Objective

Treating acute or chronic pain with more than one analgesic agent or with an analgesic agent and an adjuvant is a well-established principle of pain medicine. Combinations can be opioid-sparing without sacrificing efficacy. Our objective was to write about the current knowledge of combination therapy for pain control.

Methods

This is a narrative review based on a May 2021 literature search to review combination analgesics studied in (randomized) clinical trials. The net result of the search was 21 studies.

Results

Combination analgesia may be effective at addressing multimechanistic pain syndromes and it is often shown in studies to be equally effective to opioid monotherapy. Furthermore, there is modest evidence that these combinations may be associated with fewer and less severe side effects for acute painful conditions. Some common drug combinations for pain are paracetamol and hydrocodone, paracetamol and oxycodone, paracetamol and ibuprofen, and others.

Conclusion

Combination therapy can confer benefits on patients by offering effective analgesia with lower overall exposure to opioids. Certain specific drug combinations present synergistic benefits.