Paracetamol (acetaminophen) is a non-steroidal anti-inflammatory drug with antipyretic and weak analgesic. Paracetamol is used many conditions including headache, muscle aches, colds, and fevers. It relieves pain in mild arthritis but has no effect on inflammation and swelling of the joint. Tramadol is a opioid analgesic, used to treat moderate to severe pain.
Moderate to severe pain
Paracetamol belongs to non-steroidal anti-inflammatory drugs which inhibits cyclooxygenase. Paracetamol is a derivative of acetaminophen, or paracetamol, with the molecular formula glycine, N, N-diethyl-,4-(acetylamino)phenyl ester. Paracetamol is a weak inhibition of COX-1 and COX-2, further inhibiting prostaglandin synthesis.
Tramadol is a centrally acting synthetic opioid analgesic. Tramadol modulates the descending pain pathways within the central nervous system through the binding of parent and M1 metabolite to μ-opioid receptors and the weak inhibition of the reuptake of norepinephrine and serotonin. Tramadol affects a number of pain modulators like alpha2-adrenoreceptors, neurokinin 1 receptors, the voltage-gated sodium channel type II alpha subunit, transient receptor potential cation channel subfamily V member 1 (TRPV1 - also known as the capsaicin receptor).
Paracetamol is also well orally absorbed and volume of distribution is 1.29 l/kg. Protein binding of paracetamol is very negligible. It is metabolised in liver mainly by CYP enzymes. Paracetamol is mainly excreted in urine with a half-life of 3.6 hours.
Tramadol is well orally absorbed with a bioavailability of 75% and the concentration reaches maximum in 1.6-1.9 hours. Volume of distribution ranges from 2.6-2.9 L/kg. 20% of the dose administered is bound to plasma protein. Tramadol undergoes extensive first-pass metabolism in the liver and about 90% of the metabolites are excreted in urine with 10 % in feces. The half-life of tramadol is 5-6 hours.
Common side effect includes:
Skin redness
Allergic reaction
Shortness of breath
Nausea
Abnormal blood cell count
Stomach fullness
Difficult urination
Dizziness
Do not use this tablet in the following conditions:
Gastrointestinal haemorrhage
Hepatic impairment
Alcoholism
Consumption of antidepressants
| Tramadol | 50 mg |
| Paracetamol | 325 mg |