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Samiullah Khan, Muhammad Hassham Hassan Bin Asad, Mohammad Sohail, Abdur Rehman, Nargis Aman, Habibullah Jan and Muhammad Samie*


Pain of multiple etiologies remains a significant problem for many patients presenting in the clinical setting. Improved pain relief can be maximized and adverse effects minimized, by multimodal analgesic combinations as the method to improve pain treatment. Significant suggestion supports the use of combination analgesics for the management of pain and in some cases, they have a heterogeneous pharmacologic sparing effect. Fixed-dose combination analgesics having significant efficacy and safety are extensively suitable for pain management and are usually recommended. However, further exploration is required for the best combination that which analgesics at which doses can be pooled with a co-analgesic in a patient-specific manner to attain additive, if not synergistic, multimodal pain relief with the least possible adverse values. Unsupervised intake of over-the-counter drugs offers clinical challenges to both the patient and health care providers. Couple this often unrevealed over-the-counter medication consumption event with prescription medications, which many have similar combination constituents and the potential for a therapeutic misadventure may precipitate. Patient-specific cautions are presented for opiate/opioid combinations, codeine, hydrocodone, oxycodone and propoxyphene and there is a discussion of COX I/COX II agents. This review article address the safety and efficacy of different analgesics individually and in combination with currently available prescription dosage forms with a focus on pharmacology, pharmacotherapeutics, pharmacodynamics, and pharmacokinetics, including drug interactions and toxicity profile.

Keywords: Pain, Analgesics, multimodal analgesics, toxicology, drug interactions.

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