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. 2016 Dec 27;12(12):CD012227.
doi: 10.1002/14651858.CD012227.pub2.

Paracetamol (acetaminophen) with or without codeine or dihydrocodeine for neuropathic pain in adults

Philip J Wiffen  1 , Roger Knaggs  2 , Sheena Derry  1 , Peter Cole  3 , Tudor Phillips  1 , R Andrew Moore  1
Affiliations

Paracetamol (acetaminophen) with or without codeine or dihydrocodeine for neuropathic pain in adults

Philip J Wiffen et al. Cochrane Database Syst Rev. .

Abstract

Background: Paracetamol, either alone or in combination with codeine or dihydrocodeine, is commonly used to treat chronic neuropathic pain. This review sought evidence for efficacy and harm from randomised double-blind studies.

Objectives: To assess the analgesic efficacy and adverse events of paracetamol with or without codeine or dihydrocodeine for chronic neuropathic pain in adults.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase from inception to July 2016, together with reference lists of retrieved papers and reviews, and two online study registries.

Selection criteria: We included randomised, double-blind studies of two weeks' duration or longer, comparing paracetamol, alone or in combination with codeine or dihydrocodeine, with placebo or another active treatment in chronic neuropathic pain.

Data collection and analysis: Two review authors independently searched for studies, extracted efficacy and adverse event data, and examined issues of study quality and potential bias. We did not carry out any pooled analyses. We assessed the quality of the evidence using GRADE.

Main results: No study satisfied the inclusion criteria. Effects of interventions were not assessed as there were no included studies. We have only very low quality evidence and have no reliable indication of the likely effect.

Authors' conclusions: There is insufficient evidence to support or refute the suggestion that paracetamol alone, or in combination with codeine or dihydrocodeine, works in any neuropathic pain condition.

PubMed Disclaimer

Conflict of interest statement

PW: none known.

RK has consulted for Grünenthal Ltd (2014 to 2015) and MundiPharma Research (2015), and received lecture fees from Grünenthal Ltd (2013 to 2014), and Pfizer Ltd (2013 to 2014). He is an Associate Professor in Clinical Pharmacy Practice and Advanced Pharmacy Practitioner.

SD: none known.

PC received support from Boston Scientific (2014) for travel and accommodation at a scientific meeting; Boston Scientific does not market paracetamol products. PC is a specialist pain physician and manages patients with chronic pain.

TP: none known; TP is a specialist pain physician and manages patients with neuropathic pain.

RAM has received grant support from RB relating to individual patient level analyses of trial data on ibuprofen in acute pain and the effects of food on drug absorption of analgesics (2013), and from Grünenthal relating to individual patient level analyses of trial data regarding tapentadol in osteoarthritis and back pain (2015). He has received honoraria for attending boards with Menarini concerning methods of analgesic trial design (2014), with Novartis (2014) about the design of network meta‐analyses, and RB on understanding pharmacokinetics of drug uptake (2015).

Figures

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Study flow diagram.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD012227

References

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