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Last Updated: December 12, 2025

CLINICAL TRIALS PROFILE FOR ACETAMINOPHEN AND IBUPROFEN


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505(b)(2) Clinical Trials for ACETAMINOPHEN AND IBUPROFEN

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
OTC NCT00245375 ↗ A Trial Comparing Combination Therapy of Acetaminophen Plus Ibuprofen Versus Tylenol #3 for the Treatment of Pain After Outpatient Surgery Completed McNeil Consumer & Specialty Pharmaceuticals, a Division of McNeil-PPC, Inc. N/A 2005-01-01 Increasingly in general surgery, the investigators are conducting outpatient day surgery. Ambulatory surgery currently comprises 60 to 70% of surgeries performed in North America. These patients all require some form of analgesia which can be taken at home in the first few days after the surgery. The current standard at the investigators' centre and many others in the maritime provinces is to provide a prescription for oral acetaminophen plus codeine or oxycodone (Tylenol #3®, Percocet ®). Some patients may receive more potent opioids such as oral hydromorphone (Dilaudid®). Unfortunately, the most commonly prescribed medication (Tylenol #3®) is often poorly tolerated by patients, has several undesirable side effects, and may not provide effective pain relief. In the investigators' experience, non-steroidal anti-inflammatory drugs (NSAIDs) are uncommonly a routine addition to the home analgesic regimen. Tylenol #3®, in the investigators' experience and opinion, is a poor post surgical pain medication. They hope to show that a combination of ibuprofen and acetaminophen is better for pain relief after these procedures. The combination of acetaminophen and ibuprofen would be a safe, cheap, and readily available regimen. Unfortunately, as the prescribing practices of surgeons are old habits, it will require a very convincing argument to get them to change their practices. A randomized controlled trial comparing these two regimens, the investigators hope, would be a powerful enough argument. The hypothesis of this study, therefore, is that the pain control provided by a combination of acetaminophen plus ibuprofen (650 mg/400 mg four times per day) will be superior to Tylenol #3® (600 mg acetaminophen/60 mg codeine/15 mg caffeine four times per day). This study will attempt to enroll 150 patients in total. Eligible patients will be identified by their attending surgeon and contacted by study personnel. Patients who enroll in the study will undergo their surgery in the usual manner. After the surgery, in the recovery room, once they are ready to go home, they will be randomized to receive combination A or B and be given a week's worth of pain medication. They will then go home and take this medication as directed. They will record their pain intensity and pain relief once per day using a diary provided in the study package. One week after their surgery, they will return to the hospital clinic and be seen by the study nurse. They will hand over the diary and any unused medication. They will also be asked several questions regarding their overall satisfaction, incidence of side effects, and how long until they were pain free. The risks of participating in this study are minimal from the risks inherent to the procedures and medications the patients would receive within the standard of care. Ibuprofen is a commonly used NSAID which is widely available over the counter and has an established safety profile. The most common adverse effects of ibuprofen and other NSAIDs are gastrointestinal bleeding and ulceration. Other less common adverse effects include nephrotoxicity, hypersensitivity reactions, hepatic dysfunction (longterm use), and cognitive dysfunction. The investigators' patients will be selected to exclude those most at risk for these complications (see exclusion criteria). Acetaminophen has few side effects, with no adverse effects on platelet function and no evidence of gastric irritation.
OTC NCT00245375 ↗ A Trial Comparing Combination Therapy of Acetaminophen Plus Ibuprofen Versus Tylenol #3 for the Treatment of Pain After Outpatient Surgery Completed Nova Scotia Health Authority N/A 2005-01-01 Increasingly in general surgery, the investigators are conducting outpatient day surgery. Ambulatory surgery currently comprises 60 to 70% of surgeries performed in North America. These patients all require some form of analgesia which can be taken at home in the first few days after the surgery. The current standard at the investigators' centre and many others in the maritime provinces is to provide a prescription for oral acetaminophen plus codeine or oxycodone (Tylenol #3®, Percocet ®). Some patients may receive more potent opioids such as oral hydromorphone (Dilaudid®). Unfortunately, the most commonly prescribed medication (Tylenol #3®) is often poorly tolerated by patients, has several undesirable side effects, and may not provide effective pain relief. In the investigators' experience, non-steroidal anti-inflammatory drugs (NSAIDs) are uncommonly a routine addition to the home analgesic regimen. Tylenol #3®, in the investigators' experience and opinion, is a poor post surgical pain medication. They hope to show that a combination of ibuprofen and acetaminophen is better for pain relief after these procedures. The combination of acetaminophen and ibuprofen would be a safe, cheap, and readily available regimen. Unfortunately, as the prescribing practices of surgeons are old habits, it will require a very convincing argument to get them to change their practices. A randomized controlled trial comparing these two regimens, the investigators hope, would be a powerful enough argument. The hypothesis of this study, therefore, is that the pain control provided by a combination of acetaminophen plus ibuprofen (650 mg/400 mg four times per day) will be superior to Tylenol #3® (600 mg acetaminophen/60 mg codeine/15 mg caffeine four times per day). This study will attempt to enroll 150 patients in total. Eligible patients will be identified by their attending surgeon and contacted by study personnel. Patients who enroll in the study will undergo their surgery in the usual manner. After the surgery, in the recovery room, once they are ready to go home, they will be randomized to receive combination A or B and be given a week's worth of pain medication. They will then go home and take this medication as directed. They will record their pain intensity and pain relief once per day using a diary provided in the study package. One week after their surgery, they will return to the hospital clinic and be seen by the study nurse. They will hand over the diary and any unused medication. They will also be asked several questions regarding their overall satisfaction, incidence of side effects, and how long until they were pain free. The risks of participating in this study are minimal from the risks inherent to the procedures and medications the patients would receive within the standard of care. Ibuprofen is a commonly used NSAID which is widely available over the counter and has an established safety profile. The most common adverse effects of ibuprofen and other NSAIDs are gastrointestinal bleeding and ulceration. Other less common adverse effects include nephrotoxicity, hypersensitivity reactions, hepatic dysfunction (longterm use), and cognitive dysfunction. The investigators' patients will be selected to exclude those most at risk for these complications (see exclusion criteria). Acetaminophen has few side effects, with no adverse effects on platelet function and no evidence of gastric irritation.
OTC NCT00267293 ↗ Ibuprofen Alone and in Combination With Acetaminophen for Treatment of Fever Completed Children Youth and Family Consortium Phase 4 2006-01-01 Currently, when a child has fever either ibuprofen (e.g. Motrin, Advil) or acetaminophen (e.g. Tylenol) is given. Both Ibuprofen and Acetaminophen are approved for over the counter use for treatment of fever by the Food and Drug Administration (FDA). This study hopes to determine whether giving both medications together is better than giving one medication alone for the treatment of fever.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for ACETAMINOPHEN AND IBUPROFEN

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00006299 ↗ Celebrex for Pain Relief After Oral Surgery Completed National Institute of Dental and Craniofacial Research (NIDCR) Phase 2 1999-12-01 This study will evaluate the effects of the new anti-inflammatory drug, Celebrex, on relieving pain after oral surgery. It is also designed to assess the drug's selective inhibition of a chemical called cyclooxygenase-2 and not its closely related form, cyclooxygenase-1. This selective inhibition allows pain alleviation without the adverse side effects (e.g., bleeding and stomach upset) often associated with anti-inflammatory drugs. Healthy volunteers who require removal of their third molars are eligible for this study. Participants will have oral surgery for tooth extraction after receiving a local anesthetic (lidocaine) in the mouth and a sedative (midazolam) through an arm vein. On the evening before and 1 hour before surgery, patients will be given a dose of either the standard anti-inflammatory drug ibuprofen (Advil, Nuprin, Motrin), or Celebrex, or a placebo (a pill with no active ingredient). After surgery, a small piece of tubing will be placed in each extraction site and tied to an adjacent tooth to hold it in place. Samples will be collected from the tubing to measure chemicals involved in pain and inflammation. Patients will stay in the clinic for up to 6 hours after surgery while the anesthetic wears off and will complete pain questionnaires. During that time, they may receive acetaminophen plus codeine (Tylenol 3), if needed, for pain. The tubing then will be removed and the patient discharged with standard pain medication.
NCT00110474 ↗ Glucosamine Unum In Die [Once A Day] Efficacy (GUIDE) Trial: Glucosamine Sulfate in Patients With Knee Osteoarthritis Completed Rottapharm Phase 3 2000-05-01 The primary objective of this study is to evaluate the efficacy and safety of glucosamine sulfate versus placebo on the symptoms of knee osteoarthritis after 6 months of treatment, using acetaminophen as a reference symptomatic medication.
NCT00129506 ↗ Comparing Methotrexate Followed by Misoprostol to Misoprostol Alone for Early Abortion Completed Ibis Reproductive Health Phase 4 2005-05-01 Background: In most countries in which abortion is legal, medical abortions are induced with mifepristone and misoprostol. Since mifepristone is expensive and unavailable in many countries, it is important to find other regimens. Methotrexate, which is used with misoprostol in Canada, is also difficult to obtain in many countries. Misoprostol is inexpensive and available in almost all countries. A report from Nigeria found that 98% of 100 women aborted within 24 hours of using misoprostol given both sublingually and vaginally. Method: This will be a randomized controlled trial of the usual regimen used in Canada, methotrexate 50 mg/m2 intramuscularly (IM) followed three days later by 800 mcg vaginal misoprostol to the Nigerian regimen of 400 mcg sublingual misoprostol with 400 mcg vaginal misoprostol. The main outcome measure will be a completed abortion within the first week with secondary outcome measures including total surgery rate, time to abortion, complications, pain, side effects and patient satisfaction. Rationale: If the investigators can find an inexpensive, easily available, method of medical abortion, it will save many lives in third world countries.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for ACETAMINOPHEN AND IBUPROFEN

Condition Name

Condition Name for ACETAMINOPHEN AND IBUPROFEN
Intervention Trials
Pain 31
Pain, Postoperative 25
Postoperative Pain 19
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Condition MeSH

Condition MeSH for ACETAMINOPHEN AND IBUPROFEN
Intervention Trials
Pain, Postoperative 72
Acute Pain 17
Toothache 14
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Clinical Trial Locations for ACETAMINOPHEN AND IBUPROFEN

Trials by Country

Trials by Country for ACETAMINOPHEN AND IBUPROFEN
Location Trials
United States 356
Canada 36
Brazil 4
Israel 3
Norway 3
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Trials by US State

Trials by US State for ACETAMINOPHEN AND IBUPROFEN
Location Trials
California 34
New York 25
Pennsylvania 21
Texas 20
North Carolina 15
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Clinical Trial Progress for ACETAMINOPHEN AND IBUPROFEN

Clinical Trial Phase

Clinical Trial Phase for ACETAMINOPHEN AND IBUPROFEN
Clinical Trial Phase Trials
PHASE4 11
PHASE3 8
PHASE2 3
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Clinical Trial Status

Clinical Trial Status for ACETAMINOPHEN AND IBUPROFEN
Clinical Trial Phase Trials
Completed 127
Recruiting 54
Not yet recruiting 25
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Clinical Trial Sponsors for ACETAMINOPHEN AND IBUPROFEN

Sponsor Name

Sponsor Name for ACETAMINOPHEN AND IBUPROFEN
Sponsor Trials
Johnson & Johnson Consumer and Personal Products Worldwide 8
Lawson Health Research Institute 8
Montefiore Medical Center 7
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Sponsor Type

Sponsor Type for ACETAMINOPHEN AND IBUPROFEN
Sponsor Trials
Other 305
Industry 70
U.S. Fed 14
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Clinical Trials Update, Market Analysis, and Projection for Acetaminophen and Ibuprofen

Last updated: October 28, 2025


Introduction

Acetaminophen (paracetamol) and ibuprofen are among the most widely used over-the-counter medications globally, primarily for their analgesic and antipyretic properties. Although their market dominance remains undisputed, recent developments in clinical research, evolving market dynamics, and regulatory shifts have prompted a thorough reassessment of their current landscape and future trajectory. This report provides an up-to-date overview of clinical trials, analyzes market trends, and projects the future outlook for these essential drugs.


Clinical Trials Landscape

Recent Clinical Developments

While acetaminophen and ibuprofen have long been established as safe and effective, emerging safety concerns and new therapeutic applications have spurred ongoing clinical research. Notably:

  • Acetaminophen:
    Recent clinical trials focus on its hepatotoxicity risks, especially at higher doses or prolonged use. For example, the FDA-approved phase IV post-marketing studies aim to better delineate safe dosage thresholds, particularly in vulnerable populations such as children and those with pre-existing liver conditions. Additionally, studies are exploring its potential neuroprotective effects and utility in pediatric fever management during infectious disease outbreaks.

  • Ibuprofen:
    Trials are investigating its anti-inflammatory properties beyond pain relief, including potential roles in managing COVID-19-related cytokine storms. Notably, the RECOVERY trial in the UK examined low-dose ibuprofen's efficacy in COVID-19 patients, with findings suggesting limited benefit but ongoing research continues into synergistic therapies. Furthermore, studies on long-term use address gastrointestinal and cardiovascular safety, especially in chronic settings.

Ongoing Clinical Trials (2022-2023)

Based on major clinical trial registries such as ClinicalTrials.gov:

  • Over 150 active studies involving acetaminophen or ibuprofen are registered globally, with a focus on safety profiling, pediatric use, and novel delivery systems.
  • Major pharmaceutical players, including Johnson & Johnson and Pfizer, are investigating combination formulations aiming to optimize efficacy and reduce side effects.
  • Regulatory agencies are emphasizing real-world evidence collection, especially pertaining to OTC use and overdose risks, influencing ongoing clinical assessments.

Market Dynamics and Analysis

Global Market Size

The combined global market for acetaminophen and ibuprofen was valued at approximately $5.8 billion in 2022, with an expected compound annual growth rate (CAGR) of 4.2% over the next five years, reaching roughly $7.4 billion by 2028 ([1]).

  • Acetaminophen: Dominates the OTC analgesic market globally, especially in North America and Asia-Pacific, accounting for about 65% of the combined sales, driven by its widespread use in pain relief and fever management.
  • Ibuprofen: Holds a significant share in both OTC and prescription segments, especially in Europe and North America, where chronic and acute inflammatory conditions are prevalent.

Market Drivers

Key drivers include:

  • Rising global prevalence of pain and fever-related conditions: An aging population and increased incidence of chronic inflammatory diseases sustain high demand.
  • Over-the-counter availability: Ease of access enhances consumption, though regulatory scrutiny may modify sales patterns.
  • Product innovation: The development of combination therapies and sustained-release formulations broadens the application spectrum.
  • Pandemic impact: COVID-19 increased demand temporarily due to fever management, though long-term effects are uncertain.

Market Challenges

  • Safety concerns about hepatotoxicity (acetaminophen) and gastrointestinal/cardiovascular risks (ibuprofen) have prompted regulatory review and consumer awareness campaigns.
  • Regulatory constraints: Stricter dosing limits and label revisions in the US, EU, and Asia aim to mitigate overdose risks, potentially influencing market volume.
  • Generic penetration: Market saturation with generics limits pricing power, although branding and product differentiation remain strategies for market share expansion.

Future Market Projections

Growth Outlook (2023-2028)

Based on current trends, the acetaminophen and ibuprofen market is poised for steady growth fueled by new formulations and expanding indications:

  • Innovation in delivery systems: Transdermal patches, effervescent tablets, and multi-symptom formulations are expected to attract aging populations and pediatric consumers.
  • Emerging Markets: Asia-Pacific will lead growth, with regional markets expanding at a CAGR exceeding 5%, driven by urbanization and improved healthcare infrastructure.
  • Regulatory Environment: Increased safety oversight may hinder volume growth slightly but will promote reformulation and alternative delivery pathways, maintaining overall market vitality.

Strategic Opportunities

  • Personalized medicine: Tailoring dosages to individual risk profiles can differentiate products amidst safety concerns.
  • Non-prescription to prescription crossover: Pharmaceuticals with enhanced safety profiles could transition from OTC to prescription status, expanding market boundaries.
  • Digital health integration: Incorporating consumer education and adherence monitoring via digital tools can improve safety outcomes and brand loyalty.

Implications for Stakeholders

  • Pharmaceutical Manufacturers: The focus should remain on safety innovations, expanding therapeutic indications, and optimizing formulations for specific patient populations.
  • Regulators: Enhanced safety surveillance and clear labeling protocols will shape market access and consumer confidence.
  • Investors: The stability of acetaminophen and ibuprofen markets persists, but differentiating factors like formulation innovation and geographic expansion offer growth avenues.

Key Takeaways

  • Clinical research continues to refine safety and expand therapeutic applications, influencing regulatory policies.
  • The global market for acetaminophen and ibuprofen remains robust, with moderate growth prospects driven by demographic shifts and innovation.
  • Safety concerns are paramount; companies investing in safer, targeted formulations will gain competitive advantage.
  • Emerging markets offer significant growth potential, particularly in Asia-Pacific.
  • Product differentiation and digital health integration will play crucial roles in future success.

FAQs

1. How are safety concerns impacting the acetaminophen and ibuprofen markets?
Safety concerns, particularly hepatotoxicity for acetaminophen and gastrointestinal and cardiovascular risks for ibuprofen, have prompted stricter dosing regulations and labeling requirements, which may limit volume but encourage innovation in safer formulations.

2. What recent clinical trial findings have influenced the use of these drugs?
Recent trials underscore the risks associated with high-dose or chronic use, leading to regulatory modifications. Conversely, ongoing studies exploring new indications and delivery methods may expand their utility.

3. How is the COVID-19 pandemic affecting the demand for acetaminophen and ibuprofen?
Peak demand occurred during the pandemic's early phase due to fever management; however, long-term effects are uncertain as public health strategies evolve and safety concerns are addressed.

4. What markets are expected to experience the highest growth?
The Asia-Pacific region is poised for significant expansion, driven by economic growth, rising healthcare access, and increased awareness of OTC medications.

5. What innovations are emerging in the formulation of these drugs?
Innovations include transdermal patches, sustained-release tablets, combination therapies, and targeted delivery systems aimed at improving safety profiles and prolonging therapeutic effects.


References

[1] Market Research Future, "Global Pain Management Market," 2022.

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