• J Clin Pharm Ther · Apr 1997

    Review Comparative Study

    Do codeine and caffeine enhance the analgesic effect of aspirin?--A systematic overview.

    • W Y Zhang and A L Po.
    • Department of Pharmaceutical Sciences, University of Nottingham, UK.
    • J Clin Pharm Ther. 1997 Apr 1; 22 (2): 79-97.

    ObjectiveTo assess whether codeine and caffeine enhance the analgesic effect of aspirin in post-operative pain.MethodSystematic overview of the literature and meta-analysis of published randomized controlled trials (RCTs).ResultsCodeine 60 mg leads to a small increase in the analgesic effect of 650 mg of aspirin when total pain relief score (TOTPAR%) is used as a efficacy end-point. This increased effect was not seen when sum of pain intensity (SPID%) and proportions of patients responding with moderate to excellent pain relief were used as outcome measures. Caffeine did not enhance the analgesic effect of aspirin.ConclusionCodeine 60 mg may produce a small increase in the analgesic effect of aspirin 650 mg. However, this effect is not clinically meaningful. Caffeine has no adjuvant analgesic effect. At over-the-counter (OTC) doses, caffeine and codeine are not useful in aspirin formulations.

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