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This medication is used to help relieve moderate to moderately severe pain. Tramadol is similar to narcotic analgesics. It works in the brain to change how your body feels and responds to pain.
Paracetamol (acetaminophen) is a pain reliever and a fever reducer. Paracetamol is used to treat many conditions such as headache, muscle aches, arthritis, backache, toothaches, colds, and fevers.
Tramadol is a centrally acting opioid analgesic which binds to mu-opioid receptors and weakly inhibits the reuptake of norepinephrine and serotonin. Paracetamol, a para-aminophenol derivative, has analgesic, antipyretic and weak anti-inflammatory activity. Used together, tramadol and paracetamol combination has a faster onset of action compared to tramadol alone and longer duration of action compared to paracetamol alone.
AbsorptionTramadol: Readily absorbed from GI tract; mean absolute bioavailability 75-90%. Paracetamol: Readily absorbed from GI tract, peak plasma concentrations reached in 10-60 minutes.
DistributionTramadol: Widely distributed, crosses the placenta and distributes into the breast milk; protein binding: 20%. Paracetamol: Widely distributed; crosses placenta and distributes into breast milk; negligible protein binding.
MetabolismTramadol: Undergoes metabolism by the cytochrome P450 isoenzymes CYP3A4 and CYP2D6; one of the metabolites, O-desmethyltramadol is pharmacologically active. Paracetamol: Metabolised in liver.
ExcretionTramadol: Excreted via urine as metabolites (60%) and unchanged drug (30%); elimination half-life of O-desmethyltramadol: 7 hours. Paracetamol: Excreted mainly in urine as metabolites and unchanged drugs (<5%); elimination half life: 1-3 hours.
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