Last Saturday in the lecture I attended on pharmacology we spent at least half of our time discussing commonly prescribed pain medications. I was surprised to learn that Vicodin ES is the most frequently prescribed medication in the US. Despite the frequency with which prescriptions are written for narcotic medications they come with a host of negatives. Many of our patients will experience side effects ranging from nausea and vomiting to drowsiness and disorientation. In addition to the other side effects, these medications can be addictive and pose challenges to the prescribing doctor.
Ibuprofen is a non-narcotic medication that works both to provide pain relief and manage inflammation locally as a cox (cyclooxygenase) inhibitor. Acetaminophen is also a non-narcotic analgesic, but it’s mechanism of action is completely different. It’s effect is mediated centrally we believe by action on a variety of neurotransmitter receptors which alter pain perception and threshold. When we combine the mechanisms of Ibuprofen and Acetaminophen the analgesic effect is equal to that of many narcotic medications like Vicodin ES, with the addition of anti-inflammatory effect and the absence of the side effects associated with opiates.
For maximum pain relief the recommended dosage is 800mg of Ibuprofen three to four times per twenty-four hours in combination with 325mg of Acetaminophen 3-4 times per day. I have had the opportunity to try this out several times this week with great results reported by the patients.