What is an example of a Tramacet (tramadol + acetaminophen) prescription?

From the Guidelines

Tramadol and acetaminophen, also known as Tramacet, is typically prescribed for moderate to moderately severe pain, with a recommended maximum daily dose of 400 mg for immediate-release formulations, which can be taken as 100 mg four times a day, and 300 mg/day for extended-release formulations, for adults with normal hepatic and renal function 1.

Key Points

• The recommended dose for Tramacet can be increased until the maximum dose is attained, but it is essential to consider the patient's hepatic and renal function to reduce the risk of seizures.
• Tramacet is available as immediate-release and extended-release formulations, and the choice of formulation depends on the patient's specific needs and medical history.
• The use of Tramacet should be cautious in patients taking other serotonergic or monoamine oxidase inhibitors (MAOI)-like medications due to the risk of serotonin syndrome.
• Tramacet is less potent than other opioids and is considered to be approximately one-tenth as potent as morphine.

Example Prescription

A typical prescription for Tramacet might be: Tramadol 37.5 mg/Acetaminophen 325 mg, taken 2 tablets every 4-6 hours as needed, not to exceed 8 tablets in 24 hours, with a maximum daily dose of 400 mg of tramadol and 2600 mg of acetaminophen 1.

Important Considerations

• Patients with moderate hepatic impairment should receive lower doses, and Tramacet should be avoided in patients with severe hepatic or renal impairment.
• The efficacy and safety of Tramacet have been demonstrated in comparative phase 2-3 studies, but more research is needed to fully understand its role in cancer pain management.
• Tramacet is just one example of a combination product containing an opioid and acetaminophen, and other options are available, including codeine, dihydrocodeine, and propoxyphene 1.

From the Research

Tramacet Prescription Example

• A typical Tramacet (tramadol + acetaminophen) prescription is a fixed-dose combination tablet of tramadol (37.5 mg) and acetaminophen (325 mg) 2, 3, 4, 5
• The recommended dosage is 2 tablets every 4 to 6 hours as needed for pain, with a maximum of 4 tablets per day 2, 5
• Tramacet is indicated for the symptomatic treatment of moderate to severe pain, including postoperative pain, musculoskeletal pain, and chronic pain conditions such as osteoarthritis and diabetic peripheral neuropathy 2, 6, 4

Key Characteristics

• Tramacet is a multimodal analgesic with a rapid onset of action and a longer duration of action compared to tramadol or acetaminophen alone 2, 4
• The combination of tramadol and acetaminophen provides additive or synergistic benefits in treating multiple mechanisms of pain 6
• Tramacet has been shown to be effective and generally well tolerated in patients with moderate to severe pain, with a tolerability profile similar to other active comparators 3, 4, 5

Clinical Efficacy

• Tramacet has been demonstrated to be effective in providing pain relief in adult patients with postoperative pain, musculoskeletal pain, and chronic pain conditions 2, 3, 4, 5
• The analgesic efficacy of Tramacet is generally similar to or better than that of other active comparators, including codeine/acetaminophen and ibuprofen 2, 3, 4, 5