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Single dose oral paracetamol (acetaminophen) plus codeine for postoperative pain relief in adults

Toms L, Derry S, Moore RA, McQuay HJ
Published Online: 
9 November 2011

Pain is commonly experienced after surgical procedures, and is not always well controlled. Combining analgesics from different classes has the potential to provide adequate pain relief with reduced dose-dependent adverse events. This review assessed data from twenty-six studies comparing paracetamol plus codeine with placebo, and fourteen studies comparing paracetamol plus codeine with the same dose of paracetamol alone. The combination provided effective pain relief for about 40% of participants experiencing moderate to severe pain after an operation with 600 to 650 mg paracetamol plus 60 mg codeine, the dose most commonly used in these studies, and about 50% of participants with 800 to 1000 mg paracetamol plus 60 mg codeine, the dose most commonly used in clinical practice. The addition of codeine provided effective pain relief to about 10% more participants than the same dose of paracetamol alone. These single dose studies did not associate paracetamol plus codeine with any serious side effects.

This record should be cited as: 
Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2
Assessed as up to date: 
15 September 2011