Uses of Paratramol

☰ Table of content

1. What is Paratramol?

Paratramol belongs to the group of antipyretic, non-steroidal anti-inflammatory analgesics, treating bone and joint diseases and gout. Paratramol is manufactured by Pharmaceuticals Works Polpharma S.A - Poland, in the form of film-coated tablets, packaged in boxes of 1 blister x 10 tablets; boxes of 2 blisters x 10 tablets; boxes of 3 blisters x 10 tablets or boxes of 6 blisters x 10 tablets.

Each Paratramol tablet contains the following active ingredients:

Main active ingredients: Tramadol hydrochloride (37.5mg) and Paracetamol (325mg).

Other excipients (bare tablets): Microcrystalline cellulose (45.4mg), corn starch (36.1mg), Anhydrous colloidal silica (2.4mg), Sodium starch glycolate (type A - 28.8mg) and Magnesium stearate (4.8mg).

Excipients: Macrogol 400 (1.875mg), Hypromellose (9.375mg), Yellow iron oxide (E172 - 0.15mg) and Titandioxide (E171 - 3.6mg).

The main active ingredient Tramadol in Paratramol is a central analgesic, capable of binding the parent substance as well as the active metabolite M1 to the Mu-opioid receptor, while mildly inhibiting the reuptake of serotonin and norepinephrine in the nerve synaptic clefts. Meanwhile, Paracetamol acts as an analgesic and antipyretic that mainly affects COX in the central nervous system. Thanks to that, Paracetamol has the ability to quickly relieve pain and reduce fever, and also significantly reduces the adverse side effects on the kidneys. Because it mainly acts on COX and the central nervous system, Paracetamol does not have antiplatelet or anti-inflammatory effects like other NSAIDs.

Some experimental studies have shown that combining the two active ingredients above can have a synergistic effect.

2. Indications and contraindications for using Paratramol

2.1 Indications for using Paratramol

Paratramol is prescribed by doctors for the following cases:

• Treatment of headaches.
• Relief of toothache.
• Treatment of earache, joint pain.
• Fever reduction.
• Treatment of other moderate to severe pain.

2.2 Contraindications for using Paratramol

The following subjects should absolutely not use Paratramol without a doctor's prescription, including:

• People with a history of allergy or sensitivity to active ingredients such as Paracetamol, Tramadol or any other excipients in the drug.
• Patients with acute poisoning with sleeping pills, alcohol, opioids, centrally acting analgesics and psychoactive drugs.
• Paratramol is contraindicated in patients being treated with Monoamine oxidase inhibitors or within 14 days of stopping these drugs.
• Do not use Paratramol in patients with severe liver failure.
• Contraindicated in people with epilepsy or severe respiratory failure.
• Do not use the drug in patients with insufficient Glucose-6-phosphate dehydrogenase levels in the body.
• Patients under 15 years of age, pregnant women, women planning to become pregnant or breastfeeding should avoid using Paratramol without a doctor's prescription.

3. Dosage and how to use Paratramol

3.1 Recommended dosage of Paratramol

The treatment dose of Paratramol for pain relief and fever reduction will be determined specifically for each patient:

Paratramol dose for adults and adolescents over 15 years old:

Take a starting dose of 2 Paratramol tablets. The dose can be increased if necessary, but absolutely must not exceed 8 tablets (equivalent to Tramadol 300mg and Paracetamol 2600mg / day). According to recommendations, the interval between doses of Paratramol should be at least 6 hours and avoid using the drug for longer than the course prescribed by the doctor.
Depending on the level of pain and the patient's response to treatment, the dosage of Paratramol can be adjusted to a more reasonable level. In cases where repeated use or prolonged treatment is required due to the severity and nature of the disease, the doctor will recommend that the patient regularly monitor his or her health to decide whether or not to continue using the drug.

Paratramol dosage for elderly patients:

For patients aged 65 and over, Paratramol can be used at the same dose as adults and adolescents. Because the drug contains the active ingredient Tramadol, patients over 65 years old should ensure that the interval between doses is at least 6 hours.

3.2 Instructions for using Paratramol

Patients need to use Paratramol according to the doctor's instructions, and carefully check the information on the label to use the drug correctly. In addition, patients should not arbitrarily reduce the dose, increase the dose or prolong the use of the drug without proper instructions, because this can potentially cause many unwanted health risks.

Paratramol is prepared in tablet form and should be taken orally. Patients can take the medicine with or without food. It is best to take Paratramol with food to reduce stomach irritation, and swallow the whole tablet with a full glass of water to help the medicine move down to the stomach more easily.

3.3 How to handle Paratramol overdose

Overdose of Paratramol can lead to serious health problems for the patient. This is especially dangerous if the overdose is not detected and treated early.

If there are unusual signs after taking an overdose of Paratramol, the patient needs to be taken to a specialist unit for immediate treatment. The doctor will maintain the patient's airway and circulatory function.

In addition, before treating Paratramol overdose, the patient will also have a blood sample taken immediately to determine the concentration of Tramadol and Paracetamol in the plasma. Liver tests are then performed when the patient begins to overdose and can be repeated every 24 hours.

For Paratramol overdose, increased liver enzymes can be detected through liver tests. However, liver enzymes can return to normal levels after 1-2 weeks of treatment.

In addition to the above tests, the doctor will also perform some of the following traditional overdose treatment methods:

Empty the stomach by inducing vomiting through gastric lavage or gastric stimulation. However, this method is only applied when the patient is still conscious.

Apply some other supportive measures such as maintaining cardiovascular function, maintaining the airway, overcoming respiratory failure with Naloxone or controlling seizures with Diazepam.

The active ingredient Tramadol in Paratramol is removed in small amounts from the serum through peritoneal dialysis and hemodialysis. However, the treatment of acute Paracetamol poisoning by the above dialysis methods is not appropriate.

4. Side effects that may occur when using Paratramol

During the treatment of pain and fever with Paratramol, patients may accidentally encounter some of the following unwanted side effects:

• Arrhythmia (rare) such as tachycardia, palpitations or arrhythmia.
• Circulatory disorders (rare) such as hot flashes or high blood pressure.
• Nervous system disorders such as dizziness, vertigo, drowsiness (very common); tremor, headache (common); paresthesia, involuntary muscle contractions (rare); fainting, convulsions or ataxia (rare).
• Ear disorders such as tinnitus (rare).
• Eye disorders such as blurred vision (rare).
• Psychiatric disorders such as mood swings, confusion, sleep disorders (common); hallucinations, depression, forgetfulness, nightmares (rare); drug dependence (rare); drug abuse (very rare).
• Respiratory, mediastinal and thoracic disorders such as dyspnoea (rare).
• Gastrointestinal disorders such as nausea or vomiting (very common).
• Any of the side effects mentioned above can more or less affect the quality of life of patients being treated with Paratramol. Therefore, if you notice the presence of one of these symptoms, you should immediately notify a specialist for remedial measures.

5. Things to note when using Paratramol

5.1 What precautions should be taken when using Paratramol?

Before and during the entire treatment of pain and fever with Paratramol, patients need to be cautious of the following:

• The risk of increased dependence on drug tolerance for psychological and physical factors may occur at the therapeutic dose. The patient's clinical need for pain relief should also be periodically re-verified. For patients with a history of drug abuse or opioid dependence, Paratramol should only be used for a short time and should be closely monitored by a physician.
• Paratramol should be used with caution in patients with biliary disorders, traumatic brain injury, seizure disorders, shock, unexplained changes in consciousness, increased intracranial pressure, problems with the respiratory center or respiratory function.
• Overdose of Paratramol can lead to liver toxicity. At therapeutic doses, Tramadol has the risk of causing withdrawal symptoms, so patients need to be careful when using the drug.
• There is a risk of reactions when stopping the use of Paratramol, especially after a long period of treatment.
• Paratramol can cause dizziness or lightheadedness, even increased when used in combination with other central nervous system depressants or alcoholic beverages. Therefore, patients should not drive or operate machinery while taking Paratramol.

5.2 What drugs can Paratramol interact with?

The way Paratramol works and its effectiveness can be significantly changed or affected if used with the following drugs:

• Buprenorphine (pain reliever for chronic back pain or arthritis).
• Bupropion (treatment for depression, attention deficit hyperactivity disorder).
• Carbamazepine (anticonvulsant for people with epilepsy).
• Cimetidine (treatment for stomach ulcers).

To avoid the risk of interaction between Paratramol and any other drugs, patients need to inform their doctor of the list of drugs they are using, including herbs, health supplements or multivitamins. This will help the doctor assess the risk of interactions between drugs, thereby providing appropriate adjustments for the patient.

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