Action of painkillers with caffeine and pain crises

Autores

  • Isabela Ferreira de Freitas Faculdade de Biomedicina, Universidade Paulista, Campinas, SP, Brasil.
  • Luciana Pietro Departamento de Biomedicina, Universidade Paulista Unip. Campinas, SP, Brasil.

DOI:

https://doi.org/10.12957/bjhbs.2022.71635

Palavras-chave:

Migraine, caffeine, Combined pain relievers

Resumo

Pain is considered to be one of the main consequences of trauma and migraines, and is characterized by moderate to severe headache attacks that affect more than one billion people worldwide. Its treatment is mainly done by over-the-counter drugs, most of which are combined with caffeine. Objective: To analyze whether analgesics combined with caffeine are more effective for the treatment of acute and/or chronic pain than analgesics not combined with caffeine. Methods: A systematic review was carried out based on scientific articles published in the following databases: SCIELO, PubMed and Science Direct. We analyzed 15 original articles with clinical trials and controlled trials that evaluated the efficacy of analgesics combined with caffeine and were published between 2010 and 2020. Results:The 15 studies under analysis evaluated a total of 5,030 patients. Of these studies, ten concluded that analgesics associated with caffeine are more effective for the treatment of acute and/or chronic pain;four concluded that the two types of analgesics are equally effective; and one study concluded that the non-combined analgesic is more effective. Conclusion: analgesics combined with caffeine are more effective for the treatment of acute and/or chronic pain crises, since they promote faster pain relief and achieve a complete cessation of pain. Caffeine is believed to act by inhibiting cyclooxygenase at some sites and by blocking central and peripheral adenosine receptors. 

Downloads

Não há dados estatísticos.

Biografia do Autor

Isabela Ferreira de Freitas, Faculdade de Biomedicina, Universidade Paulista, Campinas, SP, Brasil.

Faculdade de Biomedicina, Universidade Paulista, Campinas, SP, Brasil.

Luciana Pietro, Departamento de Biomedicina, Universidade Paulista Unip. Campinas, SP, Brasil.

Departamento de Biomedicina, Universidade Paulista Unip. Campinas, SP, Brasil.

Referências

Benemei S, Fusi C, Trevisan G, Geppetti P. The TRPA1 channel in migraine mechanism and treatment. Br J Pharmacol. 2014;171(10):2552-67. DOI: 10.1111/bph.12512

Dodick DW. Migraine. Lancet. 2018;391(10127):1315-1330. DOI: https://doi.org/10.1016/S0140-6736(18)30478-1

Borkum JM. The Migraine Attack as a Homeostatic, Neuroprotective Response to Brain Oxidative Stress: Preliminary Evidence for a Theory. Headache. 2018;58(1):118-135. doi: 10.1111/head.13214

Rainero I, Roveta F, Vacca A, Noviello C, Rubino E. Migraine pathways and the identification of novel therapeutic targets. Expert Opin Ther Targets. 2020;24(3):245-253. doi: 10.1080/14728222.2020.1728255

Iyengar S, Johnson KW, Ossipov MH, Aurora SK. CGRP and the Trigeminal System in Migraine. Headache. 2019;59(5):659-681. doi: 10.1111/head.1352

Nowaczewska M, Wiciński M, Kaźmierczak W. The Ambiguous Role of Caffeine in Migraine Headache: From Trigger to Treatment. Nutrients. 2020;12(8):2259. doi: 10.3390/nu12082259

Burch RC, Buse DC, Lipton RB. Migraine: Epidemiology, Burden, and Comorbidity. Neurol Clin. 2019;37(4):631-649. oi: 10.1016/j.ncl.2019.06.001

Marmura MJ. Triggers, Protectors, and Predictors in Episodic Migraine. Curr Pain Headache Rep. 2018;22(12):81. doi: 10.1007/s11916-018-0734-0

Gross EC, Lisicki M, Fischer D, Sándor PS, Schoenen J. The metabolic face of migraine - from pathophysiology to treatment. Nat Rev Neurol. 2019;15(11):627-643. doi: 10.1038/s41582-019-0255-4

Renner B, Clarke G, Grattan T, Beisel A, Mueller C, Werner U, et al. Caffeine accelerates absorption and enhances the analgesic effect of acetaminophen. J Clin Pharmacol. 2007;47(6):715-26. doi: 10.1177/009127000729976

Gilmore B, Michael M. Treatment of Acute Migraine Headache. Am Fam Physician. 2011;83(3):271-280. PMID: 21302868

Mayans L, Walling A. Acute Migraine Headache: Treatment Strategies. Am Fam Physician. 2018;97(4):243-251. PMID: 29671521

Sawynok J. Caffeine and pain. Pain. 2011;152(4):726-729. doi: 10.1016/j.nrl.2014.12.016

Weiser T, Weigmann H. Effect of Caffeine on the Bioavailability and Pharmacokinetics of an Acetylsalicylic Acid-Paracetamol Combination: Results of a Phase I Study. Adv Ther. 2019;36(3):597-607. doi: 10.1007/s12325-019-0891-5

Martin VT, Vij B. Diet and Headache: Part 1. Headache. 2016;56(9):1543-1. doi: 10.1111/head.12953

Alstadhaug KB, Andreou AP. Caffeine and Primary (Migraine) Headaches-Friend or Foe? Front Neurol. 2019;10(1275):1275. doi: 10.3389/fneur.2019.01275

Shapiro RE. Caffeine and headaches. Neurol Sci. 2007;28(2):S179-83. doi: 10.1016/j.nrl.2014.12.016

Espinosa Jovel CA, Sobrino Mejía FE. Caffeine and headache: specific remarks. Neurologia. 2017;32(6):394-398. doi: 10.1016/j.nrl.2014.12.016

Lipton RB, Diener HC, Robbins MS, Garas SY, Patel K. Caffeine in the management of patients with headache. J Headache Pain. 2017;18(1):107. doi: 10.1186/s10194-017-0806-2

Derry CJ, Derry S, Moore RA. Caffeine as an analgesic adjuvant for acute pain in adults. Cochrane Database Syst Rev. 2012;3(3):9281. doi: 10.1002/14651858.CD009281

Palmer H, Graham G, Williams K, Day R. A risk-benefit assessment of paracetamol (acetaminophen) combined with caffeine. Pain Med. 2010;11(6):951-65. doi: 10.1111/j.1526-4637.2010.00867

Borel JF, Deschaumes C, Devoize L, Huard C, Orliaguet T, Dubray C, et al. Traitement de la douleur après avulsion dentaire: essai clinique randomisé en double aveugle comparant deux formulations de paracétamol, caféine et poudre d'opium versus tramadol et placebo. Presse Med. 2010;39(5):e103-11. doi: 10.1016/j.lpm.2009.09.025

Diener HC, Peil H, Aicher B. The efficacy and tolerability of a fixed combination of acetylsalicylic acid, paracetamol, and caffeine in patients with severe headache: a post-hoc subgroup analysis from a multicentre, randomized, double-blind, single-dose, placebo-controlled parallel group study. Cephalalgia. 2011;31(14):1466-76. doi: 10.1177/0333102411419682

Goldstein J, Hagen M, Gold M. Results of a multicenter, double-blind, randomized, parallel-group, placebo-controlled, single-dose study comparing the fixed combination of acetaminophen, acetylsalicylic acid, and caffeine with ibuprofen for acute treatment of patients with severe migraine. Cephalalgia. 2014;34(13):1070-8. doi: 10.1177/0333102414530527

Carvalho DS, Barea LM, Kowacs PA, Fragoso YD. Efficacy and tolerability of combined dipyrone, isometheptene and caffeine in the treatment of mild-to-moderate primary headache episodes. Expert Rev Neurother. 2012;12(2):159-67. doi: 10.1586/ern.11.193

Pini LA, Guerzoni S, Cainazzo M, Ciccarese M, Prudenzano MP, Livrea P. Comparison of tolerability and efficacy of a combination of paracetamol + caffeine and sumatriptan in the treatment of migraine attack: a randomized, double-blind, double-dummy, cross-over study. J Headache Pain. 2012;13(8):669-75. doi: 10.1007/s10194-012-0484-z.

Derosier F, Sheftell F, Silberstein S, Cady R, Ruoff G, Krishen A, et al. Sumatriptan-naproxen and butalbital: a double-blind, placebo-controlled crossover study. Headache. 2012;52(4):530-43. doi: 10.1111/j.1526-4610.2011.02039.x

Bjørkedal E, Flaten MA. Interaction between expectancies and drug effects: an experimental investigation of placebo analgesia with caffeine as an active placebo. Psychopharmacology (Berl). 2011;215(3):537-4. doi: 10.1007/s00213-011-2233-4

Weiser T, Weigmann H. Effect of Caffeine on the Bioavailability and Pharmacokinetics of an Acetylsalicylic Acid-Paracetamol Combination: Results of a Phase I Study. Adv Ther. 2019;36(3):597-607. doi: 10.1007/s12325-019-0891-5

Fox AW. Efficacy, end points and eventualities: sumatriptan/naproxen versus butalbital/paracetamol/caffeine in the treatment of migraine. Expert Rev Clin Pharmacol. 2012;5(5):513-6. doi: 10.1586/ecp.12.47

Weiser T, Schepers C, Mück T, Lange R. Pharmacokinetic Properties of Ibuprofen (IBU) From the Fixed-Dose Combination IBU/Caffeine (400/100 mg; FDC) in Comparison With 400 mg IBU as Acid or Lysinate Under Fasted and Fed Conditions-Data From 2 Single-Center, Single-Dose, Randomized Crossover Studies in Healthy Volunteers. Clin Pharmacol Drug Dev. 2019;8(6):742-753. doi: 10.1002/cpdd.672

Erol DD. The analgesic and antiemetic efficacy of gabapentin or ergotamine/caffeine for the treatment of postdural puncture headache. Adv Med Sci. 2011;56(1):25-9. The analgesic and antiemetic efficacy of gabapentin or ergotamine/caffeine for the treatment of postdural puncture headache

Aicher B, Peil H, Peil B, Diener HC. Pain measurement: Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS) in clinical trials with OTC analgesics in headache. Cephalalgia. 2012;32(3):185-97. doi: 10.1177/03331024111430856

Förderreuther S, Lampert A, Hitier S, Lange R, Weiser T. The Impact of Baseline Pain Intensity on the Analgesic Efficacy of Ibuprofen/Caffeine in Patients with Acute Postoperative Dental Pain: Post Hoc Subgroup Analysis of a Randomised Controlled Trial. Adv Ther. 2020 ;37(6):2976-2987. doi: 10.1007/s12325-020-01297-y

Weiser T, Richter E, Hegewisch A, Muse DD, Lange R. Efficacy and safety of a fixed-dose combination of ibuprofen and caffeine in the management of moderate to severe dental pain after third molar extraction. Eur J Pain. 2018;22(1):28-38. doi: 10.1002/ejp.1068

Broner SW, Bobker S, Klebanoff L. Migraine in Women. Semin Neurol. 2017;37(6):601-610. doi: 10.1055/s-0037-1607393

Downloads

Publicado

2022-12-23

Como Citar

1.
de Freitas IF, Pietro L. Action of painkillers with caffeine and pain crises. BJHBS [Internet]. 23º de dezembro de 2022 [citado 3º de maio de 2025];21(2):137-43. Disponível em: https://www.e-publicacoes.uerj.br/bjhbs/article/view/71635

Edição

v. 21 n. 2 (2022)

Seção

Revisão de Literatura

Licença

Termo de transferência de direitos autorais/conflitos de interesses: após o aceite final do artigo para publicação, os autores deverão enviar o termo de transferência dos direitos assinados pelo autor principal representando cada um dos autores. Neste termo deverão ser declarados quaisquer conflitos de interesses.

Informação da autoria: o mérito da autoria científica deve ser limitado aos participantes que contribuíram intelectualmente no trabalho, além de uma colaboração efetiva para a realização da pesquisa. Portanto, para ser considerado um autor, cada colaborador deve, no mínimo, preencher as seguintes condições: (a) ter contribuído significativamente na concepção e desenho do estudo, ou na análise e interpretação dos dados; (b) ter contribuído substancialmente na elaboração do artigo, ou revisado criticamente o seu conteúdo intelectual e (c) ter aprovado sua versão final a ser publicada. A supervisão/coordenação geral do grupo de pesquisa por si só não justifica a autoria. A contribuição somente na aquisição de verbas provenientes de fontes financiadoras ou na coleta de dados também não é suficiente para justificar autoria. A fim de garantir a transparência dessas informações, os autores são solicitados a incluir uma declaração a respeito da autoria, descrevendo o papel dos autores no estudo e na preparação do manuscrito.