Ibuprofen 200mg / Codeine 12.8mg tablets

There is abundant but discrepant scientific literature reporting an effect of opioids on the course of cancer. The International Agency for Research on Cancer monographs recently classified opium consumption as carcinogenic to humans in certain organs, raising concerns this may be due at least in part to the alkaloids opium contains (such as morphine and codeine). This systematic review investigated whether opioid exposure among cancer-free individuals is independently associated with the risk of future cancer incidence or cancer mortality. An electronic database search was conducted in PubMed, EMBASE, Web of Science, PsycINFO, International Pharmaceutical Abstracts, CINAHL and Scopus. Studies were included if they provided a statistical estimate of cancer mortality, cancer incidence, or cancer risk following opioid exposure. Study quality was assessed using the Newcastle-Ottawa Scale. Study characteristics and outcomes were extracted and analysed in a descriptive narrative synthesis. There were 27 studies that met the inclusion criteria, representing a total of 4,542,745 participants. Twelve of the 27 were rated as high quality according to the Newcastle-Ottawa Scale. The observed data is consistent with a small increase in the risk of cancer incidence or cancer mortality following opioid exposure, particularly in a subset of organs. There is, however, considerable uncertainty in the evidence given the substantial risk of bias in estimating the overall effect of opioid exposure on cancer outcomes in these studies. This review synthesises studies reporting cancer risk following opioid exposure and identifies the key methodological factors influencing ongoing uncertainty estimating the true effect. Rigorous epidemiological studies employing specific methods to minimize bias are warranted.

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ObjectivesThe aim of the present study was to investigate if there are differences in mitigation acute pain following oral surgery procedures within a hospital setting and regarding various medication regimens.Materials and methodsA systematic literature search was performed between the years 2013 and 2023, including the databases PUBMED, Cochrane and Scopus, to identify the clinical trials investigating the prescription of non-steroidal (NSAID's) anti-inflammatory drugs before or after an oral surgery. A meta-analysis with meta-regression model was employed on the primary and secondary outcomes, such as pain, swelling and trismus.ResultsThirty-six articles were included, 6 of them being retrospective and 30 prospective, with a higher proportion of women than men, at a ratio of 1.34:1 and an average age of 31.9 years. Drugs with medium duration of action demonstrated lower values for pain and swelling. Regarding these parameters, pain and swelling, propionic acid derivatives and acetic acid derivatives exhibited lower values respectively.ConclusionsThe quality of evidence was low to very low- certainty. The meta-analysis suggests that postoperative pain, swelling and trismus following oral surgery management may be effectively treated with the following drugs: NSAID medium-duration action drugs; propionic acid derivatives for lower pain levels and acetic acid derivatives for lower swelling measures; and Ibuprofen 400mg every 8h for 3 days or less.Clinical relevanceAnti-inflammatory and analgesic drugs are prescribed to prevent or treat dental pain. Ibuprofen 400mg was the most prescribed drug after or before an oral surgery procedure. However, the evidence is indirect and needs to be interpreted with caution.

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IntroductionVenous ulceration (VU) is a chronic lower limb wound caused by sustained venous hypertension. Treatment includes compression therapy, wound care and surgical intervention. Due to the prolonged nature of wound healing, patients experience a substantial burden on quality of life, largely influenced by pain. Existing literature generalises findings across all chronic wounds and there are no published reviews or specific guidelines informing pharmacological pain management for patients with VU.MethodsFive databases were searched to identify studies evaluating the effectiveness of pharmacological interventions for VU pain, published in English between 2000 and 2024. The CASP appraisal tools were used to assess the quality of publications, and findings are reporting descriptively and following PRISMA guidance.ResultsInitial literature searches yielded 1,161 references, of which 447 were duplicates. Once screening was complete, thirteen studies were included in this evaluation. The majority (10/13) were randomised controlled trials comparing pharmacological interventions with standard care. Small sample sizes and poor reporting quality were common across all papers, and overall limits the evidence. Eight studies evaluated ibuprofen-impregnated dressings, all reporting some degree of pain reduction. Three studies investigated localized oxygen therapy, demonstrating improved wound healing outcomes. However, pain reduction was not statistically significant and may be secondary to healing. The remaining two studies examined topical sevoflurane and aspirin. Sevoflurane showed pain reduction over time in a single, low-quality retrospective study. The aspirin trial was inconclusive due to poor recruitment and underpowering.ConclusionCurrently, there is a lack of high-quality studies, evaluating the pharmacological treatment of pain in people experiencing VU. While there may be some evidence to support the use of topical agents such as ibuprofen, further industry-independent efficacy studies and cost analyses are required. Further research is also required to compare standard of care to commonly used agents such as oral paracetamol.

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BACKGROUND: Post-endodontic pain is a common complication that negatively impacts patients’ daily lives. Single-dose oral analgesics are often prescribed after non-surgical root canal treatments to manage discomfort; however, their relative efficacy remains unclear. This systematic review and meta-analysis aimed to evaluate the effectiveness of different single-dose postoperative medications for pain relief following root canal treatment (RCT). METHODS: A comprehensive search of PubMed, Scopus, Embase, and Cochrane CENTRAL up to February 2025 was conducted to identify randomized controlled trials (RCTs) comparing single-dose postoperative analgesics with placebo in patients undergoing non-surgical endodontic treatment. Pain outcomes were assessed using Visual Analog Scales (VAS) at 6–8, 12, and 24 h post-treatment. Risk of bias was evaluated using the Cochrane RoB 2 tool. Pairwise and frequentist network meta-analyses were performed, and treatments were ranked using P-scores. RESULTS: Ten RCTs were qualitatively analyzed, while five of them were eligible for quantitative analyses and were included in our meta-analysis. They were from four countries with a combined sample size of 347 participants. At 6–8 h, Diclofenac + Acetaminophen provided the greatest pain reduction (MD: -6.28, 95% CI: -11.99 to -0.56), followed by Novafen and Ibuprofen + Acetaminophen. At 12 and 24 h, Novafen and Naproxen consistently demonstrated superior analgesic effects, whereas Tramadol and Ibuprofen offered moderate relief. Ibuprofen combinations with Acetaminophen or Alprazolam showed variable efficacy. Sensitivity analyses confirmed the robustness of these findings. CONCLUSIONS: Single-dose oral medications administered after non-surgical root canal treatments effectively reduce post-endodontic pain. Diclofenac + Acetaminophen is most effective for immediate short-term relief, while Novafen and Naproxen provide sustained efficacy at later time points. These results can guide clinicians in selecting optimal single-dose medications for post-RCT pain management. Keywords: postoperative endodontic pain; network meta-analysis; pain management; endodontic treatment TRIAL REGISTRATION: Not applicable.

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