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Equivalent pain relief with different doses of ibuprofen

Question clinique

In patients with acute pain, does a higher dose of ibuprofen produce greater pain relief?

L’Essentiel

Higher doses of ibuprofen for acute pain relief offer no more benefit at 60 minutes than a single 400-mg dose. The same has been shown for chronic treatment of osteoarthritis--an anti-inflammatory dose is not needed. Furthermore, another study showed equivalence between 200-mg and 400-mg dose. The same has been shown for chronic treatment of osteoarthritis--an anti-inflammatory dose is not needed. Furthermore, another study showed equivalence between 200-mg and 400-mg doses of ibuprofen. 2b

Référence

Motov S, Masoudi A, Drapkin J, et al. Comparison of oral ibuprofen at three single-dose regimens for treating acute pain in the emergency department: a randomized controlled trial. Ann Emerg Med 2019;74(4):530-537.

Plan de l'etude: Randomized controlled trial (double-blinded)

Financement: Foundation

Cadre: Emergency department

Sommaire

These authors enrolled 225 adults who presented to a single emergency department with an acute painful condition (~75% with musculoskeletal pain). The average pain score was between 6 and 7 on a scale of 1 to 10, with higher scores indicating higher pain. Using concealed allocation, patients were randomly assigned to receive a single dose of ibuprofen, either 400 mg, 600 mg, or 800 mg. Using intention-to-treat analysis, pain scores after 60 minutes dropped to 4.36 to 4.50 in all 3 groups. The study had 80% power to find a difference of at least 1.3 points, if it existed, among the groups.

Reviewer

Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA


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