Tramadol and Paracetamol

Narcotic Analgesic · Opiate analogue/Para-aminophenol derivative

Indications

Severe acute and chronic pain, diagnostic measures and surgical pain.

Dosage

Adults: 1-2 tab three to four times daily. Children: Not recommended.

Adverse Effects

Sweating, dizziness, nausea, vomiting, dry mouth, fatigue, somnolence, headache, trembling, confusion, mood changes, anxiety, nervousness, euphoria, sleep disorders, pruritus.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Acute intoxication with alcohol, hypnotics, analgesics or other CNS-acting drugs. Severe respiratory, renal or hepatic impairment. Uncontrolled epilepsy. Precautions: Mild renal or hepatic impairment. Risk of tolerance and dependence. Head injury, raised intracranial pressure, shock, impaired consciousness, biliary tract disorders, respiratory depression. History of convulsions. Withdraw gradually. Elderly.

Interactions

Alcohol, CNS depressants, MAOIs, ondansetron, buprenorphine, pentazocine, SSRIs, SNRIs, TCADs, mirtazapine, barbiturates, benzodiazepines, thalidomide, baclofen, warfarin, antipsychotics, triptans, bupropion, carbamazepine, ketoconazole, erythromycin and other CYP3A4 inhibitors and inducers.

Advice to Patient

Take with or without meals.

Pharmacokinetics

TRAMADOL: Onset of action: Immediate release: Within 1 hr; Peak effect: 2-3 hrs. Metabolism: Extensively hepatic. Bioavailability: Immediate release: Approx. 75%. Extended release: Approx. 85%-95% (as compared to immediate release). Half-life elimination: Immediate release: 6.3 ± 1.4 hrs; active metabolite (M1): 7.4 ± 1.4 hrs; prolonged in elderly. Extended-release: Cap: Approx. 10 hrs; active metabolite (M1): Approx. 11 hrs. Tab: Approx. 7.9 hrs; active metabolite (M1): 8.8 hrs. Time to peak, plasma: Immediate release: Approx. 2 hrs; active metabolite (M1): 3 hrs. Extended release: Approx. 4-12 hrs; active metabolite (M1): Approx. 5-15 hrs. Excretion: Urine (approx. 30% as unchanged drug; 60% as metabolites). PARACETAMOL: Onset of action: Oral: <1 hr. IV: Analgesia: 5-10 min. Antipyretic: Within 30 min. Peak effect: IV: Analgesic: 1 hr. Duration: IV, Oral: Analgesia: 4-6 hrs. IV:…

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.