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2013 ; 60
(4
): 178-87
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Three newly approved analgesics: an update
#MMPMID24423420
Saraghi M
; Hersh EV
Anesth Prog
2013[Win]; 60
(4
): 178-87
PMID24423420
show ga
Abstract Since 2008, three new analgesic entities, tapentadol immediate release
(Nucynta) diclofenac potassium soft gelatin capsules (Zipsor), and bupivacaine
liposome injectable suspension (EXPAREL) were granted US Food and Drug
Administration (FDA) approval to treat acute pain. Tapentadol immediate-release
is a both a mu-opioid agonist and a norepinephrine reuptake inhibitor, and is
indicated for the treatment of moderate to severe pain. Diclofenac potassium soft
gelatin capsules are a novel formulation of diclofenac potassium, which is a
nonsteroidal anti-inflammatory drug (NSAID), and its putative mechanism of action
is through inhibition of cyclooxygenase enzymes. This novel formulation of
diclofenac allows for improved absorption at lower doses. Liposomal bupivacaine
is a new formulation of bupivacaine intended for single-dose infiltration at the
surgical site for postoperative analgesia. Bupivacaine is slowly released from
this liposomal vehicle and can provide prolonged analgesia at the surgical site.
By utilizing NSAIDs and local anesthetics to decrease the transmission of
afferent pain signals, less opioid analgesics are needed to achieve analgesia.
Since drug-related adverse events are frequently dose related, lower doses from
different drug classes may be employed to reduce the incidence of adverse
effects, while producing synergistic analgesia as part of a multimodal analgesic
approach to acute pain.
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