Paratramol Dosage

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Dosage of Paratramol in details

infoThe dose of a drug and dosage of the drug are two different terminologies. Dose is defined as the quantity or amount of medicine given by the doctor or taken by the patient at a given period. Dosage is the regimen prescribed by the doctor about how many days and how many times per day the drug is to be taken in specified dose by the patient. The dose is expressed in mg for tablets or gm, micro gm sometimes, ml for syrups or drops for kids syrups. The dose is not fixed for a drug for all conditions, and it changes according to the condition or a disease. It also changes on the age of the patient.
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Adults and Children >16 years: 1-2 tablets every 4-6 hrs as needed for pain relief up to a maximum of 8 tablets/day.

Children: The safety and effectiveness of Paratramol has not been studied in the pediatric population (<16 years). Therefore treatment is not recommended in this population.

Elderly: Elimination of the active components may be prolonged in elderly patients >75 yrs. Therefore, if necessary the dosage interval may be extended according to the patients requirements.

Renal/Dialysis/Hepatic Insufficiency: The pharmacokinetics of the Tramadol (Paratramol)/Paracetamol (Paratramol) combination in patients with renal impairment have not been studied. Experience with Tramadol (Paratramol) suggests that impaired renal function results in a decreased rate and extent of excretion of Tramadol (Paratramol). In patients with creatinine clearance of <30 mL/min, it is recommended that the dosing interval of Paratramol be increased not to exceed 2 tablets every 12 hrs. The pharmacokinetics and tolerability of Paratramol in patients with impaired hepatic function has not been studied. Tramadol (Paratramol) and Paracetamol (Paratramol) are both extensively metabolized by the liver. The use of Paratramol in patients with severe hepatic impairment is not recommended.

The tablets should be taken whole, not divided or chewed, with sufficient liquid, without regard to food.

Paratramol should under no circumstances be administered for longer than absolutely necessary. If long-term pain treatment with Paratramol is necessary in view of the nature and severity of the illness, then careful and regular monitoring should be carried out (if necessary with breaks in treatment) to establish whether and to what extent further treatment is necessary.

What other drugs will affect Paratramol?

Cold or allergy medicine, sedatives, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by Tramadol (Paratramol). Tell your doctor if you regularly use any of these medicines, or any narcotic pain medicine.

The following drugs can interact with acetaminophen and Tramadol (Paratramol). Tell your doctor if you are using any of these:

  • carbamazepine (Carbatrol, Equetro, Tegretol);
  • warfarin (Coumadin, Jantoven);
  • digoxin (Lanoxin, Lanoxicaps);
  • ketoconazole (Nizoral);
  • erythromycin (E-Mycin, E.E.S., Ery-Tab);
  • rifampin (Rifadin, Rimactane, Rifater);
  • quinidine (Quin-G);
  • St. John's wort;
  • sumatriptan (Imitrex, Treximet) and other migraine headache medicines;
  • an antidepressant such as amitriptyline (Elavil), citalopram (Celexa), desipramine (Norpramin), fluoxetine (Prozac, Sarafem), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), or sertraline (Zoloft); or
  • drugs to treat high blood pressure or a prostate disorder, such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), terazosin (Hytrin), tamsulosin (Flomax).

This list is not complete and other drugs may interact with acetaminophen and Tramadol (Paratramol). Tell your doctor about all medications you use. This includes prescription, over the counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Paratramol interactions

infoInteractions are the effects that happen when the drug is taken along with the food or when taken with other medications. Suppose if you are taking a drug Paratramol, it may have interactions with specific foods and specific medications. It will not interact with all foods and medications. The interactions vary from drug to drug. You need to be aware of interactions of the medicine you take. Most medications may interact with alcohol, tobacco, so be cautious.
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CYP2D6 And CYP3A4 Inhibitors

Concomitant administration of CYP2D6 and/or CYP3A4 inhibitors, such as quinidine, fluoxetine, paroxetine, and amitriptyline (CYP2D6 inhibitors), and ketoconazole and erythromycin (CYP3A4 inhibitors), may reduce metabolic clearance of Tramadol (Paratramol), increasing the risk for serious adverse events including seizures and serotonin syndrome.

Serotonergic Drugs

There have been postmarketing reports of serotonin syndrome with use of Tramadol (Paratramol) and SSRIs/SNRIs or MAOIs and α2-adrenergic blockers. Caution is advised when Paratramol® is coadministered with other drugs that may affect the serotonergic neurotransmitter systems, such as SSRIs, MAOIs, triptans, linezolid (an antibiotic which is a reversible non-selective MAOI), lithium, or St. John's Wort. If concomitant treatment of Paratramol® with a drug affecting the serotonergic neurotransmitter system is clinically warranted, careful observation of the patient is advised, particularly during treatment initiation and dose increases.

Triptans

Based on the mechanism of action of Tramadol (Paratramol) and the potential for serotonin syndrome, caution is advised when Paratramol® is coadministered with a triptan. If concomitant treatment of Paratramol® with a triptan is clinically warranted, careful observation of the patient is advised, particularly during treatment initiation and dose increases.

Use With Carbamazepine

Patients taking carbamazepine may have a significantly reduced analgesic effect of Tramadol (Paratramol). Because carbamazepine increases Tramadol (Paratramol) metabolism and because of the seizure risk associated with Tramadol (Paratramol), concomitant administration of Paratramol® and carbamazepine is not recommended.

Use With Quinidine

Tramadol (Paratramol) is metabolized to M1 by CYP2D6. Quinidine is a selective inhibitor of that isoenzyme; so that concomitant administration of quinidine and Tramadol (Paratramol) results in increased concentrations of Tramadol (Paratramol) and reduced concentrations of M1. The clinical consequences of these findings are unknown. In vitro drug interaction studies in human liver microsomes indicate that Tramadol (Paratramol) has no effect on quinidine metabolism.

Potential For Other Drugs To Affect Tramadol (Paratramol)

In vitro drug interaction studies in human liver microsomes indicate that concomitant administration with inhibitors of CYP2D6 such as fluoxetine, paroxetine, and amitriptyline could result in some inhibition of the metabolism of Tramadol (Paratramol). Administration of CYP3A4 inhibitors, such as ketoconazole and erythromycin, or inducers, such as rifampin and St. John's Wort, with Paratramol® may affect the metabolism of Tramadol (Paratramol), leading to altered Tramadol (Paratramol) exposure.

Potential For Tramadol (Paratramol) To Affect Other Drugs

In vitro studies indicate that Tramadol (Paratramol) is unlikely to inhibit the CYP3A4-mediated metabolism of other drugs when Tramadol (Paratramol) is administered concomitantly at therapeutic doses. Tramadol (Paratramol) does not appear to induce its own metabolism in humans, since observed maximal plasma concentrations after multiple oral doses are higher than expected based on single-dose data. Tramadol (Paratramol) is a mild inducer of selected drug metabolism pathways measured in animals.

Use With Cimetidine

Concomitant administration of Paratramol® and cimetidine has not been studied. Concomitant administration of Tramadol (Paratramol) and cimetidine does not result in clinically significant changes in Tramadol (Paratramol) pharmacokinetics. Therefore, no alteration of the Paratramol® dosage regimen is recommended.

Use With Digoxin

Post-marketing surveillance of Tramadol (Paratramol) has revealed rare reports of digoxin toxicity.

Use With Warfarin-Like Compounds

Post-marketing surveillance of both Tramadol (Paratramol) and acetaminophen individual products have revealed rare alterations of warfarin effect, including elevation of prothrombin times.

While such changes have been generally of limited clinical significance for the individual products, periodic evaluation of prothrombin time should be performed when Paratramol® and warfarin-like compounds are administered concurrently.


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References

  1. FDA/SPL Indexing Data. "0NG5TTM63P: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
  2. MeSH. "Narcotics". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
  3. European Chemicals Agency - ECHA. "Tramadol: The information provided here is aggregated from the "Notified classification and labelling" from ECHA's C&L Inventory. ". https://echa.europa.eu/information-o... (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Paratramol are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Paratramol. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

5 consumers reported frequency of use

How frequently do I need to take Paratramol?
It was reported by ndrugs.com website users that Paratramol should ideally be taken Twice in a day as the most common frequency of the Paratramol. You should you adhere strictly to the instructions and guidelines provided by your doctor on how frequently this Paratramol should be taken. Get another patient's view on how frequent the capsule should be used by clicking here.
Users%
Twice in a day2
40.0%
Once in a day2
40.0%
4 times in a day1
20.0%


4 consumers reported doses

What doses of Paratramol drug you have used?
The drug can be in various doses. Most anti-diabetic, anti-hypertensive drugs, pain killers, or antibiotics are in different low and high doses and prescribed by the doctors depending on the severity and demand of the condition suffered by the patient. In our reports, ndrugs.com website users used these doses of Paratramol drug in following percentages. Very few drugs come in a fixed dose or a single dose. Common conditions, like fever, have almost the same doses, e.g., [acetaminophen, 500mg] of drug used by the patient, even though it is available in various doses.
Users%
11-50mg2
50.0%
1-5mg1
25.0%
201-500mg1
25.0%


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Information checked by Dr. Sachin Kumar, MD Pharmacology

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