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Paracetamol is known to used over 50 years and is also given along with opioid drugs like codeine and dihydrocodeine.
Paracetamol has commonly used pain reliever across the globe. It is a common practice to use paracetamol as a monotherapy or in combination with codeine or dihydrocodeine for chronic neuropathic pain.
The review mentioned here explains the evidences for efficacy and harmful effects of the aforementioned therapies from randomised double-blind studies. The aim of the study was to estimate the analgesic efficacy and adverse events of paracetamol with or without codeine or dihydrocodeine for chronic neuropathic pain in adults.
A literature search was performed using Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase from inception to July 2016, together with reference lists of retrieved papers and reviews, and two online study registries.
Randomized, double-blind studies of two weeks' duration or longer were included, distinguishing paracetamol, alone or in combination with codeine or dihydrocodeine, with placebo or another active treatment in chronic neuropathic pain. Two review authors independently searched the studies, extracted efficacy and adverse event data, and assessed issues of study quality and potential bias. No pooled analyses was performed, and GRADE was used to assess the quality of the evidence.
As per the results, no study satisfied the inclusion criteria. As there were no included study, effects of interventions were not assessed. The evidence was of low quality and have no reliable indication of the likely effect. Also, there is inadequate evidence to support or disapprove the suggestion that paracetamol alone, or in combination with codeine or dihydrocodeine, relieves neuropathic pain.
Cochrane Database Syst Rev
Paracetamol (acetaminophen) with or without codeine or dihydrocodeine for neuropathic pain in adults
Philip J Wiffen et al.
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