No Difference Between Oxycodone/Acetaminophen and Hydrocodone/Acetaminophen for Acute Extremity Pain


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Am Fam Physician. 2016 Mar 1;93(5):411.

Clinical Question

How effective is oxycodone/acetaminophen compared with hydrocodone/acetaminophen in the management of acute extremity pain in adults, including sprains/strains and fractures?

Bottom Line

This study found no significant difference in the management of acute musculoskeletal extremity pain, including fractures, with oxycodone/acetaminophen vs. hydrocodone/acetaminophen. Adverse events, including nausea and dizziness, occurred significantly more often with oxycodone/acetaminophen (number needed to treat to harm = 10). (Level of Evidence = 1b)


It is commonly believed that oxycodone/acetaminophen provides better pain relief than hydrocodone/acetaminophen for adults with acute pain. These investigators identified adults (N = 240), 21 to 64 years of age, who presented to an urban emergency department

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP,search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


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Oct 15, 2016

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