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Fixed Dose Versus Loose Dose: Analgesic Combinations
Native Cardio Inc, Cardiol, Naples, FL 34108 USA..
Paolo Procacci Fdn, Res, Rome, Italy..
NEMA Res Inc, Pain Management, Naples, FL 34108 USA..
Temple Univ, Pharm, Philadelphia, PA USA..
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2023 (English)In: Cureus, E-ISSN 2168-8184, Vol. 15, no 1, article id e33320Article, review/survey (Refereed) Published
Abstract [en]

Combinations of drugs may be fixed (two or more entities in a single product) or loose (two or more agents taken together but as individual agents) to help address multimechanistic pain. The use of opioids plus nonopioids can result in lower opioid consumption without sacrificing analgesic benefits. Drug combinations may offer additive or synergistic benefits. A variety of fixed-dose combination products are available on the market such as diclofenac plus thiocolchicoside, acetaminophen and caffeine, acetaminophen and opioid, ibuprofen and acetaminophen, tramadol and acetaminophen, and others. Fixeddose combination products offer predictable pharmacokinetics and pharmacodynamics, known adverse events, and can reduce the pill burden. However, they are limited to certain drug combinations and doses; loose dosing allows prescribers the versatility to meet individual patient requirements as well as the ability to titrate as needed. Not all drug combinations offer synergistic benefits, which depend on the drugs and their doses. Certain drugs offer dual mechanisms of action in a single molecule, such as tapentadol, and these may further be used in combination with other analgesics. New technology allows for co-crystal productions of analgesic agents which may further improve drug characteristics, such as bioavailability. Combination analgesics are important additions to the analgesic armamentarium and may offer important benefits at lower doses than monotherapy.

Place, publisher, year, edition, pages
Springer Nature, 2023. Vol. 15, no 1, article id e33320
Keywords [en]
pain, opioids, nonopioid analgesics, loose dose combination analgesics, fixed-dose combination analgesics, analgesia
National Category
Pharmacology and Toxicology Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-523450DOI: 10.7759/cureus.33320ISI: 001119651800041PubMedID: 36741676OAI: oai:DiVA.org:uu-523450DiVA, id: diva2:1840034
Available from: 2024-02-22 Created: 2024-02-22 Last updated: 2024-02-22Bibliographically approved

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Magnusson, Peter

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