Is (30/500) Kapake superior to (8/500) Cocodamol in mild to moderate pain in headache

Date First Published:
January 25, 2008
Last Updated:
September 6, 2001
Report by:
Muhammed Al Zarrad, Registrar Emergency Medicine (Manchester Royal Infirmary)
Search checked by:
TBC, Manchester Royal Infirmary
Three-Part Question:
In [a young adult with mild to moderate pain from tension headaches] does [kapake or cocodamol offer better analgesia] in terms of [onset and duration of pain relief]?
Clinical Scenario:
A 27 year old female with a 2 day history of headache attends the A&E department. Clinical assessment of this patient comforms with a diagnosis of tension headaches. She was given Kapake for pain relief and discharged.
Search Strategy:
Medline using OVID interface 1966-6/98.
Search Details:
(exp acetaminophen/ or paracetamol.ti, ab, sh.) AND (exp codeine/ or codeine.ti, ab, sh.) AND (exp tension headache/ or exp headache/ or headache.ti, ab, sh.)
Outcome:
28 papers of which 1 Russian, 1 German, 19 not relevant and 6 not specific to the question.
Relevant Paper(s):
Study Title Patient Group Study type (level of evidence) Outcomes Key results Study Weaknesses
Symptomatic treatment of chronically recurring tension headache: a placebo-controlled, multicenter investigation of Fioricet and acetaminophen with codeine. Friedman AP, DiSerio FJ. 1987 USA 198 adults evaluated for Fioricet, acetaminophen with codeine and placebo. PRCT multicentre 4 hrs assessment of pain relief, emotional tension and muscle contraction. Active analgesics effective than placebo. Different strength than used in UK.
Not comparing the analgesics in question.
Poor explanation of statistics.
Author Commentary:
Regarding the proposed question there was no paper addressing the different strengths of codeine compound.
Bottom Line:
Unable to make a comparison between kapake and cocodamol as to pain relief effectiveness.
References:
  1. Friedman AP, DiSerio FJ.. Symptomatic treatment of chronically recurring tension headache: a placebo-controlled, multicenter investigation of Fioricet and acetaminophen with codeine.