Co-proxamol is no better than paracetamol alone

Analgesic combinations of paracetamol and opiates are widely used, but controversy exists about whether they are more effective than paracetamol alone. Li Wan Po and Zhang (p 1565) conducted a meta-analysis of trials of paracetamol (650 mg) and of its combination with dextropropoxphene (32.5 mg) looking at sum of pain intensity difference and the proportion of patients who obtained at least moderate pain relief. In both direct and indirect comparisons (paracetamol v placebo and combination v placebo) the combination was no better than paracetamol alone. There were small, but probably unimportant, differences in rates of adverse drug reactions.


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