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Fixed Dose Versus Loose Dose: Analgesic Combinations
Combinations of drugs may be fixed (two or more entities in a single product) or loose (two or more agents taken together but as individual agents) to help address multimechanistic pain. The use of opioids plus nonopioids can result in lower opioid consumption without sacrificing analgesic benefits....
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894647/ https://www.ncbi.nlm.nih.gov/pubmed/36741676 http://dx.doi.org/10.7759/cureus.33320 |
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author | Pergolizzi, Joseph Varrassi, Giustino LeQuang, Jo Ann K Breve, Frank Magnusson, Peter |
author_facet | Pergolizzi, Joseph Varrassi, Giustino LeQuang, Jo Ann K Breve, Frank Magnusson, Peter |
author_sort | Pergolizzi, Joseph |
collection | PubMed |
description | Combinations of drugs may be fixed (two or more entities in a single product) or loose (two or more agents taken together but as individual agents) to help address multimechanistic pain. The use of opioids plus nonopioids can result in lower opioid consumption without sacrificing analgesic benefits. Drug combinations may offer additive or synergistic benefits. A variety of fixed-dose combination products are available on the market such as diclofenac plus thiocolchicoside, acetaminophen and caffeine, acetaminophen and opioid, ibuprofen and acetaminophen, tramadol and acetaminophen, and others. Fixed-dose combination products offer predictable pharmacokinetics and pharmacodynamics, known adverse events, and can reduce the pill burden. However, they are limited to certain drug combinations and doses; loose dosing allows prescribers the versatility to meet individual patient requirements as well as the ability to titrate as needed. Not all drug combinations offer synergistic benefits, which depend on the drugs and their doses. Certain drugs offer dual mechanisms of action in a single molecule, such as tapentadol, and these may further be used in combination with other analgesics. New technology allows for co-crystal productions of analgesic agents which may further improve drug characteristics, such as bioavailability. Combination analgesics are important additions to the analgesic armamentarium and may offer important benefits at lower doses than monotherapy. |
format | Online Article Text |
id | pubmed-9894647 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-98946472023-02-03 Fixed Dose Versus Loose Dose: Analgesic Combinations Pergolizzi, Joseph Varrassi, Giustino LeQuang, Jo Ann K Breve, Frank Magnusson, Peter Cureus Pain Management Combinations of drugs may be fixed (two or more entities in a single product) or loose (two or more agents taken together but as individual agents) to help address multimechanistic pain. The use of opioids plus nonopioids can result in lower opioid consumption without sacrificing analgesic benefits. Drug combinations may offer additive or synergistic benefits. A variety of fixed-dose combination products are available on the market such as diclofenac plus thiocolchicoside, acetaminophen and caffeine, acetaminophen and opioid, ibuprofen and acetaminophen, tramadol and acetaminophen, and others. Fixed-dose combination products offer predictable pharmacokinetics and pharmacodynamics, known adverse events, and can reduce the pill burden. However, they are limited to certain drug combinations and doses; loose dosing allows prescribers the versatility to meet individual patient requirements as well as the ability to titrate as needed. Not all drug combinations offer synergistic benefits, which depend on the drugs and their doses. Certain drugs offer dual mechanisms of action in a single molecule, such as tapentadol, and these may further be used in combination with other analgesics. New technology allows for co-crystal productions of analgesic agents which may further improve drug characteristics, such as bioavailability. Combination analgesics are important additions to the analgesic armamentarium and may offer important benefits at lower doses than monotherapy. Cureus 2023-01-03 /pmc/articles/PMC9894647/ /pubmed/36741676 http://dx.doi.org/10.7759/cureus.33320 Text en Copyright © 2023, Pergolizzi et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Pain Management Pergolizzi, Joseph Varrassi, Giustino LeQuang, Jo Ann K Breve, Frank Magnusson, Peter Fixed Dose Versus Loose Dose: Analgesic Combinations |
title | Fixed Dose Versus Loose Dose: Analgesic Combinations |
title_full | Fixed Dose Versus Loose Dose: Analgesic Combinations |
title_fullStr | Fixed Dose Versus Loose Dose: Analgesic Combinations |
title_full_unstemmed | Fixed Dose Versus Loose Dose: Analgesic Combinations |
title_short | Fixed Dose Versus Loose Dose: Analgesic Combinations |
title_sort | fixed dose versus loose dose: analgesic combinations |
topic | Pain Management |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894647/ https://www.ncbi.nlm.nih.gov/pubmed/36741676 http://dx.doi.org/10.7759/cureus.33320 |
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