An overview of systematic reviews looking at acute pain relief in dental patients, primarily following third-molar extractions, found non-opioid medications were associated with longer lasting and more effective pain relief than opioids and opioid drug combinations.
While oxycodone was noted to have a duration of pain relief comparable to acetaminophen or the NSAID diflunisal, it was also associated with a higher frequency of adverse outcomes.
The review authors suggest that NSAIDs (e.g., ibuprofen) with or without acetaminophen provide the most optimal balance of benefits and risks for the majority of dental pain patients.
Widespread consumption of codeine-containing cough syrup has led to increased rates of opioid addiction in Nigerian youth. A pharmaceutical executive with Emzor was recorded discussing his participation in the illicit marketing, and sale of the drug and cough syrup containing codeine has subsequently been banned by the Nigerian government.
Codeine clinical information
Methadone is a synthetic μ-opioid receptor agonist prescribed for the treatment of opioid dependence and withdrawal. It is also used in severe pain conditions at lower doses.
Methadone has a longer half-life and fewer euphoric effects than morphine and other opioids, but still carries a dose-dependent risk of the toxicities associated with this class of drugs. Sedation, dizziness, and headache are common side effects and incorrect dosing or abuse can result in profound sedation, respiratory depression, and death.
- Wishart DS, Feunang YD, Guo AC, Lo EJ, Marcu A, Grant JR, Sajed T, Johnson D, Li C, Sayeeda Z, Assempour N, Iynkkaran I, Liu Y, Maciejewski A, Gale N, Wilson A, Chin L, Cummings R, Le D, Pon A, Knox C, Wilson M. DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic Acids Res. 2017 Nov 8. doi: 10.1093/nar/gkx1037
- Epocrates Rx Online [Internet database]. San Mateo (CA): Epocrates, Inc. 2003. Retrieved at mobile.epocrates.com. Web-based; continuous content updates. Accessed 2018 April 24.
- “Prescription Prices, Coupons & Pharmacy Information – GoodRx.” Prescription Prices, Coupons & Pharmacy Information – GoodRx, www.goodrx.com