are uncommonly a routine addition to the home analgesic
regimen.
Tylenol #3®, in the investigators' experience and opinion, is a poor post surgical pain
medication. They hope to show that a combination of ibuprofen and acetaminophen is better for
pain relief after these procedures. The combination of acetaminophen and ibuprofen would be a
safe, cheap, and readily available regimen. Unfortunately, as the prescribing practices of
surgeons are old habits, it will require a very convincing argument to get them to change
their practices. A randomized controlled trial comparing these two regimens, the
investigators hope, would be a powerful enough argument.
The hypothesis of this study, therefore, is that the pain control provided by a combination
of acetaminophen plus ibuprofen (650 mg/400 mg four times per day) will be superior to
Tylenol #3® (600 mg acetaminophen/60 mg codeine/15 mg caffeine four times per day).
This study will attempt to enroll 150 patients in total. Eligible patients will be identified
by their attending surgeon and contacted by study personnel. Patients who enroll in the study
will undergo their surgery in the usual manner. After the surgery, in the recovery room, once
they are ready to go home, they will be randomized to receive combination A or B and be given
a week's worth of pain medication. They will then go home and take this medication as
directed. They will record their pain intensity and pain relief once per day using a diary
provided in the study package. One week after their surgery, they will return to the hospital
clinic and be seen by the study nurse. They will hand over the diary and any unused
medication. They will also be asked several questions regarding their overall satisfaction,
incidence of side effects, and how long until they were pain free.
The risks of participating in this study are minimal from the risks inherent to the
procedures and medications the patients would receive within the standard of care. Ibuprofen
is a commonly used NSAID which is widely available over the counter and has an established
safety profile. The most common adverse effects of ibuprofen and other NSAIDs are
gastrointestinal bleeding and ulceration. Other less common adverse effects include
nephrotoxicity, hypersensitivity reactions, hepatic dysfunction (longterm use), and cognitive
dysfunction. The investigators' patients will be selected to exclude those most at risk for
these complications (see exclusion criteria). Acetaminophen has few side effects, with no
adverse effects on platelet function and no evidence of gastric irritation.
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Page last updated: 2013-05-16
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