A multiple dose comparison of combinations of ibuprofen and codeine and paracetamol, codeine and caffeine after third molar surgery

Abstract

In a randomised, double‐blind, double‐dummy, multiple dose, crossover study in 30 patients we compared an ibuprofen/codeine combination (400 mg ibuprofen/25.6 mg codeine phosphate) with a paracetamol/codeine/caffeine combination (1 g paracetamol/ 16 mg codeine phosphate/60 mg caffeine) for pain relief over 6 days after two‐stage bilateral lower third molar removal. The ibuprofen combination produced significantly greater analgesia than the paracetamol combination, both on single‐dose analysis of the first and second days and on multiple‐dose measures for days 1, 2, 3 and 4. The mean incidence of adverse effects over the 6 days was 20% for both combinations. This trial design (crossover with multiple dosing in outpatients) is a sensitive way of testing for analgesia, and is potentially more predictive of adverse effect problems than single‐dose studies. It confirms that multiple dosing may show increased efficacy. Copyright © 1992, Wiley Blackwell. All rights reserved