Vol. 21 No. 2 (2022)
Literature Review

Action of painkillers with caffeine and pain crises

Published 2023-01-03

Keywords

  • Migraine,
  • Caffeine,
  • Combined pain relievers

How to Cite

1.
F. de Freitas I, Pietro L. Action of painkillers with caffeine and pain crises. BJHBS [Internet]. 2023 Jan. 3 [cited 2024 Oct. 11];21(2):137-43. Available from: https://bjhbs.hupe.uerj.br/bjhbs/article/view/12

Abstract

Introduction: 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.

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References

  1. Calil AM, Pimenta CAM. Intensidade da dor e adequação de analgesia. Rev Latina-Am. Enf. 2005; 13(5):692-9
  2. Benemei S, Fusi C, Trevisan G, et al. The TRPA1 channel in migraine mechanism and treatment. Br J Pharmacol. 2014;171(10):2552-67.
  3. Dodick DW. Migraine. Lancet. 2018;391(10127):1315-1330.
  4. 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.
  5. Rainero I, Roveta F, Vacca A, et al. Migraine pathways and the identification of novel therapeutic targets. Expert Opin Ther Targets. 2020;24(3):245-253.
  6. Iyengar S, Johnson KW, Ossipov MH, et al. CGRP and the Trigeminal System in Migraine. Headache. 2019;59(5):659-681.
  7. Drummond JP. Neurofisiologia. São Paulo (SP): Atheneu; 2000. In: Drummond JP. Dor aguda: fisiologia clínica e terapêutica; São Paulo (SP): Atheneu; 200. p. 1-23
  8. Barros GAM, Calonegoa MAM, et al. Uso de analgésicos e o risco da automedicação em amostra de população urbana: estudo transversal. Rev. Bras. Anestesiol. 2019, 69 (9): 529-536.
  9. Nowaczewska M, Wiciński M, Kaźmierczak W. The Ambiguous Role of Caffeine in Migraine Headache: From Trigger to Treatment. Nutrients. 2020;12(8):2259.
  10. Burch RC, Buse DC, Lipton RB. Migraine: Epidemiology, Burden, and Comorbidity. Neurol Clin. 2019;37(4):631-649.
  11. Marmura MJ. Triggers, Protectors, and Predictors in Episodic Migraine. Curr Pain Headache Rep. 2018;22(12):81.
  12. Gross EC, Lisicki M, Fischer D, et al. The metabolic face of migraine - from pathophysiology to treatment. Nat Rev Neurol. 2019;15(11):627-643.
  13. Renner B, Clarke G, Grattan T, et al. Caffeine accelerates absorption and enhances the analgesic effect of acetaminophen. J Clin Pharmacol. 2007;47(6):715-26.
  14. Benjamim G, Magdalena M. Treatment of Acute Migraine Headache. Am Fam Physician. 2011;83(3):271-280.
  15. Mayans L, Walling A. Acute Migraine Headache: Treatment Strategies. Am Fam Physician. 2018;97(4):243-251.
  16. Sawynok J. Caffeine and pain. Pain. 2011;152(4):726-729.
  17. 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.
  18. Martin VT, Vij B. Diet and Headache: Part 1. Headache. 2016;56(9):1543-1
  19. Alstadhaug KB, Andreou AP. Caffeine and Primary (Migraine) Headaches-Friend or Foe? Front Neurol. 2019;10(1275):1275.
  20. Shapiro RE. Caffeine and headaches. Neurol Sci. 2007;28(2):S179-83.
  21. Espinosa Jovel CA, Sobrino Mejía FE. Caffeine and headache: specific remarks. Neurologia. 2017;32(6):394-398.
  22. Lipton RB, Diener HC, Robbins MS, et al. Caffeine in the management of patients with headache. J Headache Pain. 2017;18(1):107.
  23. Derry CJ, Derry S, Moore RA. Caffeine as an analgesic adjuvant for acute pain in adults. Cochrane Database Syst Rev. 2012;3(3):9281.
  24. Palmer H, Graham G, Williams K, et al. A risk-benefit assessment of paracetamol (acetaminophen) combined with caffeine. Pain Med. 2010;11(6):951-65.
  25. Borel JF, Deschaumes C, Devoize L, 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.
  26. 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.
  27. 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.
  28. Carvalho DS, Barea LM, Kowacs PA, et al. 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.
  29. Pini LA, Guerzoni S, Cainazzo M, et al. 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.
  30. Derosier F, Sheftell F, Silberstein S, et al. Sumatriptan-naproxen and butalbital: a double-blind, placebo-controlled crossover study. Headache. 2012;52(4):530-43.
  31. 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
  32. 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.
  33. 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.
  34. Weiser T, Schepers C, Mück T,et al. 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.
  35. 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.
  36. Aicher B, Peil H, Peil B,et al. 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.
  37. Förderreuther S, Lampert A, Hitier S, Lange R, et al. 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.
  38. 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.
  39. Broner SW, Bobker S, Klebanoff L. Migraine in Women. Semin Neurol. 2017;37(6):601-610.