dexketoprofen + tramadol: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
dexketoprofen + tramadol: clinical details
Prescribing considerations
- Confirm that acute pain requires both an NSAID and an opioid rather than either component alone.
- Assess gastrointestinal, renal, hepatic, cardiovascular, respiratory and seizure risks.
- Review concurrent NSAIDs, opioids, anticoagulants, serotonergic medicines and central nervous system depressants.
- Discuss tolerance, dependence, withdrawal and opioid use disorder.
- Use particular caution in older adults and in mild renal or hepatic impairment; the product is not established for children or adolescents.
Contraindications and cautions
- Hypersensitivity to either component, another NSAID or relevant excipients, including previous NSAID-triggered asthma or angioedema.
- Active or previous gastrointestinal ulceration, haemorrhage or perforation; active bleeding or coagulation disorders.
- Crohn's disease, ulcerative colitis or chronic dyspepsia.
- Severe heart failure, moderate-to-severe renal impairment, severe hepatic impairment or severe dehydration.
- Uncontrolled epilepsy, severe respiratory depression or acute intoxication with alcohol, opioids, hypnotics, analgesics or psychotropic medicines.
- Concurrent or recent MAO-inhibitor treatment.
- Pregnancy and breastfeeding.
Monitoring
- Pain response and continuing need for both components.
- Sedation, respiratory depression, confusion and sleep-related breathing symptoms.
- Gastrointestinal bleeding, ulceration or severe abdominal symptoms.
- Renal function and hydration in at-risk patients; blood pressure, oedema and cardiovascular symptoms where relevant.
- Liver tests if hepatic symptoms occur or clinically relevant enzyme elevations are suspected.
- Serotonin toxicity, seizures, tolerance, withdrawal, dependence and opioid-seeking behaviour.
Clinical pharmacology
Dexketoprofen inhibits COX-1 and COX-2, reducing prostaglandin synthesis. Tramadol has opioid-receptor activity and inhibits noradrenaline and serotonin reuptake; its active O-desmethyl metabolite contributes to opioid activity.
Formulation and product differences
- The product is an oral film-coated tablet.
- Its score line facilitates breaking for swallowing but does not produce equal portions.
- It is described as essentially sodium-free.
dexketoprofen + tramadol preparations and strengths
Tablet
Route: Oral
Strengths: 75 mg + 25 mg
dexketoprofen + tramadol interactions
Check prescribed, pharmacy and recreational substances before use. Important interactions include:
Other NSAIDs, including ibuprofen, naproxen and anti-inflammatory-dose aspirin
Increased risk of gastrointestinal ulceration, bleeding and kidney injury.
Warfarin, heparins and antiplatelet medicines
Bleeding risk may increase and closer monitoring may be needed.
MAO inhibitors
Concurrent or recent use is contraindicated because serious central nervous system, breathing and cardiovascular reactions may occur.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.