Ibuprofen-acetaminophen excellent choice for pain relief

According to a new study in JAMA there were no important differences in pain reduction after 2 hours with ibuprofen-acetaminophen or opioid-acetaminophen combination pills in emergency department patients with acute extremity pain. 

The findings suggest that ibuprofen-acetaminophen is a reasonable alternative to opioid management of acute extremity pain due to sprain, strain, or fracture. 

Acetaminophen (Tylenol) is cleared by the liver, while ibuprofen (Advil, Motrin)is cleared by the kidneys. Each medication works differently and they are broken down differently so taking both is of is minimal concern. Acetaminophen is a pain reliever and fever reducer but not an anti-inflammatory. Ibuprofen is all three.

416 patients (ages 21 to 64 years) with moderate to severe acute extremity pain in two urban emergency departments were randomly assigned to receive

• 400 mg ibuprofen and 1,000 mg acetaminophen
• 5 mg oxycodone and 325 mg acetaminophen
• 5 mg hydrocodone and 300 mg acetaminophen; or
• 30 mg codeine and 300 mg acetaminophen

Results: After 2 hours pain was less in all participants, without any important difference in effect between the four groups.