RODRIGUEZ, R.F.    CAICEDO, M.L.. Validation of the second step of the WHO analgesic ladder: is the use of weak opioids necessary?. []. , 20, 6, pp.285-290. ISSN 1134-8046.  https://dx.doi.org/10.4321/S1134-80462013000600002.

Objective: Compare the analgesic efficacy and tolerability of acetaminophen versus acetaminophen plus codeine in the relief of cancer-related pain. Methods: This 7-day, prospective, double-blind, randomized, parallel-group study was conducted with 36 patients with cancer pain. Outpatients were eligible for the study if they were aged ≥ 18 years and had moderate to severe cancer-related pain. Eligible patients were randomly assigned to receive acetaminophen or acetaminophen plus codeine. The primary end point was the proportion of patients who achieved pain relief; the second end point was time to achieve relief pain. Results: Of the 36 patients who participated, 20 received acetaminophen and 16 acetaminophen plus codeine. At baseline there were not differences between the groups. None of the between-group differences in response rates were significant (p > 0,05). The most common adverse effect in codeine group was constipation (p = 0,001). Conclusion: Efficacy was comparable between acetaminophen and acetaminophen plus codeine over 7 days of treatment in this patients with moderate or severe cancer-related pain. Codeine was associated with significantly greater constipation.

: Codeine; Acetaminophen; Analgesic ladder; Pain; Cancer.

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