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Drug Res (Stuttg). <> 2013
Jun;63(6):289-92. doi: 10.1055/s-0033-1334963. Epub 2013 Mar 22.
B-vitamin mixture improves the analgesic effect of diclofenac in patients
with osteoarthritis: a double blind study.
Magaña-Villa MC
1, Rocha-González HI
Fernández del Valle-Laisequilla C
Granados-Soto V
Rodríguez-Silverio J
Flores-Murrieta FJ
Carrasco-Portugal MC
Reyes-García JG
Author information <>

According to the high consumption of the mixture of B vitamins and
diclofenac in several countries, this combination has constituted a
frequently used option in pain therapy from inflammatory origin. Although
the evidence obtained from inflammatory pain animal models has shown the
existence of analgesic synergy between diclofenac and the B vitamins
mixture, the corresponding clinical evidence is scarce. A double-blind,
randomized clinical trial study was designed to characterize the analgesic
effect and safety of diclofenac and B vitamins against diclofenac alone in
patients with severe osteoarthritis. Forty eight patients programmed to
total knee arthroplasty with a pain level ≥7 in a 1-10 cm visual analogue
scale were allocated to receive a single intramuscular injection of sodium
diclofenac (75 mg) alone or combined with thiamine (100 mg), pyridoxine
(100 mg) and cyanocobalamin (5 mg), and the pain level was evaluated during
12 h post-injection. Diclofenac+B vitamins mixture showed a superior
analgesic effect during the assessed period and also a better assessment of
the pain relief perception by patients than diclofenac alone. This study
constitutes a clinical support on the improvement of the analgesic effect
of diclofenac by B vitamins in patients with osteoarthritis programmed to
total knee arthroplasty, as a clinical model of inflammatory pain.

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