Combination of tramadol with paracetamol in pain pharmacotherapy. Why is the soluble form of the drug so important in practice? Review article
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Published:
Mar 31, 2025
Keywords:
tramadol, paracetamol, pain, soluble forms
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Abstract
In clinical practice, pain is most often caused by complex pathophysiological mechanisms. 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 provide more effective and optimal pain control. Moreover, combinations of different analgesics, in addition to potentiating therapeutic effects, additionally reduce the risk of adverse effects in a patient with pain. One of the elements of effective pain pharmacotherapy is the selection of soluble forms of the drug in different patient populations.
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Woroń, J. (2025). Combination of tramadol with paracetamol in pain pharmacotherapy. Why is the soluble form of the drug so important in practice?. Medycyna Faktow (J EBM), 18(1(66), 47-51. https://doi.org/10.24292/01.MF.0125.07
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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 fluid 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.