Rodriguez, R.F., Castillo, J.M., Castillo, M.P., Montoya, O., Daza, P., Rodriguez, M.F., . . . Angel, A.M. (2008). Hydrocodone/acetaminophen and tramadol chlorhydrate combination tablets for the management of chronic cancer pain: A double-blind comparative trial. The Clinical Journal of Pain, 24(1), 1–4.doi: 10.1097/AJP.0b013e318156ca4d
To compare the efficacy of hydrocodone-acetaminophen with that of tramadol in the management of cancer pain; to compare the tolerability of hydrocodone-acetaminophen and tramadol used to relieve cancer pain
Patients were assigned to receive either hydrocodone-acetaminophen (25 mg hydrocodone, 2,500 acetaminophen) or tramadol (200 mg) for 21 days. Patients rated pain intensity at the beginning of the study, two days after the beginning of the study, and once weekly for three weeks. Patients were to note all adverse events.
Randomized double-blind comparative trial
In this study, tramadol and hydrocodone-acetaminophen were equally efficacious in relieving cancer pain. Patients taking hydrocodone-acetaminophen experienced fewer side effects than did patients who took tramadol.
All analgesics, except medications for neuropathic pain, were discontinued. Note that the group that took tramadol contained significantly more women than did the group that took hydrocodone-acetaminophen. This difference may relate to the differing side-effect profiles.
This study showed that hydrocodone-acetaminophen and tramadol were equally effective at treating cancer pain; however, tramadol was associated with more adverse effects. Nurses should keep this in mind and provide patients with anticipatory guidance as appropriate.