Tylenol #1
Place in Therapy
A comprehensive review of the available evidence regarding the use of combination products (acetaminophen, low dose codeine (8 mg), caffeine) such as Tylenol No. 1, shows that their place in therapy for treating OA pain is quite ambiguous. There is no primary literature that directly compares the efficacy of these products at the specified dosages in OA pain. The majority of the recommendations are based on extrapolated data that address the use of opioids in general in managing OA pain. Although such assumptions are valid, it is difficult to compare such combination products to other products with extensive evidence in treating OA pain. Nevertheless, the majority of available evidence seems to agree that such combination products may be indicated for the management of OA pain in individuals at serious risk of adverse events from NSAIDs or in whom single ingredient acetaminophen therapy proved insufficient.
References:
1. Lexicomp Online [Internet]. Codeine and acetaminophen. Hudson OH: Wolters Kluwer Health; [date unknown]
Available from: http://online.lexi.com. Accessed March 16, 2014
2. Conaghan PG, O'Brien CM, Wilson M, Schofield JP. Transdermal buprenorphine plus oral paracetamol vs an oral codeine-paracetamol combination for osteoarthritis of hip and/or knee: a randomised trial.Osteoarthritis Cartilage 2011;19 (8), pp. 930-938.
3. Hochberg MC, Altman RD, April KT et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care & Res 2012; 64(4): 465–474.
4. Grindrod, K. & C. Marra. Osteoarthritis. Patient Self-Care 2nd ed. Ottawa, ON: Canadian Pharmacists Association, 2010.
5. Jordan KM, Arden NK, Doherty M et al. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2003; 62:1145-55.
6. Lexicomp Online [Internet]. Codeine. Hudson OH: Wolters Kluwer Health; [date unknown]
Available from: http://online.lexi.com. Accessed March 16, 2014.
References:
1. Lexicomp Online [Internet]. Codeine and acetaminophen. Hudson OH: Wolters Kluwer Health; [date unknown]
Available from: http://online.lexi.com. Accessed March 16, 2014
2. Conaghan PG, O'Brien CM, Wilson M, Schofield JP. Transdermal buprenorphine plus oral paracetamol vs an oral codeine-paracetamol combination for osteoarthritis of hip and/or knee: a randomised trial.Osteoarthritis Cartilage 2011;19 (8), pp. 930-938.
3. Hochberg MC, Altman RD, April KT et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care & Res 2012; 64(4): 465–474.
4. Grindrod, K. & C. Marra. Osteoarthritis. Patient Self-Care 2nd ed. Ottawa, ON: Canadian Pharmacists Association, 2010.
5. Jordan KM, Arden NK, Doherty M et al. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2003; 62:1145-55.
6. Lexicomp Online [Internet]. Codeine. Hudson OH: Wolters Kluwer Health; [date unknown]
Available from: http://online.lexi.com. Accessed March 16, 2014.