Analgesic Dose‐Response Relationship of Ibuprofen 50, 100, 200, and 400 mg after Surgical Removal of Third Molars: A Single‐Dose, Randomized, Placebo‐Controlled, and Double‐Blind Study of 304 Patients

Schou, Søren; Nielsen, Henrik; Nattestad, Anders; Hillerup, Søren; Ritzau, M; Branebjerg, Poul Erik; Bugge, Christine; Skoglund, Lasse A.

doi:10.1002/j.1552-4604.1998.tb04452.x

Cited by 49 publications

(40 citation statements)

References 19 publications

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“…This study found that for the 200 mg/30 mg combination starting treatment with two tablets is more efficacious than with a single tablet, irrespective of symptom score or of analytical approach being applied. This is in line with findings from previous studies comparing the efficacy of 50‐400 mg ibuprofen25 or in meta‐analyses of ibuprofen studies in analgesic indications, demonstrating an increased efficacy with higher doses in the 200‐800 mg dose range 26. It is also in line with dose‐ranging studies with 15‐180 mg pseudoephedrine effects on nasal airway resistance 19.…”

Section: Discussionsupporting

confidence: 90%

Factors associated with efficacy of an ibuprofen/pseudoephedrine combination drug in pharmacy customers with common cold symptoms

Klimek

Schumacher²,

Schütt

et al. 2016

Int J Clin Pract

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SummaryAimThe aim of this study was to explore factors affecting efficacy of treatment of common cold symptoms with an over‐the‐counter ibuprofen/pseudoephedrine combination product.MethodsData from an anonymous survey among 1770 pharmacy customers purchasing the combination product for treatment of own common cold symptoms underwent post‐hoc descriptive analysis. Scores of symptoms typically responsive to ibuprofen (headache, pharyngeal pain, joint pain and fever), typically responsive to pseudoephedrine (congested nose, congested sinus and runny nose), considered non‐specific (sneezing, fatigue, dry cough, cough with expectoration) and comprising all 11 symptoms were analysed. Multiple regression analysis was applied to explore factors associated with greater reduction in symptom intensity or greater probability of experiencing a symptom reduction of at least 50%.ResultsAfter intake of first dose of medication, typically ibuprofen‐sensitive, pseudoephedrine‐responsive, non‐specific and total symptoms were reduced by 60.0%, 46.3%, 45.4% and 52.8%, respectively. A symptom reduction of at least 50% was reported by 73.6%, 55.1%, 50.9% and 61.6% of participants, respectively. A high baseline score was associated with greater reductions in symptom scores but smaller probability of achieving an improvement of at least 50%. Across both multiple regression approaches, two tablets at first dosing were more effective than one and (except for ibuprofen‐sensitive symptoms) starting treatment later than day 2 of the cold was generally less effective.Discussion and ConclusionsEfficacy of an ibuprofen/pseudoephedrine combination in the treatment of common cold symptoms was dose‐dependent and greatest when treatment started within the first 2 days after onset of symptoms.

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Section: Discussionsupporting

confidence: 90%

Factors associated with efficacy of an ibuprofen/pseudoephedrine combination drug in pharmacy customers with common cold symptoms

Klimek

Schumacher²,

Schütt

et al. 2016

Int J Clin Pract

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“…Eleven studies had 40 or more participants in both treatment arms Forbes 1991a;Hersch 1993b;Jain 1986;Kiersch 1993;Medve 2001;Mehlisch 2002;Nelson 1994;Schou 1998;Seymour 2000;Wahl 1997) (Analysis 3.5.1). The proportion of participants with at least 50% pain relief was 49% (553/1126) for ibuprofen 200 mg, and 10% (80/827) for placebo; the RB was 4.6 (3.7 to 5.6), and the NNT was 2.5 (2.3 to 2.8).…”

Section: Ibuprofen 200 Mg: (Analysis 35)mentioning

confidence: 99%

“…Nineteen studies had 40 or more participants in both treatment arms (Bakshi 1994;Cheung 2007;Cooper 1977;Cooper 1989;Hill 2001;Mehlisch 1990;Mehlisch 1995;Mehlisch 2002;Morrison 1999;Schou 1998;Seymour 1998;Edwards 2002;Van Dyke 2004;Zelenakas 2004) (Analysis 4.5.1). The proportion of participants with at least 50% pain relief was 54% (1000/1842) for ibuprofen 400 mg, and 12% (152/1244) for placebo; the RB was 4.4 (3.8 to 5.2), and the NNT was 2.4 (2.2 to 2.6).…”

Section: Ibuprofen 400 Mg: (Analysis 45)mentioning

confidence: 99%

“…The proportion of participants with at least 50% pain relief was 54% (1000/1842) for ibuprofen 400 mg, and 12% (152/1244) for placebo; the RB was 4.4 (3.8 to 5.2), and the NNT was 2.4 (2.2 to 2.6). Fourteen studies had fewer than 40 participants in both treatment arms (Ahlstrom 1993;Ehrich 1999;Forbes 1984;Forbes 1990;Forbes 1991b;Forbes 1992;Hersch 1993b;Laska 1986;Nørholt 1998;Schwartz 2007; (study 1); Seymour 1991 (study 2); Seymour 1996) (Analysis 4.5.2). The proportion of participants with at least 50% pain relief was 60% (280/463) for ibuprofen 400 mg, and 14% (56/393) for placebo; the RB was 4.1 (3.2 to 5.2), and the NNT was 2.2 (1.9 to 2.5).…”

Section: Ibuprofen 400 Mg: (Analysis 45)mentioning

confidence: 99%

“…• Three studies using ibuprofen 100 mg reported the proportion of participants using rescue medication over 6 hours (Jain 1986;Schou 1998;. The weighted mean proportion was 38% (54/143) with ibuprofen and 64% (88/153) with placebo, giving an NNTp of 3.8 (2.7 to 6.5) (Analysis 2.2).…”

Section: Use Of Rescue Medicationmentioning

confidence: 99%

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Single dose oral ibuprofen for acute postoperative pain in adults

Collins

Moore²,

McQuay³

et al. 1999

Cochrane Database of Systematic Reviews

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Single dose oral ibuprofen for acute postoperative pain in adults

Derry

Derry²,

Moore³

et al. 2009

Cochrane Database of Systematic Reviews

116

113

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Background This review updates a 1999 Cochrane review showing that ibuprofen at various doses was effective in postoperative pain in single dose studies designed to demonstrate analgesic efficacy. New studies have since been published. Ibuprofen is one of the most widely used non-steroidal anti-inflammatory (NSAID) analgesics both by prescription and as an over-the-counter medicine. Ibuprofen is used for acute and chronic painful conditions. Objectives To assess analgesic efficacy of ibuprofen in single oral doses for moderate and severe postoperative pain in adults. Search methods We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies to May 2009. Selection criteria Randomised, double blind, placebo-controlled trials of single dose orally administered ibuprofen (any formulation) in adults with moderate to severe acute postoperative pain. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Pain relief or pain intensity data were extracted and converted into the dichotomous outcome of number of participants with at least 50% pain relief over 4 to 6 hours, from which relative risk and number-needed-to-treat-to-benefit (NNT) were calculated. Numbers of participants using rescue medication over specified time periods, and time to use of rescue medication, were sought as additional measures of efficacy. Information on adverse events and withdrawals were collected. Main results Seventy-two studies compared ibuprofen and placebo (9186 participants). Studies were predominantly of high reporting quality, and the bulk of the information concerned ibuprofen 200 mg and 400 mg. For at least 50% pain relief compared with placebo the NNT for ibuprofen 200 mg (2690 participants) was 2.7 (2.5 to 3.0) and for ibuprofen 400 mg (6475 participants) it was 2.5 (2.4 to 2.6). The proportion with at least 50% pain relief was 46% with 200 mg and 54% with 400 mg. Remedication within 6 hours was less frequent with higher doses, with 48% remedicating with 200 mg and 42% with 400 mg. The median time to remedication was 4.7 hours with 200 mg and 5.4 hours with 400 mg. Sensitivity analysis indicated that pain model and ibuprofen formulation may both affect the result, with dental impaction models and soluble ibuprofen salts producing better efficacy estimates. Adverse events were uncommon, and not different from placebo. Authors’ conclusions The very substantial amount of high quality evidence demonstrates that ibuprofen is an effective analgesic in treating postoperative pain. NNTs for 200 mg and 400 mg ibuprofen did not change significantly from the previous review even when a substantial amount of new information was added. New information is provided on remedication.

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Analgesic Dose‐Response Relationship of Ibuprofen 50, 100, 200, and 400 mg after Surgical Removal of Third Molars: A Single‐Dose, Randomized, Placebo‐Controlled, and Double‐Blind Study of 304 Patients

Cited by 49 publications

References 19 publications

Factors associated with efficacy of an ibuprofen/pseudoephedrine combination drug in pharmacy customers with common cold symptoms

Factors associated with efficacy of an ibuprofen/pseudoephedrine combination drug in pharmacy customers with common cold symptoms

Single dose oral ibuprofen for acute postoperative pain in adults

Single dose oral ibuprofen for acute postoperative pain in adults

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