‘We need to actively use acetaminophen ER tablets'

Byung-Wook Yoo, Professor of Family Medicine, Soonchunhyang University Seoul Hospital

Young-Jin Kwak, Pharmacist, Raemian Star Pharmacy                 

Byung-Wook Yoo, Professor of Family Medicine, Soonchunhyang University Seoul Hospital and Young-Jin Kwak, Pharmacist, Raemian Star Pharmacy                 

The use of extended-release formulations is increasing in the field of analgesics.

 

Acetaminophen-based medicines, which consumers commonly regard as cold and fever relievers, are usually given in the form of IR tablets (Immediate Release tablets), which are regular tablets that dissolve quickly in the stomach without any special controlled release technology.

 

On the other hand, extended-release tablets (ER tablets) are designed to release slowly in the body using special controlled release technology.

 

Extended-release tablets are characterized by their longer-lasting effect compared to IR tablets and are convenient because they can be taken less often.

 

Dailypharm met with Byung-Wook Yoo, Professor of Family Medicine, Soonchunhyang University Seoul Hospital, and Young-Jin Kwak, Pharmacist, Raemian Star Pharmacy, to hear about the safety and effect of the less familiar ‘acetaminophen ER tablets.’ ◆Useful for muscle and joint pain as it offers 8 hours of pain relief Studies have already demonstrated that acetaminophen extended-release tablets effectively relieve muscle pain.

 

"In a study that provided acetaminophen extended-release tablets or a placebo to patients who experienced muscle soreness after a marathon, patients who received the extended-release tablets showed significantly higher levels of 'muscle soreness relief' and 'treatment satisfaction' than the placebo group, and significantly lower rates of ‘sleeplessness and sleep disturbance due to pain,’" said Professor Yoo.

 

He added, “In practice, we often see age-related degenerative arthritis patients, many of which take multiple prescription medications.

 

It is necessary to consider acetaminophen as a first-line analgesic in these patients due to concerns over drug interactions.” "The commercially available acetaminophen extended-release tablets are 650 mg in dosages and have a two-layer structure with an immediate-release layer and an extended-release layer.

 

Half of the drug dissolves quickly while the other half dissolves slowly, lasting for 8 hours.

 

Because it provides pain relief over a relatively long period of time, it can be useful for muscle and joint pain, which are often known to linger." ◆What about patients with a weak GI system or the need to take pain medication on an empty stomach? Gastrointestinal side effects are always a concern that accompanies the use of analgesics.

 

Acetaminophen can help in this situation as well.

 

"Acetaminophen has similar analgesic effects to non-steroidal anti-inflammatory drugs (NSAIDs), but with greater gastrointestinal safety and significantly lower side effects," explained Professor Kwak.

 

“NSAIDs, on the other hand, can have problematic GI side effects and are sometimes difficult to use in older patients because of underlying medical conditions and drug interactions from polypharmacy." Kwak added that patients with a weak stomach, related medical conditions, and those taking medications that interact with NSAIDs, such as selective serotonin reuptake inhibitors, may want to first consider the use of acetaminophen.

 

"Pharmacists can assess the patient's situation by asking questions on whether the patient usually has gastrointestinal problems and whether the patient often feels uncomfortable after taking medications, and first consider the use of acetaminophen extended-release tablets, which provide longer-lasting pain relief with fewer gastrointestinal side effects for patients with weak stomachs." "In addition, acetaminophen extended-release tablets are usually taken 3 times daily, usually 1-2 tablets, 8 hours apart, and should not be split, as splitting breaks down the drug’s bilayer structure.

 

Also, care should be taken not to exceed the maximum dose of 4,000 mg (up to a maximum of 6 tablets per day)."