Comparison of Butorphanol Nasal Spray and Fiorinal With Codeine in the Treatment of Migraine
| Autor: | Paul Winner, Neil M. Sussman, Jerome Goldstein, Seymour Diamond, Wendy J. Davidson, Linda A. Reich, Marek Gawel |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Adolescent Butorphanol medicine.drug_class Migraine Disorders Analgesic Codeine Phosphate Hypnotic Butalbital Double-Blind Method Caffeine medicine Humans Functional ability Administration Intranasal Aged Aerosols Aspirin Codeine business.industry Middle Aged medicine.disease Analgesics Opioid Drug Combinations Neurology Migraine Anesthesia Barbiturates Female Neurology (clinical) business medicine.drug |
| Zdroj: | Headache: The Journal of Head and Face Pain. 38:516-522 |
| ISSN: | 1526-4610 0017-8748 |
| DOI: | 10.1046/j.1526-4610.1998.3807516.x |
| Popis: | Butorphanol tartrate is a synthetic mixed agonist-antagonist opioid analgesic. Its transnasal dosage form, which may be self-administered when the use of an opioid analgesic is appropriate, was previously shown to provide rapid relief of migraine pain. In this double-blind, parallel-group, outpatient study, we compared butorphanol nasal spray 1 mg followed in 1 hour by an optional second 1-mg dose with the orally administered analgesic, Fiorinal with Codeine (one capsule containing butalbital 50 mg, caffeine 40 mg, aspirin 325 mg, and codeine phosphate 30 mg). Patients (N=321) were assigned by randomization to one of two treatment groups (butorphanol or Fiorinal with Codeine) and instructed to self-administer medication when migraine pain reached an intensity of moderate or severe and to record study-related events in a diary for 24 hours posttreatment. Efficacy analyses were performed on data from 275 patients who took study medication and returned a patient diary; 136 in the butorphanol group and 139 in the Fiorinal with Codeine group. During the first 2 hours after treatment, butorphanol was more effective than Fiorinal with Codeine in treating migraine pain as measured by pain intensity difference scores, percentage of responders (pain decreased to mild or none), percentage of pain-free patients, and degree of pain relief, with a more rapid time to onset of 15 minutes. A similar percentage of patients in the two groups used rescue medication during the first 4 hours, after which more butorphanol-treated than Fiorinal with Codeine-treated patients used rescue medication. Butorphanol patients had more side effects, less improvement in digestive symptoms, and less improvement in functional ability than Fiorinal with Codeine patients. |
| Databáze: | OpenAIRE |
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