The Open Pain Journal




ISSN: 1876-3863 ― Volume 12, 2019
REVIEW ARTICLE

Dose Can Help to Achieve Effective Pain Relief for Acute Mild to Moderate Pain with Over-the-Counter Paracetamol



Charly Gaul1, *#, Alain Eschalier2, #
1 Migraine and Headache Clinic Königstein, 61462 Königstein im Taunus, Germany
2 Université Clermont Auvergne, UMR Inserm Neuro-dol, Institut Analgesia, Clermont-FerrandFrance

Abstract

Background:

Paracetamol (acetaminophen) is one of the most widely used Over-The-Counter (OTC) analgesics for the self-treatment of mild to moderate acute pain. Different dosages are used in different countries and, in some of them, a large proportion of adults are using low doses (325 mg to 500 mg).

Objectives:

The objective of the study was to review information from published research studies to answer the question: is there a dose-dependent analgesic effect of paracetamol in the treatment of mild to moderate acute pain?

Methods:

A detailed assessment of available systematic reviews, meta-analyses and single randomised trials was undertaken based on an electronic literature search focusing on studies comparing higher and lower doses of paracetamol in the management of mild to moderate acute pain.

Results:

Reviews and comparative trials generally showed greater efficacy with higher dose paracetamol (1000 mg) than with lower doses (500 mg or 650 mg) in achieving clinically significant pain relief with comparable tolerability in different types of pain.

Conclusions

The nature and intensity of the pain are two key elements of the therapeutic choice.

Higher dose immediate-release paracetamol (1000 mg), used for a short duration of time (4-5 days) and adhering to recommendations within the label for risk groups, delivers safe and more effective analgesia than lower doses for adults with mild to moderate acute pain.

Strengths and Limitations of this Study:

• Paracetamol is one of the most widely used OTC analgesics for the self- treatment of mild to moderate acute pain and this study aims to explore the practical question of whether the use of low doses, which is common in some countries, provides suboptimal pain relief.

• This review provides an overview of previous studies focusing on comparing the analgesic efficacy of different doses of paracetamol rather than comparing the effect of different OTC analgesics.

• This review details a narrative assessment of available systematic reviews, meta-analysis and randomised trials but does not offer a quantitative analysis of pain relief achieved with different doses of paracetamol.

• The review does not provide an overview of studies focusing on different forms of paracetamol.

• The focus for this review is immediate release paracetamol. Combined and slow release paracetamol formulations were not considered of relevance. The latter are in the process of being suspended across the European Union due to safety concerns with overdosing [1].

Keywords: Paracetamol, OTC, Pain, Doses, Review, Clinical trials.


Article Information


Identifiers and Pagination:

Year: 2018
Volume: 11
First Page: 12
Last Page: 20
Publisher Id: TOPAINJ-11-12
DOI: 10.2174/1876386301811010012

Article History:

Received Date: 15/5/2018
Revision Received Date: 20/06/2018
Acceptance Date: 31/07/2018
Electronic publication date: 28/09/2018
Collection year: 2018

Article Metrics:

CrossRef Citations:
0

Total Statistics:

Full-Text HTML Views: 1332
Abstract HTML Views: 715
PDF Downloads: 238
ePub Downloads: 185
Total Views/Downloads: 2470

Unique Statistics:

Full-Text HTML Views: 748
Abstract HTML Views: 486
PDF Downloads: 169
ePub Downloads: 132
Total Views/Downloads: 1535
Geographical View

© 2018 Gaul and Eschalier.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Charly Gaul Ölmühlweg 31, 61462 Königstein im Taunus, Germany, Tel: +49 (0) 6174-29040, Fax: +49 (0) 6174-2904100, E-mail: c.gaul@migraene-klinik.de
# Both authors contributed equally to this work.



Endorsements



"Open access will revolutionize 21st century knowledge work and accelerate the diffusion of ideas and evidence that support just in time learning and the evolution of thinking in a number of disciplines."


Daniel Pesut
(Indiana University School of Nursing, USA)

"It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. This is exactly what Open Access Journals provide and this is the reason why I support this endeavor."


Jacques Descotes
(Centre Antipoison-Centre de Pharmacovigilance, France)

"Publishing research articles is the key for future scientific progress. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community."


Patrice Talaga
(UCB S.A., Belgium)

"Open access journals are a novel concept in the medical literature. They offer accessible information to a wide variety of individuals, including physicians, medical students, clinical investigators, and the general public. They are an outstanding source of medical and scientific information."


Jeffrey M. Weinberg
(St. Luke's-Roosevelt Hospital Center, USA)

"Open access journals are extremely useful for graduate students, investigators and all other interested persons to read important scientific articles and subscribe scientific journals. Indeed, the research articles span a wide range of area and of high quality. This is specially a must for researchers belonging to institutions with limited library facility and funding to subscribe scientific journals."


Debomoy K. Lahiri
(Indiana University School of Medicine, USA)

"Open access journals represent a major break-through in publishing. They provide easy access to the latest research on a wide variety of issues. Relevant and timely articles are made available in a fraction of the time taken by more conventional publishers. Articles are of uniformly high quality and written by the world's leading authorities."


Robert Looney
(Naval Postgraduate School, USA)

"Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets."


Richard Reithinger
(Westat, USA)

"Not only do open access journals greatly improve the access to high quality information for scientists in the developing world, it also provides extra exposure for our papers."


J. Ferwerda
(University of Oxford, UK)

"Open Access 'Chemistry' Journals allow the dissemination of knowledge at your finger tips without paying for the scientific content."


Sean L. Kitson
(Almac Sciences, Northern Ireland)

"In principle, all scientific journals should have open access, as should be science itself. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. The articles are high standard and cover a wide area."


Hubert Wolterbeek
(Delft University of Technology, The Netherlands)

"The widest possible diffusion of information is critical for the advancement of science. In this perspective, open access journals are instrumental in fostering researches and achievements."


Alessandro Laviano
(Sapienza - University of Rome, Italy)

"Open access journals are very useful for all scientists as they can have quick information in the different fields of science."


Philippe Hernigou
(Paris University, France)

"There are many scientists who can not afford the rather expensive subscriptions to scientific journals. Open access journals offer a good alternative for free access to good quality scientific information."


Fidel Toldrá
(Instituto de Agroquimica y Tecnologia de Alimentos, Spain)

"Open access journals have become a fundamental tool for students, researchers, patients and the general public. Many people from institutions which do not have library or cannot afford to subscribe scientific journals benefit of them on a daily basis. The articles are among the best and cover most scientific areas."


M. Bendandi
(University Clinic of Navarre, Spain)

"These journals provide researchers with a platform for rapid, open access scientific communication. The articles are of high quality and broad scope."


Peter Chiba
(University of Vienna, Austria)

"Open access journals are probably one of the most important contributions to promote and diffuse science worldwide."


Jaime Sampaio
(University of Trás-os-Montes e Alto Douro, Portugal)

"Open access journals make up a new and rather revolutionary way to scientific publication. This option opens several quite interesting possibilities to disseminate openly and freely new knowledge and even to facilitate interpersonal communication among scientists."


Eduardo A. Castro
(INIFTA, Argentina)

"Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use. The articles published in the open access journals are high quality and cover a wide range of fields."


Kenji Hashimoto
(Chiba University, Japan)

"Open Access journals offer an innovative and efficient way of publication for academics and professionals in a wide range of disciplines. The papers published are of high quality after rigorous peer review and they are Indexed in: major international databases. I read Open Access journals to keep abreast of the recent development in my field of study."


Daniel Shek
(Chinese University of Hong Kong, Hong Kong)

"It is a modern trend for publishers to establish open access journals. Researchers, faculty members, and students will be greatly benefited by the new journals of Bentham Science Publishers Ltd. in this category."


Jih Ru Hwu
(National Central University, Taiwan)


Browse Contents



Webmaster Contact: info@benthamopen.net
Copyright © 2019 Bentham Open