UCB · PTGS1 · Small Molecule
feprazone + paracetamol + guaifenasin is a small molecule developed by UCB. It is approved for therapeutic indications via oral (po).
| Brand Names | Fepramol |
| Company | UCB |
| Drug Class | Small Molecule |
| Molecular Target | PTGS1, PTGS2 |
| Route | Oral (PO) |
| Status | Approved |
feprazone + paracetamol + guaifenasin acts on 2 molecular targets:
| PTGS1 | prostaglandin-endoperoxide synthase 1 (COX3, PCOX1) |
| PTGS2 | prostaglandin-endoperoxide synthase 2 (GRIPGHS, hCox-2) |
feprazone + paracetamol + guaifenasin is developed for 1 unique indication across 1 therapeutic area.
| Therapeutic Area | Condition | Phase |
|---|---|---|
| Respiratory, thoracic and mediastinal disorders | Pneumonitis | ✓ Approved |
Owen Adrian A, Majeed Kamran K, Pillay Roselyn R, Jeyakumar Jerusha J et al.
Kilinc Leyla L, Turk Hacer Sebnem HS, Salkaya Aysel A, Yildiz Sevki S et al.
Breast reduction surgery is a common aesthetic procedure associated with significant postoperative pain. Effective analgesia plays an important role in reducing opioid consumption, minimizing adverse effects, facilitating postoperative recovery, and improving patient satisfaction. Fascial plane blocks have recently gained popularity for breast surgery. This randomized study aimed to compare the effects of bilateral erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) on postoperative analgesia in patients undergoing breast reduction surgery. Seventy female patients undergoing bilateral breast reduction surgery were randomly allocated into two groups: ESPB (Group ESPB, n = 35) and SAPB (Group SAPB, n = 35). Blocks were performed bilaterally under ultrasound guidance, with 20 mL of 0.25% bupivacaine each side, 30 min before surgery. All procedures were performed using the wise-pattern reduction mammoplasty technique with a superiomedial pedicle by the same surgical team. Postoperative analgesia included intravenous paracetamol, ibuprofen, and intravenous tramadol patient-controlled analgesia (PCA). Primer outcome was 24-h tramadol consumption through intravenous patient-controlled analgesia (PCA). Secondary outcomes included time to first analgesic requirement from PCA, postoperative pain scores (NRS), intraoperative remifentanil consumption, perioperative variables, length of hospital stay, and adverse effects. Primary-outcome data were available for 35 SAPB and 34 ESPB patients. Mean 24-hour tramadol consumption was 70.0 ± 37.7 mg with SAPB and 53.2 ± 29.1 mg with ESPB (mean difference, SAPB minus ESPB, 16.8 mg; 95% confidence interval, 0.5-33.0 mg; p = 0.043). Median time to first analgesic requirement was 420 min with SAPB and 630 min with ESPB (log-rank p < 0.001). Pain scores did not differ significantly. Nausea occurred in five SAPB patients and no ESPB patients (Fisher's exact p = 0.054); vomiting occurred in either group. Bradycardia occurred in one ESPB group patient (p = 1). In this single-center trial, ESPB was associated with lower 24-h tramadol consumption and a longer time to first PCA demand than SAPB, while pain scores were comparable. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Mohammed Saba A SA, Mahmood Samira A SA, Abdulwali Fekry A FA, Mohidden Afnan T AT et al.
The unsupervised use of over-the-counter analgesics constitutes a significant public health concern, particularly in environments with limited regulatory oversight. This study assessed the prevalence, usage patterns, and unadjusted associations of over-the-counter analgesic use among health sciences students in Aden, Yemen. A cross-sectional study was conducted between December 2024 and January 2025, enrolling 422 randomly selected students from medicine, pharmacy, dentistry, medical laboratory sciences, and nursing. Data were collected via a structured, pilot-tested, self-administered questionnaire. Descriptive statistics, chi-square, and Fisher's exact tests were applied; all inferential analyses were unadjusted. The six-month prevalence of over-the-counter analgesic use was 88.9%. Medical Laboratory Sciences students demonstrated the highest observed prevalence (100.0%), whereas nursing students exhibited the lowest (71.4%). Headache was the most frequently cited reason (48.8%). Paracetamol was the most utilised analgesic (74.7%), and community pharmacies served as the primary source (70.9%). Self-reported gastric upset (42%) and vomiting (17%) were common. Fisher's exact test revealed no significant association between faculty and use (p = 0.179), whereas sex was significantly associated with reasons for use (p = 0.004). Over-the-counter analgesic use was highly prevalent and predominantly driven by health-related complaints, though study-related motivations were reported. Targeted educational interventions and research investigating local dispensing practices are recommended.
Cheema Asad Shabbir AS
Sphincter of Oddi symptoms can make perioperative analgesia challenging, particularly in patients who have previously developed severe biliary-type pain after opioid administration. We describe the perioperative management of a 51-year-old woman with a clinically diagnosed history of sphincter of Oddi dysfunction. During previous surgery, she reported developing severe right upper quadrant pain and nausea shortly after receiving opioids. She subsequently underwent approximately three hours of L4/5 lumbar decompression under general anaesthesia. An opioid-sparing multimodal analgesic regimen was used, including paracetamol, ibuprofen, tramadol, ketamine, intravenous lidocaine, clonidine, pregabalin, and local levobupivacaine infiltration. Fentanyl was given at induction, and remifentanil was used during the procedure. Postoperatively, regular tramadol was continued with pregabalin, clonidine, and a lidocaine patch. At 24 hours, pain was 4/10 at rest and increased to 8/10 during physiotherapy. By 48 hours, pain at rest was 4/10. She did not develop the right upper quadrant or biliary-type pain that she had previously experienced with opioids. She had nausea in the recovery area, which settled with standard antiemetic treatment. She mobilised successfully with physiotherapy and was satisfied with her pain management, stating that she would choose the same approach again. This case describes a practical opioid-sparing approach in a patient with a history of opioid-associated sphincter of Oddi symptoms. Although opioids could not be completely avoided, multimodal analgesia allowed their use to be limited while providing acceptable postoperative pain control.
Szyszko Marta M, Wegrzyn Julien J, Rossel Jean-Benoit JB, Koninckx Alexandre A et al.
Infiltration between the popliteal artery and the capsule of the knee (IPACK) and the selective tibial nerve block provide analgesia for the posterior aspect of the knee after total knee arthroplasty. This randomised controlled triple-blinded trial tested the hypothesis that IPACK provides superior analgesia to selective tibial nerve block after total knee arthroplasty. Patients having total knee arthroplasty under spinal anaesthesia with a femoral triangle block were allocated randomly to receive either IPACK with 19 ml ropivacaine 0.2% or a selective tibial nerve block with 5 ml ropivacaine 0.75%. The postoperative analgesic strategy included paracetamol; ibuprofen; and intravenous morphine patient-controlled analgesia. Primary outcome was cumulative intravenous morphine consumption on postoperative day 1. Secondary analgesic outcomes included pain scores at rest and during movement measured on postoperative days 1, 2 and 3. Functional outcomes were quadriceps strength; walking distance; and range of motion. In total, data from 90 patients were analysed (45 allocated to each group). Cumulative intravenous morphine consumption on postoperative day 1 was similar between the patients allocated to the IPACK and selective tibial nerve block groups (mean (SD) 6 (7) mg vs. 5 (6) mg, respectively; p = 0.36). Four patients (9%) who received selective tibial nerve block had motor block of the common peroneal nerve. No other differences were seen between groups in secondary outcomes. The IPACK and selective tibial nerve block provide similar analgesia after total knee arthroplasty under spinal anaesthesia with a femoral triangle block.
Mansouri Mojtaba M, Massoumi Gholamreza G, MirMohammad-Sadeghi Mohsen M, Mir-Mohammad Sadeghi Amir A et al.
This study was performed to investigate the effect of prescribing remifentanil, along with paracetamol and gabapentin in comparison of fentanyl and morphine, on pain relief and faster recovery of patients undergoing coronary artery bypass graft (CABG). A double-blind controlled randomized clinical trial study was performed on 60 CABG candidates. In the control group, the patients underwent anesthesia drugs, analgesic drugs (fentanyl and morphine), and muscle relaxant drugs (without premedication with paracetamol, gabapentin, and remifentanil). In the intervention group, in addition to the control group medications, and bolus doses of remifentanil were used as an analgesic during the operation if analgesia was needed. Also, gabapentin 300 mg orally 1 h before surgery; gabapentin 300 mg every 8 h in the ICU; paracetamol 1 g as an intravenous infusion 30 min before the induction of anesthesia; Paracetamol 1 g every 6 h in the ICU for 3 days were prescribed. The pain scores mean in the intervention group on the first, second, and third days after CABG were significantly lower than the control group (P < 0.05). Also, the percentage of delirium in the control group was significantly higher than the intervention group in the first and second days after CABG (P < 0.05). According to the results, administration of remifentanil as a short-acting intraoperative opioid, and the gabapentin to treat nerve pain along with paracetamol before and after CABG surgery could effectively control pain and hemodynamic stability of patients with the least side effects besides reducing the need for additional opioids.
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