paracetamol + tramadol at a glance
Medicine class
An opioid analgesic combined with a non-opioid analgesic.
Use
Symptomatic relief of moderate to severe pain requiring both components.
Administration
Swallow film-coated tablets whole with liquid; do not break or chew them.
Safety point
Do not add another paracetamol- or tramadol-containing product unless a clinician confirms it is appropriate.
What is paracetamol + tramadol used for?
The selected product is licensed for:
Symptomatic treatment of moderate to severe pain when tramadol and paracetamol are both considered necessary.
How does paracetamol + tramadol work?
Tramadol acts in the central nervous system through opioid-receptor activity and effects on noradrenaline and serotonin signalling. Paracetamol reduces pain through incompletely understood central and peripheral mechanisms.
paracetamol + tramadol preparations and strengths
Tablet
Route: Oral
Strengths: 37.5 mg + 325 mg
How to take paracetamol + tramadol
Follow the prescription label and supplied leaflet. The selected film-coated tablets are taken by mouth.
Swallow tablets whole with enough liquid; do not break or chew them.
Avoid alcohol, which can increase drowsiness and other opioid effects.
Check other painkillers, cold remedies and prescribed products for paracetamol or tramadol.
Do not stop suddenly after regular use without discussing this with the prescriber, as withdrawal symptoms can occur.
paracetamol + tramadol side effects
Common or expected effects
- Nausea or vomiting
- Dizziness or sleepiness
- Constipation, abdominal discomfort or dry mouth
- Headache or trembling
- Sweating or itching
- Confusion, altered mood, anxiety or sleep disturbance
Get urgent medical advice
- Slow, shallow or difficult breathing, extreme sleepiness or loss of consciousness
- Seizure
- Severe allergic reaction, including facial or throat swelling
- Serotonin syndrome, such as agitation or confusion with fever, sweating, diarrhoea, muscle jerking or poor coordination
- Severe or blistering skin reaction
- Signs of liver injury, including yellow skin or eyes
- Dependence, loss of control over use or significant withdrawal symptoms
paracetamol + tramadol in pregnancy
The selected product's SmPC states that this fixed combination should not be used during pregnancy. Contact the prescriber if pregnant, planning pregnancy or becoming pregnant during treatment. Do not stop regular tramadol abruptly without advice.
paracetamol + tramadol while breastfeeding
The selected product's SmPC advises against this fixed combination during breastfeeding. Tramadol can sometimes be used with caution after individual assessment, with monitoring of a full-term, healthy infant for unusual sleepiness, poor feeding, breathing difficulty, gastrointestinal effects and weight gain.
paracetamol + tramadol interactions
Important interactions include:
Other paracetamol- or tramadol-containing products
Increase the risk of accidental overdose and serious liver or opioid toxicity.
Monoamine oxidase inhibitors (MAOIs)
Contraindicated during treatment and for the specified washout period because severe serotonergic or central nervous system reactions may occur.
SSRIs, SNRIs, tricyclic antidepressants, mirtazapine and other serotonergic medicines
May increase the risk of serotonin syndrome and, for some medicines, seizures.
Common questions about paracetamol + tramadol
Answers are fully visible for fast scanning and source review.
Can I take this with ordinary paracetamol?
Not unless a clinician has checked the total exposure. Adding another paracetamol product can cause accidental overdose and delayed liver injury.
Can I drink alcohol?
Avoid alcohol because it can increase sleepiness, impaired coordination and respiratory depression.
Can it make me sleepy?
Yes. Sleepiness and dizziness are commonly reported. Do not drive or operate machinery if affected.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.