Efficacy and Safety of Fixed-Dose Combinations for Pain in Older Adults.

Pain is common in older adults and managing pain in this population can be challenging owing to altered pharmacokinetics, multimorbidity, polypharmacy, cognitive impairment, and physical frailty. A fixed-dose combination (FDC) analgesic contains two or more pharmaceutical ingredients in a single pill and may offer more benefits when compared with loose-dose formulations. The benefits include reduced pill burden and better adherence, a broader analgesic spectrum well-suited to multimechanistic pain conditions and more predictable pharmacokinetic and pharmacodynamic properties. These advantages may outweigh disadvantages such as reduced flexibility in dose adjustment. Most of the commonly used FDC analgesics are made up of a combination of paracetamol, muscle relaxant, nonsteroidal anti-inflammatory drug or opioid. They have been shown to have better efficacy and similar safety profiles compared with individual drugs. Adverse effects from the use of FDC analgesics in older patients were comparable with that observed in younger populations. With proper patient selection and continuous surveillance, FDC analgesics will likely benefit older adults by simplifying dosing regimen and improving compliance.
Competing Interests: Declarations Funding No funding was received for the submitted work. Conflicts of Interest Q.P.Z. and D.X.H.C. have no competing interests to declare that are relevant to the submitted work. K.Y.H. has received research and advisory board fees from Menarini; speaker fees from Avanos, Boston Scientific, GSK, Juniper Biologics, and Medtronic outside the submitted work. Ethics Approval Not applicable. Consent to Participate Not applicable. Consent for Publication Not applicable. Availability of Data and Material Not applicable. Code Availability Not applicable. Author Contributions All authors contributed to the conception and literature search for the work. Q.P.Z. prepared the first draft of the manuscript. All authors revised and contributed to the final manuscript. All authors read and approved the final version of the manuscript.
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