NEW DRUG COMBINATION MIGHT BE A MORE EFFECTIVE PAIN RELIEVER

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NEW DRUG COMBINATION MIGHT BE A MORE EFFECTIVE PAIN RELIEVER

The nutritional supplement, glucosamine, boosts the pain relieving power of

ibuprofen, according to a new study by Temple University researchers in the

Journal of Pharmacology and Experimental Therapeutics (JPET). This new drug

combination could one day allow patients to take a lower dose and get the

same pain relief with fewer unwanted side effects.

Tallarida, Ph.D., and Alan Cowan, Ph.D., of Temple's School of

Medicine, and Raffa, Ph.D., of Temple's School of Pharmacy, conducted

the study " Antinociceptive Synergy, Additivity, and Subadditivity with

Combinations of Oral Glucosamine Plus Nonopioid Analgesics in Mice, " which

was published in the November 2003 issue of JPET.

Ibuprofen is a non-steroidal anti-inflammatory drug, or NSAID. NSAIDs, which

also include aspirin, are quite effective in relieving pain. They are so

effective, in fact, that pain sufferers sometimes take higher and higher

doses in hope of more pain relief. High doses of NSAIDs, especially when

taken over long periods of time, can cause gastrointestinal upset, such as

heartburn, or even bleeding.

" Combining pain relievers into one pill can increase patient compliance,

simplify prescribing, and improve efficacy without increasing side effects,

or conversely, decrease side effects without losing efficacy, " said Raffa.

In addition to these benefits, drug combinations can also sometimes yield a

totally unexpected effect, such as the magnification of a drug's powers.

" When this happens, a phenomenon known as drug synergism, it's like finding

buried treasure, " added Tallarida.

Glucosamine, a naturally occurring substance in the body, which is also

available in synthetic form over the counter, is used to treat

osteoarthritis, a painful, degenerative joint disorder. While it has been

shown to prevent and repair bone and cartilage damage, researchers have yet

to demonstrate that glucosamine actually blocks pain.

" We embarked on this study with several questions: Can glucosamine actually

block pain? And, can glucosamine improve the pain-relieving powers of other

drugs when the two are combined? " said Tallarida.

First, the researchers confirmed that glucosamine, alone, does not block

pain. It's believed that any pain-relieving properties of glucosamine are a

side effect of its ability to repair bone damage. Next, they combined

glucosamine with a variety of NSAIDs at a variety of dosages. With several

NSAIDs, including naproxen, the addition of glucosamine caused an additive

effect, meaning the sum of each drug's properties. When combined with

aspirin or acetaminophen, the result was subadditive, or less than the sum

of each drug's properties. But when combined with ibuprofen, the researchers

found pain relief was enhanced and therefore synergistic.

" The next step will be to study this drug combination in clinical trials to

see whether it can enhance pain relief or offer pain relief using a lower

dose of ibuprofen and therefore a lower risk of side effects, " said Cowan.

The researchers are also investigating other possible drug combinations for

the potential relief of pain. Raffa and Tallarida played a role in the

development of Ultracet, a combination of tramadol and acetominophen used in

the treatment of pain. And Cowan contributed to the development of

buprenorphine which, when combined with naloxone, is used in the treatment

of opiate addiction.

Eryn Jelesiewicz

Director

Public Relations, HSC

http://www.temple.edu/news_media/ej0312_462.html