European Journal of Clinical Pharmacology

, Volume 53, Issue 5, pp 303–311

Analgesic efficacy of ibuprofen alone and in combination with codeine or caffeine in post-surgical pain: a meta-analysis

  • A. Li Wan Po
  • W. Y. Zhang

DOI: 10.1007/s002280050383

Cite this article as:
Li Wan Po, A. & Zhang, W. E J Clin Pharmacol (1998) 53: 303. doi:10.1007/s002280050383


Objective: To estimate the analgesic effect of ibuprofen and to test whether codeine and caffeine enhance its effect on post-surgical pain.

Method: Systematic overview of the literature and meta-analysis of published randomised, controlled trials.

Results: Ibuprofen is effective in dental pain, episiotomy pain and other post-operative pain. There is a dose–response relationship over the range 50–400 mg. The difference in total pain-relief score relative to placebo was 19–31%. On average, patients were over three times more likely to obtain moderate to excellent pain relief with ibuprofen than with placebo (response-rate ratio = 3.45) and the number needed to treat was 2.44. Codeine 60 mg enhanced the analgesic effect of ibuprofen 400 mg by about 8% in the total pain-relief scale, but it also increased its adverse effects. The additive effect of caffeine was inconsistent.

Conclusion: Ibuprofen is an effective analgesic in postoperative pain. Codeine 60 mg adds to the analgesic effect of ibuprofen 400 mg. Any additive caffeine effect requires validation.

Key words Ibuprofen Analgesic effect 

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • A. Li Wan Po
    • 1
  • W. Y. Zhang
    • 1
  1. 1.Centre for Evidence-Based Pharmacotherapy, Department of Pharmaceutical Sciences, The University of Nottingham, University Park, Nottingham NG7 2RD, UK Tel./Fax +44 115 9515066GB

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