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• W1921087195 abstract "In their recently published analysis, Moore and colleagues have analyzed available data concerning pharmacokinetic properties of oral analgesics under fed and fastened conditions 1. They debated whether the advice to take analgesics with a meal to prevent gastrointestinal discomfort and complications is still valid, since analgesic efficacy is superior on an empty stomach. Although this conclusion is well-founded under certain conditions, we raise the question whether it is transferable to ‘real life’ conditions. The conclusion that fast release ibuprofen products act faster and better than ibuprofen acid analgesics is based on a few number of investigations in the dental surgery pain model (five studies cited in Moore et al. 2 where ‘time to meaningful pain relief’ was reported). Fast release formulations were observed to provide meaningful pain relief earlier compared with standard ibuprofen (see references in 2. Elective dental surgery is performed under fasting conditions. In every day life, pain cannot be planned and, therefore, cannot be treated after a 10 h fast. How do fast releasing ibuprofen analgesics perform under such conditions? We have identified two randomized, controlled trials investigating the effects of 400 mg ibuprofen in fast release formulation, 400 mg ibuprofen acid and placebo on episodic tension type headache. In one study 3 in 200 patients the primary endpoint (‘time-weighted sum of pain relief rating and pain intensity difference from 0–3 h (SPRID 0-3) for ibuprofen sodium vs. placebo tablet’) was missed (P = 0.299). In the second study 4 the primary endpoint was reached, but ‘pain intensity difference (PID)’ at 1, 2 and 3 h after intake was not different for the two ibuprofen formulations (P values of 0.651, 0.669 and 0.396, respectively). Thus, under every day conditions, the fast releasing analgesic formulations might be not as advantageous as the highly controlled elective dental surgery pain model might suggest. It can be speculated that following other avenues might be more promising to provide patients with more effective, well tolerated analgesics. One well-proven approach is to combine analgesic compounds with complementary modes of action, e. g. ibuprofen and paracetamol 5 or NSAIDs with caffeine 6. There are no competing interests to declare." @default.
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• W1921087195 date "2015-08-27" @default.
• W1921087195 modified "2023-09-27" @default.
• W1921087195 title "Effects of food on pharmacokinetics of immediate release oral formulations" @default.
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• W1921087195 doi "https://doi.org/10.1111/bcp.12712" @default.
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