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May 29, 2005
ASA/caffeine pill better than coffee+asa?

A 60+ y.o. woman with chronic back pain and sciatica came into the office stating that she had found a wonder drug and it was over the counter, too!  Her friend told her to take Bayer Extra Strength for Back & Body Pain (500 mg asa + 32.5 caffeine).  Since she started taking this (2 tabs q6 hours), she hadn't needed her Celebrex or her aspirin, neither of which helped her sciatica anyway.  She didn't even drink her daily 2 cups of coffee any more because she felt great.  She had little/no back or sciatica pain anymore and was much more active these days.

We couldn't figure out why the OTC worked out better than the coffee & asa, so I spent some quality time with ovid trying to find out what was going on.  One article stated that subjects who ingested a large dose of caffeine reported less leg muscle pain during moderate intensity cycling exercise.  It postulated that the caffeine improved endurance exercise performance due to it's hypoalgesic properties. 

Another article found that caffeine increased systolic and diastolic bp's, made people feel more clearheaded and energetic (surprise), and produced higher pain threshold and pain tolerance levels compaired to placebos.  One interesting point was that the systolic and pain effects were stronger in women.

My doctor and I wondered whether this patient's success had to do with the fact that the caffeine in the asa potentiated the analgesic effects, helping the asa to kick in faster and possible more effectively.  Previously, she may have taken the aspirin and coffee at different times or she may have taken less aspirin throughout the day.  Whatever the case, we were excited for her relief of pain, but we're now keeping an eye on her bp. 

Posted At : 6:14 PM. | Link | Rotation 5 04-05 | Comments (2)

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Comments

Interesting blog. This is something to keep in mind for pain relief in the future. Unfortunately I was unable to open the links except for the emedicine one so I can't comment on the studies.

Posted By Marcela Mcdonald / Posted At 5/31/05 10:25 PM

Very interesting finding! I don't think any of my patient had been on Bayer for pain relief. I'll be sure to ask my attending his thoughts on the matter and use the articles. Thanks!

Posted By Robyn Kuroki / Posted At 6/1/05 5:41 PM