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Paracetamol + tramadol: new preparation. No advance.
Prescrire Int. 2003 Dec; 12(68):211-3.PI

Abstract

(1) First-line treatment for both acute and chronic pain is paracetamol or, if necessary, ibuprofen, a nonsteroidal antiinflammatory drug. If relief is inadequate, the best option is a combination of paracetamol with codeine (a weak opiate). (2) A fixed-dose combination of paracetamol (325 mg) and tramadol (37.5 mg), a weak opiate, arrived on the French market in May 2003. (3) In the acute setting, three trials in a total of 1197 patients showed that a single dose of the paracetamol 650 mg + tramadol 75 mg combination after dental surgery was no more effective than ibuprofen 400 mg. Compared with each drug used alone, the paracetamol + tramadol combination prolongs the analgesic effect but does not increase its intensity. (4) A trial after gynaecological surgery and another trial after orthopaedic surgery showed that a single dose of paracetamol 975 mg + tramadol 112.5 mg had similar efficacy to tramadol alone at 112.5 mg. (5) In the chronic setting, we found no trials comparing the paracetamol + tramadol combination with each drug used alone. A comparative double-blind trial in 462 patients with low back pain or osteoarthritic pain showed no difference in efficacy between paracetamol 325 mg + tramadol 37.5 mg and paracetamol 300 mg + codeine 30 mg. (6) The main adverse effects of the paracetamol + tramadol combination are the same as other weak opiates: nausea, vomiting, dizziness, headache, drowsiness and constipation. Tramadol carries a higher risk of drug interactions than codeine. (7) In practice, the paracetamol + tramadol combination offers patients no advantages relative to standard analgesics.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

14986689

Citation

"Paracetamol + Tramadol: New Preparation. No Advance." Prescrire International, vol. 12, no. 68, 2003, pp. 211-3.
Paracetamol + tramadol: new preparation. No advance. Prescrire Int. 2003;12(68):211-3.
(2003). Paracetamol + tramadol: new preparation. No advance. Prescrire International, 12(68), 211-3.
Paracetamol + Tramadol: New Preparation. No Advance. Prescrire Int. 2003;12(68):211-3. PubMed PMID: 14986689.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Paracetamol + tramadol: new preparation. No advance. PY - 2004/2/28/pubmed PY - 2004/3/26/medline PY - 2004/2/28/entrez SP - 211 EP - 3 JF - Prescrire international JO - Prescrire Int VL - 12 IS - 68 N2 - (1) First-line treatment for both acute and chronic pain is paracetamol or, if necessary, ibuprofen, a nonsteroidal antiinflammatory drug. If relief is inadequate, the best option is a combination of paracetamol with codeine (a weak opiate). (2) A fixed-dose combination of paracetamol (325 mg) and tramadol (37.5 mg), a weak opiate, arrived on the French market in May 2003. (3) In the acute setting, three trials in a total of 1197 patients showed that a single dose of the paracetamol 650 mg + tramadol 75 mg combination after dental surgery was no more effective than ibuprofen 400 mg. Compared with each drug used alone, the paracetamol + tramadol combination prolongs the analgesic effect but does not increase its intensity. (4) A trial after gynaecological surgery and another trial after orthopaedic surgery showed that a single dose of paracetamol 975 mg + tramadol 112.5 mg had similar efficacy to tramadol alone at 112.5 mg. (5) In the chronic setting, we found no trials comparing the paracetamol + tramadol combination with each drug used alone. A comparative double-blind trial in 462 patients with low back pain or osteoarthritic pain showed no difference in efficacy between paracetamol 325 mg + tramadol 37.5 mg and paracetamol 300 mg + codeine 30 mg. (6) The main adverse effects of the paracetamol + tramadol combination are the same as other weak opiates: nausea, vomiting, dizziness, headache, drowsiness and constipation. Tramadol carries a higher risk of drug interactions than codeine. (7) In practice, the paracetamol + tramadol combination offers patients no advantages relative to standard analgesics. SN - 1167-7422 UR - https://www.unboundmedicine.com/medline/citation/14986689/Paracetamol_+_tramadol:_new_preparation__No_advance_ L2 - https://medlineplus.gov/pain.html DB - PRIME DP - Unbound Medicine ER -