Acute pain, prevalent as part of postoperative and traumatic
pain, is often sub-optimally or inadequately treated. Fixed-dose combination
analgesic products that combine a reduced amount of
opioid with a
nonopioid analgesic such as
acetaminophen (
paracetamol) in a single
tablet offer potential pharmacodynamic and/or pharmacokinetic benefits, and may also result in an
opioid-sparing effect. A new
analgesic product (XARTEMIS™ XR, Mallinckrodt Brand
Pharmaceuticals, Dublin, Ireland) combines
oxycodone (7.5 mg) with
acetaminophen (325 mg) in an immediate-release/extended-release (ER) formulation that is indicated for the treatment of
acute pain. The ER formulation of this product provides stable serum
drug concentrations that in this case lasts 12 h.
Oxycodone/acetaminophen is a
drug combination that offers safe and effective
pain relief in a variety of
acute pain syndromes such as
postoperative pain. The combination formulation allows a smaller amount of
oxycodone per
tablet and the biphasic-layered matrix of the pill for ER may present obstacles to potential abusers. No
opioid is totally abuse resistant, but the lower
opioid content and tamper-resistant formulation of this product might discourage abuse. Clinicians must still be mindful of the
acetaminophen part of this product in the patient's overall daily intake (in light of
acetaminophen hepatotoxicity). The new product appears to provide an important new choice in the armamentarium against
acute pain.