Fixed-Dose Combination of NSAIDs and Spasmolytic Agents in the Treatment of Different Types of Pain—A Practical Review

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Abstract

This review presents the most common disease entities in which combinations of NSAIDs and spasmolytic drugs are used to reduce pain. The benefits of fixed-dose combination products (FDCs) are that they improve the response in people with insufficient monotherapy. Using the synergy or additive effect of drugs, it is possible to obtain a significant therapeutic effect and faster action with the use of smaller doses of individual drugs. In addition, one active ingredient may counteract adverse reactions from the other. Another essential aspect of the use of FDCs is the improvement of medical adherence due to the reduction in the pill burden on patients. It is also possible to develop a fixed-dosed combination product de novo to address a new therapeutic claim and be protected by patents so that the manufacturer can obtain exclusive rights to sell a particular FDC or a formulation thereof. The proposed fixed-dose combinations should always be based on valid therapeutic principles and consider the combined safety profile of all active substances included in the medicinal product. This review aims to identify which combinations of NSAIDs and spasmolytics have been developed and tested and which combinations are still under development.

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A Comprehensive Review of Non-Steroidal Anti-Inflammatory Drug Use in The Elderly

Supakanya Wongrakpanich, Amaraporn Wongrakpanich, Katie Melhado … (2018)

NSAIDs, non-steroidal anti-inflammatory drugs, are one of the most commonly prescribed pain medications. It is a highly effective drug class for pain and inflammation; however, NSAIDs are known for multiple adverse effects, including gastrointestinal bleeding, cardiovascular side effects, and NSAID induced nephrotoxicity. As our society ages, it is crucial to have comprehensive knowledge of this class of medication in the elderly population. Therefore, we reviewed the pharmacodynamics and pharmacokinetics, current guidelines for NSAIDs use, adverse effect profile, and drug interaction of NSAIDs and commonly used medications in the elderly.

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Current Advances in Chitosan Nanoparticles Based Drug Delivery and Targeting

Unnati Garg, Swati Chauhan, Upendra Nagaich … (2019)

Nanoparticles (NPs) have been found to be potential targeted and controlled release drug delivery systems. Various drugs can be loaded in the NPs to achieve targeted delivery. Chitosan NPs being biodegradable, biocompatible, less toxic and easy to prepare, are an effective and potential tool for drug delivery. Chitosan is natural biopolymer which can be easily functionalized to obtain the desired targeted results and is also approved by GRAS (Generally Recognized as Safe by the United States Food and Drug Administration [US FDA]). Various methods for preparation of chitosan NPs include, ionic cross-linking, covalent cross-linking, reverse micellar method, precipitation and emulsion-droplet coalescence method. Chitosan NPs are found to have plethora of applications in drug delivery diagnosis and other biological applications. The key applications include ocular drug delivery, per-oral delivery, pulmonary drug delivery, nasal drug delivery, mucosal drug delivery, gene delivery, buccal drug delivery, vaccine delivery, vaginal drug delivery and cancer therapy. The present review describes the formation of chitosan, synthesis of chitosan NPs and their various applications in drug delivery.

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Nonsteroidal anti-inflammatory drugs for dysmenorrhoea.

Jane Marjoribanks, Reuben Olugbenga Ayeleke, Cindy Farquhar … (2015)

Dysmenorrhoea is a common gynaecological problem consisting of painful cramps accompanying menstruation, which in the absence of any underlying abnormality is known as primary dysmenorrhoea. Research has shown that women with dysmenorrhoea have high levels of prostaglandins, hormones known to cause cramping abdominal pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that act by blocking prostaglandin production. They inhibit the action of cyclooxygenase (COX), an enzyme responsible for the formation of prostaglandins. The COX enzyme exists in two forms, COX-1 and COX-2. Traditional NSAIDs are considered 'non-selective' because they inhibit both COX-1 and COX-2 enzymes. More selective NSAIDs that solely target COX-2 enzymes (COX-2-specific inhibitors) were launched in 1999 with the aim of reducing side effects commonly reported in association with NSAIDs, such as indigestion, headaches and drowsiness.

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Author and article information

Contributors

Emilio Sacco: Role: Academic Editor

Journal

Journal ID (nlm-ta): J Clin Med

Journal ID (iso-abbrev): J Clin Med

Journal ID (publisher-id): jcm

Title: Journal of Clinical Medicine

Publisher: MDPI

ISSN (Electronic): 2077-0383

Publication date (Electronic): 15 July 2021

Publication date Collection: July 2021

Volume: 10

Issue: 14

Electronic Location Identifier: 3118

Affiliations

[1 ]Synteza sp. z o.o., św. Michała 67/71, 61-005 Poznań, Poland; magdalena.janczura@ 123456synteza.com.pl (M.J.); malgorzata.kobus-moryson@ 123456synteza.com.pl (M.K.-M.)

[2 ]Department of Pharmacognosy, Faculty of Pharmacy, Poznań University of Medical Sciences, Święcickiego 4, 60-780 Poznań, Poland; szymonsip@ 123456ump.edu.pl

[3 ]Department of Developmental Neurology, Poznan University of Medical Sciences, Przybyszewski 49 Str., 60-355 Poznań, Poland; zarowski@ 123456ump.edu.pl

[4 ]Clinic for Rehabilitation, Poznan University of Medical Sciences, 28 Czerwca 1956r. nr 135/147 Street, 61-545 Poznań, Poland; agnieszka.warenczak@ 123456ump.edu.pl

Author notes

[* ]Correspondence: jpiontek@ 123456ump.edu.pl

Author information

Magdalena Janczura https://orcid.org/0000-0002-6649-5179

Małgorzata Kobus-Moryson https://orcid.org/0000-0002-2225-6344

Szymon Sip https://orcid.org/0000-0002-6618-9956

Marcin Żarowski https://orcid.org/0000-0002-9800-9446

Agnieszka Wareńczak https://orcid.org/0000-0002-5973-1946

Judyta Cielecka-Piontek https://orcid.org/0000-0003-0891-5419

Article

Publisher ID: jcm-10-03118

DOI: 10.3390/jcm10143118

PMC ID: 8306558

PubMed ID: 34300284

SO-VID: 8be57d76-d645-482d-9ba9-80794e485c0f

License:

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

History

Date received : 20 May 2021

Date accepted : 13 July 2021

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