Trado-Plus
Generic Name
Tramadol Hydrochloride & Paracetamol
Manufacturer
Example Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| trado plus 325 mg tablet | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Trado-Plus 325 mg Tablet is a combination medicine containing Tramadol Hydrochloride and Paracetamol. It is used for the management of moderate to severe pain.
Uses & Indications
Dosage
Adults
Recommended dose is 1 to 2 tablets every 4 to 6 hours as needed, not exceeding 8 tablets (300 mg Tramadol / 2600 mg Paracetamol) in 24 hours.
Elderly
Dosage adjustment may be necessary in elderly patients (>75 years) due to reduced renal function; generally, not to exceed 2 tablets per dose and total daily dose.
Renal_impairment
Dose interval should be extended to every 12 hours in patients with creatinine clearance less than 30 mL/min. Not recommended for patients with severe renal impairment.
How to Take
Oral administration. Tablets can be taken with or without food. Swallow whole with a glass of water, do not crush or chew.
Mechanism of Action
Tramadol is a centrally acting synthetic opioid analgesic. It binds to µ-opioid receptors and inhibits reuptake of norepinephrine and serotonin, which contributes to its analgesic effect. Paracetamol produces analgesia by inhibiting prostaglandin synthesis in the central nervous system and peripherally by blocking pain impulse generation.
Pharmacokinetics
Onset
Within 30-60 minutes
Excretion
Tramadol: Excreted primarily via the kidneys (90%). Paracetamol: Excreted mainly by the kidneys as glucuronide and sulfate conjugates.
Half life
Tramadol: ~5-7 hours. Paracetamol: ~2-3 hours.
Absorption
Tramadol: Rapidly and almost completely absorbed. Bioavailability is about 75%. Paracetamol: Rapidly and almost completely absorbed from the GI tract.
Metabolism
Tramadol: Metabolized in the liver by CYP2D6 and CYP3A4 to O-desmethyltramadol (active) and other metabolites. Paracetamol: Primarily metabolized in the liver by conjugation with glucuronide and sulfate, and via CYP2E1 to a toxic intermediate (NAPQI) detoxified by glutathione.
Side Effects
Contraindications
- Hypersensitivity to tramadol, paracetamol, or any component
- Acute intoxication with alcohol, hypnotics, analgesics, opioids, or psychotropic drugs
- Patients receiving MAO inhibitors or within 14 days of discontinuing them
- Severe hepatic impairment
- Epilepsy not controlled by treatment
Drug Interactions
Carbamazepine
Significantly reduces tramadol plasma levels, reducing analgesic effect.
MAO Inhibitors
Increased risk of serotonin syndrome and seizures.
Warfarin and coumarin derivatives
Reports of increased INR/prothrombin time with paracetamol, especially with prolonged use.
Serotonergic Drugs (e.g., SSRIs, SNRIs)
Increased risk of serotonin syndrome.
CNS Depressants (e.g., alcohol, benzodiazepines)
Increased risk of respiratory depression, sedation, coma, and death.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms: Nausea, vomiting, abdominal pain (paracetamol overdose); respiratory depression, seizures, coma, miosis (tramadol overdose). Management: Gastric lavage, activated charcoal. Naloxone for tramadol-induced respiratory depression. N-acetylcysteine (NAC) for paracetamol overdose, administered promptly.
Pregnancy & Lactation
Pregnancy Category C. Not recommended during pregnancy, especially in the third trimester, due to risk of neonatal withdrawal syndrome. Excreted in breast milk; use with caution or avoid during lactation due to potential for infant sedation/respiratory depression.
Side Effects
Contraindications
- Hypersensitivity to tramadol, paracetamol, or any component
- Acute intoxication with alcohol, hypnotics, analgesics, opioids, or psychotropic drugs
- Patients receiving MAO inhibitors or within 14 days of discontinuing them
- Severe hepatic impairment
- Epilepsy not controlled by treatment
Drug Interactions
Carbamazepine
Significantly reduces tramadol plasma levels, reducing analgesic effect.
MAO Inhibitors
Increased risk of serotonin syndrome and seizures.
Warfarin and coumarin derivatives
Reports of increased INR/prothrombin time with paracetamol, especially with prolonged use.
Serotonergic Drugs (e.g., SSRIs, SNRIs)
Increased risk of serotonin syndrome.
CNS Depressants (e.g., alcohol, benzodiazepines)
Increased risk of respiratory depression, sedation, coma, and death.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms: Nausea, vomiting, abdominal pain (paracetamol overdose); respiratory depression, seizures, coma, miosis (tramadol overdose). Management: Gastric lavage, activated charcoal. Naloxone for tramadol-induced respiratory depression. N-acetylcysteine (NAC) for paracetamol overdose, administered promptly.
Pregnancy & Lactation
Pregnancy Category C. Not recommended during pregnancy, especially in the third trimester, due to risk of neonatal withdrawal syndrome. Excreted in breast milk; use with caution or avoid during lactation due to potential for infant sedation/respiratory depression.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved by drug regulatory authorities (e.g., FDA, DGDA)
Patent Status
Generic available, original patent expired
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of tramadol/paracetamol combination for moderate to severe pain relief. Post-marketing surveillance continues to monitor long-term effects.
Lab Monitoring
- Liver function tests (especially with chronic use)
- Renal function tests
- Prothrombin time/INR (if on warfarin)
Doctor Notes
- Assess patient history for opioid abuse or dependence before prescribing.
- Educate patients on the risks of addiction and overdose.
- Monitor for signs of respiratory depression, especially during initiation or dose escalation.
- Advise against concomitant use of alcohol and other CNS depressants.
Patient Guidelines
- Do not exceed the recommended dose.
- Avoid alcohol while taking this medicine.
- Inform your doctor about all other medications you are taking.
- Do not stop taking this medicine suddenly without consulting your doctor, especially after prolonged use, to avoid withdrawal symptoms.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
May cause dizziness, drowsiness, or blurred vision. Do not drive or operate heavy machinery until you know how this medicine affects you.
Lifestyle Advice
- Manage chronic pain with a holistic approach including physical therapy, exercise, and stress reduction techniques.
- Maintain good hydration.
- Avoid activities requiring mental alertness until you know how the medicine affects you.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.