Author(s) : Magali Fontaine-Adam, Mikaël Daouphars, Jean Doucet, Service de pharmacie, CHU C. Nicolle, Rouen, Service de pharmacie, CLCC H. Becquerel, Rouen, Service de médecine interne gériatrique, CHU C. Nicolle Rouen St Julien.
Summary : Analgesics are part of the drugs for which sales have progressed the most between 1999 and 2009. The analgesics, such as codeine, tramadol and dextropropoxyphen make it parties. However, since 1st March 2011, the commercialization of drugs containing dextropropoxyphen is stopped and the requirements must be reviewed. This decision was the consequence of the voluntary death in Sweden and the United States and of an intention to harmonize European decisions. Afssaps proposes to replace dextropropoxyphen with paracetamol in the first intention, and if necessary by a level 2 analgesic or anti-inflammatory drugs. A bibliographic study concluded that dextropropoxyphen is better tolerated than tramadol. However the safety of codeine is more controversial. Regarding the efficacy among the 3 level 2 analgesic drugs, codeine would be most effective. However, data are not sufficient to conclude in favor of dextropropoxyphene versus acetaminophene.
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