Paracetamol + Tramadol Hydrochloride

Paracetamol + Tramadol Hydrochloride is a opioid analgesic combination medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

Doctors prescribe Paracetamol + Tramadol Hydrochloride for the short-term relief of moderate to moderately severe pain, such as:

• Post-operative pain after surgery or dental procedures
• Injury pain — fractures, sprains and trauma
• Severe back pain or joint pain flare-ups not controlled by paracetamol or NSAIDs alone
• Cancer-related pain, as part of a doctor-led pain plan

Paracetamol + Tramadol Hydrochloride is meant for pain that genuinely needs an opioid-containing medicine, for the shortest time possible. It is not for mild everyday aches, and it must never be used casually or shared with others.

Paracetamol + Tramadol Hydrochloride is strictly prescription-only; your doctor decides the dose and duration. General adult information (tablets usually contain 325 mg paracetamol + 37.5 mg tramadol):

• Commonly 1–2 tablets every 6 hours as needed, up to a maximum of 8 tablets in 24 hours.
• Keep at least 6 hours between doses; use the lowest dose that controls the pain.
• Paracetamol limit: total paracetamol from ALL sources — including fever or pain medicines, cold remedies — must not exceed 4 g (4000 mg) per day. Do not take other paracetamol products alongside Paracetamol + Tramadol Hydrochloride.
• Elderly patients and those with kidney or liver problems need lower doses or longer gaps — the doctor will adjust.
• Not for children under 12 years.

After regular use for more than a few weeks, do not stop suddenly — tramadol withdrawal (restlessness, sweating, anxiety, insomnia) can occur; your doctor will taper it. Avoid alcohol completely and be cautious about driving.

Common side effects of Paracetamol + Tramadol Hydrochloride:

• Nausea and vomiting — the most frequent; taking it with food may help
• Dizziness, drowsiness and light-headedness
• Constipation, dry mouth
• Sweating, headache
• Itching in some people

Serious effects needing urgent care: very slow or shallow breathing, extreme sleepiness or unresponsiveness (overdose — especially with alcohol or sedatives); seizures (tramadol lowers the seizure threshold); agitation, fever, fast heartbeat and confusion with serotonergic drugs (serotonin syndrome); allergic swelling of face or throat; and paracetamol overdose — which may show few early symptoms but can destroy the liver. Never exceed the prescribed dose.

Key precautions with Paracetamol + Tramadol Hydrochloride:

• Dependence warning: tramadol is an opioid — with regular use beyond a few weeks, tolerance, craving and dependence can develop. Use strictly per prescription, never increase the dose yourself, never use it for sleep or mood, and never share it.
• Paracetamol limit: count ALL paracetamol sources; total must stay under 4 g/day to protect your liver.
• No alcohol — it increases drowsiness, breathing suppression and liver risk.
• Driving caution: avoid driving or operating machinery until you know how it affects you.
• Tell your doctor about epilepsy or past seizures, depression or antidepressant use, breathing problems, liver or kidney disease, or any history of substance misuse.
• After prolonged use, stop only by gradual tapering under medical guidance.

Tell your doctor about everything you take. Important interactions with Paracetamol + Tramadol Hydrochloride:

• Other paracetamol-containing products — risk of liver-damaging overdose; do not combine.
• Alcohol, benzodiazepines, sleeping pills and other sedatives — dangerous, potentially fatal breathing suppression.
• Antidepressants (SSRIs such as sertraline, SNRIs, tricyclics, mirtazapine) and triptans — raised risk of serotonin syndrome and seizures.
• MAO inhibitors — contraindicated; at least 14 days gap required.
• Carbamazepine — reduces tramadol's effect.
• Warfarin — bleeding tendency may increase; INR should be checked.
• Ondansetron — may reduce tramadol's pain relief.

Paracetamol + Tramadol Hydrochloride must not be used in:

• Allergy to paracetamol, tramadol, other opioids or any ingredient
• Acute intoxication with alcohol, sleeping pills, opioids or psychotropic drugs
• Treatment with MAO inhibitors now or within the last 14 days
• Severe liver disease
• Epilepsy not controlled by treatment
• Severe breathing problems
• Children under 12, and in breastfeeding when repeated dosing is needed
• As a substitute medicine in opioid withdrawal treatment

Pregnancy: Paracetamol + Tramadol Hydrochloride should not be used in pregnancy unless the doctor judges it absolutely necessary. Tramadol crosses the placenta; regular use can cause withdrawal symptoms in the newborn, and use near delivery can depress the baby's breathing. For pain in pregnancy, plain paracetamol at the correct dose is usually preferred — always ask your doctor first.

Breastfeeding: tramadol and paracetamol both pass into breast milk. A single dose is unlikely to harm, but repeated use is not recommended while breastfeeding — the infant may become unusually sleepy or feed poorly. Discuss safer pain-relief options with your doctor.

Store Paracetamol + Tramadol Hydrochloride below 30°C in a dry place, away from light and moisture, in its original packaging. Because it contains an opioid, keep it securely stored, out of the reach of children and of anyone it was not prescribed for — accidental ingestion by a child can be fatal. Do not use after the expiry date, and return unused tablets to a pharmacy instead of keeping them at home.