What is Vicoprofen?

Vicoprofen is the brand name for an oral analgesic medication. It is prescribed for short-term management of acute pain, such as post-surgical pain or active cancer treatment, generally for less than ten days.¹

Vicoprofen is a fixed-dose combination of hydrocodone bitartrate and ibuprofen.

• Hydrocodone bitartrate is a semi-synthetic opioid.² Its immediate-release (IR) form is commercially available in combination with other acting analgesics such as ibuprofen, acetaminophen, or aspirin. It is an FDA-approved opioid for the management of severe pain for which alternative, non-opioid treatments are insufficient or inadequate. ^{1, 2} Hydrocodone is a centrally acting opioid analgesic. It inhibits the processing of pain in the central nervous system (CNS).³

• Ibuprofen is a nonsteroidal, anti-inflammatory drug (NSAID). It is widely used for its analgesic and antipyretic (reduces fever) properties. Ibuprofen is a peripherally acting analgesic that acts outside the CNS.³ It binds to cyclo-oxygenase (COX) enzymes that produce prostaglandins, mediators of inflammation.¹  The binding reduces the synthesis of prostaglandins in peripheral tissue and reduces inflammation at the site of injury.³

How does Vicoprofen work?

Vicoprofen binds to opioid receptors responsible for sensing pain.³ Opioid receptors are abundant on the surface of nerve cells of the brain and spinal cord (CNS) but are also located on peripheral nerve cells throughout the body. When an opioid binds to an opioid receptor, it triggers a cascade of chemical reactions that leads to pain relief.

Vicoprofen has an enhanced efficacy due to the additive effect of two analgesics that have different pharmacologic mechanisms of action to relieve pain.³ The combination of a peripherally acting agent (ibuprofen) and a centrally acting agent (hydrocodone) provides a greater analgesic effect than either drug would if prescribed alone. Thus, Vicoprofen relieves short-term, acute pain by a dual mechanism of action:¹

• Binding to opioid receptors, through the action of hydrocodone

• Inhibiting COX enzymes, through the action of Ibuprofen

Side effects of Vicoprofen

Serious side effects have been associated with Vicoprofen.¹

• Opioid addiction: with the risk of abuse and misuse of the drug.
• Respiratory depression: leads to slow and shallow breathing which may result in respiratory arrest and death.
• Cardiovascular event: such as heart attack or stroke. This side effect is more likely to occur in patients who already have heart disease.
• Gastrointestinal bleeding, ulceration, and perforation: results in bloody stools or coughing up blood.
• Effects on the endocrine system (adrenal insufficiency): may cause nausea, vomiting, fatigue, weakness, dizziness, and low blood pressure

References

1. Vicoprofen https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020716s012s013s014s015s016lbl.pdf
2. Dydyk AM, Sizemore DC, Haddad LM, Lindsay L, Porter BR. NP Safe Prescribing Of Controlled Substances While Avoiding Drug Diversion. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 33232099.
3. Ziccardi VB, Desjardins P, Daly-Dejoy E, Seng GF. Single-dose vicoprofen compared with acetaminophen with codeine and placebo in patients with acute postoperative pain after third molar extractions. Journal of oral and maxillofacial surgery. 2000;58(6):622-628. doi:10.1016/S0278-2391(00)90154-X
4. Image by Arek Socha from Pixabay