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N NERVOUS SYSTEM
N02 ANALGESICS

This group comprises general analgesics and antipyretics.

All salicylic acid derivatives except combinations with corticosteroids are classified in N02BA - Salicylic acid and derivatives, as it is difficult to differentiate between the use of salicylates in rheumatic conditions and other therapeutic uses of salicylates.

All plain ibuprofen preparations are classified in M01A, even if they are only intended for use as pain relief.

Salicylic acid derivatives in combination with corticosteroids are classified in M01B.

There are a number of combined preparations, which contain analgesics and psycholeptics. These are classified in N02, as pain relief must be regarded as the main indication. Analgesics used for specific indications are classified in the respective ATC groups. E.g.:

A03D/
A03EA - Antispasmodic/psycholeptics/analgesic combinations
M01 - Antiinflammatory and antirheumatic products
M02A - Topical products for joint and muscular pain
M03 - Muscle relaxants

See comments to these groups.

Lidocaine indicated for postherpetic pain is classified in N01BB.


N02B OTHER ANALGESICS AND ANTIPYRETICS

See general considerations under N02.

Combinations with opioid analgesics should be classified in N02A at separate 5th levels, using the corresponding 50-series (combinations excl. psycholeptics) or the 70-series (combinations with psycholeptics) or in N02AG - Opioids in combination with antispasmodics. Combinations with codeine or dihydrocodeine are, however, classified in this group if the codeine or dihydrocodeine content per unit dose is less than 20 mg. Otherwise these combinations are classified in N02AA.

Combinations with muscle relaxants are classified in M03B.

Combined preparations which contain more than one analgesic, should be classified by using the following ranking:

1. Phenacetin
2. Bucetin
3. Dipyrocetyl
4. Paracetamol
5. Acetylsalicylic acid
6. Phenazone
7. Salicylamide
8. Propyphenazone

This means that a product containing paracetamol and phenazone should be classified in N02BE51 - paracetamol, combinations excl. psycholeptics and not in N02BB51 - phenazone, combinations excl. psycholeptics.

Dextropropoxyphene plain, and in combination with other analgesics, is classified in N02AC.

Cold preparations with therapeutic levels of analgesics are classified in this group at separate 5th levels by using the 50-series.

Preparations are subdivided on 4th levels according to chemical structure.

Combinations with ascorbic acid (i.e. 50 mg or more per unit dose) are classified at separate 5th levels using the corresponding 50-series. Products containing less than 50 mg per unit dose are classified at the plain level of the analgesic component.

The DDDs are based on approved dose recommendations.

When establishing DDDs for combination products in the 50-series, all analgesic components are taken into consideration if the amount of each component is a therapeutic dose.
The DDD expressed in UD, should normally not exceed the approved dose recommendations for any of the components. See list of DDDs for combinations products, www.whocc.no.

For combination products with codeine (i.e. less than 20 mg per unit dose), the amount of codeine is not taken into account when assigning a DDD.


N02BA Salicylic acid and derivatives

All salicylic acid derivatives including some commonly regarded as non-steroid antiinflammatory drugs, e.g. diflunisal, are classified in this group. See comment under N02 - Analgesics.

Salicylic acid derivatives in combination with corticosteroids are classified in M01B. Acetylsalicylic acid preparations specifically intended for use as antithrombotic agents are classified in B01AC.



Lysine acetylsalicylate is classified at the same 5th level as acetylsalicylic acid.

Combinations with antiemetics are classified here.

The DDDs are based on the treatment of pain and not on use in rheumatic diseases.

DDDs for combined preparations, see N02B.


List of abbreviations

Last updated: 2013-12-19