Combination of tramadol with paracetamol in pain pharmacotherapy – when, for whom and why? Review article
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Abstract
It is rare for pain to be caused by a single mechanism. It is obvious that no single analgesic can fully modify multiple mechanisms of pain development. Analgesics with different mechanisms of action are effective because they activate multiple pain-inhibiting pathways and cause more effective and optimal pain control. One of the most frequently used combination drugs in pain pharmacotherapy is the combination of tramadol and paracetamol. This is an example of hyperadditive synergism, and the drug is used in many therapeutic indications.
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Woroń , J. (2024). Combination of tramadol with paracetamol in pain pharmacotherapy – when, for whom and why?. Medycyna Faktow (J EBM). Retrieved from https://journalsmededu.pl/index.php/jebm/article/view/3186
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References
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2. Sahbaie P, Shi X, Guo TZ et al. Role of substance P signaling in enhanced nociceptive sensitization and local cytokine production after incision. Pain. 2009; 145(3): 341-9.
3. Cepeda MS, Camargo F, Zea C et al. Tramadol for osteoarthritis. Cochrane Database Syst Rev. 2006; 3: 005522.
4. Bianchi M, Broggini M, Balzarini P et al. Effects of tramadol on synovial fuid concentrations of substance P and interleukin-6 in patients with knee osteoarthritis: comparison with paracetamol. Int Immunopharmacol. 2003; 3(13-14): 1901-8.
5. Schou WS, Ashina S, Amin FM et al. Calcitonin gene-related peptide and pain: a systematic review. J Headache Pain. 2017; 18(1): 34.
6. Smith H, Elliott J. Alpha2 receptors and agonists in pain management. Curr Opin Anesthesiol. 2001; 14(5): 513-8.
7. Rawal N, Macquaire V, Catala E et al. Tramadol/paracetamol combination tablet for postoperative pain following ambulatory hand surgery: a double-blind, double-dummy, randomized, parallel-group trial. J Pain Res. 2011; 4: 103-10.
8. Filitz J, Ihmsen H, Gunther W et al. Supra-additive effects of tramadol and acetaminophen in a human pain model. Pain. 2008; 136(3): 262-70.
9. Mullican WS, Lacy JR: Tramadol/acetaminophen combination tablets and codeine/acetaminophen combination capsules for the management of chronic pain: a comparative trial. Clin Ther. 2001; 23(9): 1429-45.
10. Bazire S. Psychotropic Drug Directory. Lloyd-Reinhold Publications, London 2021.
11. Shear NH. Drug Eruption &Reaction Manual. CRC Press, Boca Raton 2021.