Meds and you

27 September 2013

Tramadol and paracetamol

The combination of tramadol and paracetamol is a potent analgesic. An analgesic is a substance which reduces or eliminates pain.

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Tramadol and paracetamol The combination of tramadol and paracetamol is the active ingredient of Tramacet (Nappi Code: 700243-002).

General information
The combination of tramadol and paracetamol is a potent analgesic. An analgesic is a substance which reduces or eliminates pain.

In South Africa this combination is registered for the short-term treatment of mild to moderate pain. It is also effective in reducing fever.

Paracetamol is the analgesic of choice for mild to moderate pain and to reduce fever, while tramadol is an opioid analgesic, effective in relieving pain that does not respond to paracetamol.

By combining tramadol with paracetamol, tramadol provides an additive analgesic effect. It should be used with caution in those patients with a history of alcohol or drug abuse as some risk of dependency does exist. It should be noted that pain is a symptom and not a disease, and although this combination may be useful for short-term pain management, long-term relief often requires treatment of the underlying cause. None of the ingredients in this combination cure the underlying condition responsible for pain or fever, but simply keep the symptoms under control.

A combination product such as this is helpful in reducing the number of tablets taken for pain management.

Because the combination of tramadol and paracetamol may cause dizziness, light-headedness and/or sedation, driving and any hazardous tasks should be avoided until you know how this medication affects you.

How does the combination of tramadol and paracetamol work?
Paracetamol blocks the production of chemicals in the body that are responsible for pain and fever, while tramadol exerts its effect by acting on parts of the central nervous system which process pain signals.

Fast facts

Drug schedule: schedule 5
Available as: the combination of tramadol and paracetamol is available as tablets.
What does it do? The combination of tramadol and paracetamol reduces pain.
Overdose risk: medium
Dependence risk: medium
Is this combination available as a generic? no
Is this combination available on prescription only? yes

User information Onset of effect: within 1 hour
Duration of action: up to 6 hours
Stopping this medicine: this medication can be safely stopped when no longer needed.
Prolonged use: the combination of tramadol and paracetamol is generally only prescribed for short-term use; prolonged use may increase likelihood of tolerance and may cause dependence.

Special precautions
Consult your doctor before using this drug if:

 

  • you have a head injury
  • you have a condition that makes breathing difficult
  • you have a liver or kidney disease
  • you have epilepsy
  • you have a history of alcoholism or substance abuse
  • you are being treated, or have been treated within the last 14 days, with a monoamine-oxidase inhibitor antidepressant

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.
Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.
Infants and children: this medication is not intended for use in children under the age of 16.
The elderly: caution is advised in the elderly as side effects may be more frequent.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

 

Side Effect
Frequency
Consult your doctor
 
Common
Rare
Only if severe
In all cases
drowsiness
X
 
X
 
dizziness
X
 
X
 
abdominal pain
 
X
X
 
nausea and vomiting
 
X
X
 
diarrhoea/constipation
 
X
X
 
dry mouth
 
X
X
 
sweating
 
X
X
 
urinary retention/dry mouth
 
X
X
 
low blood pressure
 
X
X
 
palpitations/change in heart rate
 
X
 
X
blurred vision
 
X
 
X
memory loss
 
X
 
X
seizures
 
X
 
X
skin rash
 
X
 
X
difficulty breathing
 
X
 
X
yellow-tinged skin and eyes
 
X
 
X

Interactions

 

atropine and related drugs increased risk of constipation, urinary retention, etc
drugs for diarrhoea increased risk of constipation
blood pressure medication increased risk of low blood pressure
carbamazepine reduced effect of tramadol
drugs that may cause sedation i.e. alcohol, benzodiazepines, barbiturates, opioids and antihistamines increased risk of sedation
cholestyramine reduced effect of paracetamol
isoniazid increased risk of paracetamol toxicity
metoclopramide, domperidone increased risk of paracetamol toxicity
oral contraceptives reduced effect of paracetamol
monoamine oxidase inhibitors increase risk of low blood pressure
bupropion, mefloquine, fluoxetine and other SSRI’s, amitriptyline and other tricyclic antidepressants increase risk of seizures
warfarin increased effect of warfarin

Disease interactions
Consult your doctor before using this drug if you have a head injury, asthma, a liver or kidney disease, epilepsy or if you have a history of alcoholism or substance abuse.

Overdose action
An overdose of this medication can be fatal. Seek immediate emergency medical attention.

Recommended dosage
Adults: oral, 2 tablets 4-6 hourly with a maximum daily dose of 8 tablets

 

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.
 
 

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