Sometimes the pain we experience is so severe that we can't bear it, right? There are times when even ordinary painkillers don't reduce the pain. Today, we are going to talk about a special medicine that doctors prescribe to control such severe pain. This contains a combination of two drugs called Tramadol and Acetaminophen. Acetaminophen is the same as the paracetamol we all know.
What really happens with this medicine?
Simply put, this is a strong painkiller. It is prescribed especially when other painkillers cannot control it, or when you cannot tolerate other painkillers. The tramadol part in this belongs to the opioid class of strong painkillers . It goes directly to the brain and stops the pain signals from traveling. The paracetamol part also helps reduce pain and fever. When these two are combined, you get good pain relief. This medicine can be found in the market under brands like Ultracet.
Things you should definitely tell your doctor before taking the medicine
Since this is a very strong medicine, it is very important to inform your doctor about any other medical conditions you have. If you have any of the following, be sure to tell them before starting this medicine.
| Disease or condition | Why is that important? |
|---|---|
| A brain tumor or head injury | This medicine can increase pressure in the brain. |
| Frequent drinking | Liver damage and other side effects can be very serious. |
| Kidney disease or difficulty urinating | The drug may be delayed in leaving the body and may increase side effects. |
| Lung disease, asthma, or breathing difficulties | This medicine can be dangerous because it can slow breathing. |
| Decreased function of the adrenal gland | This situation could get worse. |
| Seizures | This medicine may increase the risk of seizures. |
| Substance use disorder | This is also a drug that can be addictive, so the risk is high. |
| Taking MAOI medications (such as Marplan, Nardil, Parnate) in the past 14 days | This can cause a very dangerous reaction. |
| Pregnancy or trying to get pregnant, and breastfeeding | Medical advice is essential as this can affect the baby. |
| Allergy to other medicines, foods or substances | Please inform us if you are allergic to tramadol, paracetamol or anything else. |
How should I use this medicine?
Take only the prescribed dose as prescribed by your doctor. Swallow the tablet with a full glass of water. If you experience stomach upset, take it with food or a glass of milk. Never take more than your doctor tells you to.
Use for children
This medicine is not given to children under 12 years of age. Also, this medicine is not given to children under 18 years of age after surgery to remove the tonsils or adenoids, because it can cause severe breathing problems.
Most importantly: This medicine is prescribed for you only. Do not give the same medicine to someone else who is in pain as you. It is very dangerous.
What to do if you overdose ?
If you think you have taken too much medicine, contact the National Poisons Information Centre at the Colombo National Hospital immediately. Or go to the Emergency Department (ETU) of the nearest hospital. Do not wait until symptoms appear. Taking too much paracetamol can cause serious liver damage.
Special points to be aware of when taking the medicine
- If the pain does not go away: Tell your doctor if your pain does not go away, if it gets worse, or if you have a new type of pain.
- Tolerance: After taking this medication for a while, the pain may not be relieved by the previous dose. This is called tolerance. This means that a slightly higher dose is needed to control the pain. This is normal. But talk to your doctor about it.
- Addiction and stopping the medication: Your body gets used to this medication. But that doesn't mean you're "addicted" to it. Addiction is when you use the medication without a medical reason. You have a medical reason for taking the medication because you're in pain. Never stop taking this medication suddenly. Doing so can cause severe withdrawal symptoms. If you need to stop taking the medication, your doctor will gradually reduce the dose.
- Be careful with paracetamol: This medicine already contains paracetamol (Acetaminophen). Therefore, do not take other medicines like paracetamol or Panadol for fever or other pain. Doing so may increase the paracetamol level and cause liver damage.
Warning: Avoid taking other medicines containing paracetamol at the same time. Read the medicine leaflet carefully. If in doubt, ask your doctor.
- Driving and operating machinery: This medicine may make you feel sleepy, dizzy, or have difficulty thinking clearly. Therefore, avoid driving or operating machinery until you know how this medicine affects you.
- Constipation: Constipation is a common side effect of this medication. If you have not had a bowel movement for 3 days, tell your doctor. This can be controlled by eating fiber-rich foods, fruits, vegetables, and drinking plenty of water.
Possible side effects of the medicine
Like all medications, this one can have side effects. Some are minor, but others require immediate attention.
| Serious side effects that should be reported to your doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Slow breathing (CNS depression) | Slow or shallow breathing, excessive sleepiness, unconsciousness, difficulty waking up. |
| Liver injury | Pain in the upper right side of the stomach, loss of appetite, nausea, yellowing of the skin or eyes, dark yellow/brown urine. |
| Low blood pressure | Dizziness, fainting, blurred vision. |
| Severe skin reactions | Redness of the skin, blistering, peeling of the skin (even inside the mouth), and fever with rash . |
| Seizures | A sudden seizure. |
| Common side effects that should be reported to the doctor if they persist or are bothersome | |
| Constipation | Dizziness |
| Drowsiness | Dry mouth |
| Headache | Nausea/Vomiting |
How to store and dispose of medicine safely?
This is very important. Do not leave this medicine where children and pets can get it. It can be fatal if someone else drinks it by mistake. Therefore, keep it in a safe place that can be protected from theft.
Expired or no longer needed medications should be disposed of properly.
- Some pharmacies or hospitals have programs that accept old medications. Check them out.
- If that's not possible, take the pills out of the bottle, mix them with something like used coffee grounds, soil, or cat litter, put them in a tightly sealed bag, and throw them in the trash. Never flush this medication down the toilet.
Take-Home Message
- This is a strong medicine that should only be taken for severe pain and only under medical advice.
- Before starting the medication, tell your doctor about all the medications you are taking and all the illnesses you have.
- Avoid drinking alcohol completely while taking this medicine.
- Never take more than the dose prescribed by your doctor. Do not take other medicines containing paracetamol with this medicine.
- If you experience a severe side effect, such as excessive drowsiness or difficulty breathing, go to a hospital immediately.
- Store the medicine in a safe place out of the reach of children and pets.
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