Combination of aspirin and paracetamol is additive (not supraadditive) and a ceiling analgesic effect is obtained when the total amount of aspirin + paracetamol is ~ 1000 mg.
ANALGESIC COMBINATIONS
Combination of aspirin
and paracetamol is additive (not supraadditive) and a ceiling analgesic effect
is obtained when the total amount of aspirin + paracetamol is ~ 1000 mg. The
same is true of combinations of paracetamol with other NSAIDs like ibuprofen,
diclofenac, etc. There is no convincing evidence that such combinations are
superior to single agents, either in efficacy or in safety. If at all used,
such combinations should be limited to short periods.
Combination of codeine
(an opioid analgesic) with aspirin or paracetamol is also additive, but in this
case combination provides additional analgesia beyond the ceiling effect of
aspirin/ paracetamol. The mechanisms of pain relief by these two classes of
drugs are different. Such combination can be considered rational for providing
greater analgesia. Adequate clinical data supports use of such combination for
pain refractory to single agent.
To obviate in-advertant
misuse and chance of producing dependence, fixed dose combinations of
analgesics with hypnotics/sedatives/anxiolytics is banned in India.
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