Tramadol and Dexketoprofen are combined in this medicine.
This medicine helps relieve moderate to severe sudden pain.
Take Tramadol + Dexketoprofen exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Take this medicine at least 30 minutes before meals.
This medicine is available as a tablet or granules for oral solution.
If you are taking the tablet, swallow it whole with a glass of water.
If you are taking the granules for oral solution, empty the contents of the sachet into a glass of water then shake or stir to dissolve the granules. Drink the solution immediately.
You may stop taking this medicine when you have no more pain.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
Do not take this medicine if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to tramadol, dexketoprofen or similar painkillers such as ibuprofen, aspirin, or ketoprofen.
Alert your doctor if you have the following conditions:
- history of asthma attacks, acute rhinitis (inflamed lining of the nose), lumps in the nose due to allergy, skin rash, or swollen face, eyes, lips or tongue after taking aspirin or other NSAIDs (medicines for pain and inflammation)
- known photoallergic or phototoxic reactions (reddening or blistering of the skin when exposed to sunlight) while taking ketoprofen (medicine for pain and inflammation) or fibrates (cholesterol-lowering medicines)
- current or history of stomach or bowel bleeding or ulcer, or hole in the stomach or bowel including cases caused by previous NSAID (medicine for pain and inflammation) use
- bowel problems e.g. long-term indigestion, Crohn's disease (long-term inflammatory disease of the digestive tract), ulcerative colitis (inflammation of the large intestines)
- severe heart failure
- bleeding or blood clotting problems
- severe dehydration (excessive water loss from the body) due to vomiting, diarrhoea, or insufficient fluid intake
- uncontrolled epilepsy (fits or seizures)
- have consumed large amounts of alcohol, sleeping pills, medicines that affect your mood and emotions or strong painkillers
- moderate to severe kidney disease
- severe liver disease
- severe respiratory depression (slow or ineffective breathing)
- chickenpox
as Tramadol + Dexketoprofen may not be suitable for you.
Do not take this medicine if you are pregnant. If you become pregnant while on Tramadol + Dexketoprofen therapy, alert your doctor immediately. This medicine may cause harm to your unborn child.
Do not breastfeed while you are being treated with this medicine.
Some genetic traits can affect this medicine's level in the blood. Individuals who are ultrarapid metaboliser of CYP2D6 may experience enhanced effects of this medicine which also increases the risk of causing serious side effects. On the other hand, individuals who are poor metaboliser of CYP2D6 may respond poorer to this medicine. Though not routinely done, your doctor may advise you to undergo genetic testing to check if this medicine is best suited for you. If you know you have either of these gene types, inform your doctor.
Do not take Tramadol + Dexketoprofen if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days. Do not take this medicine with other medicines for pain and inflammation.
Inform your doctor if you have the following conditions:
- history of stomach or bowel disease
- history of heart disease
- high blood pressure
- heart problems or at risk of these problems e.g. diabetes, high blood cholesterol, smoker
- disorder of the blood vessels supplying the brain
- disorder in the formation of blood and blood cells
- porphyria (an inherited disorder that may cause skin or nerve problems)
- increased pressure in the brain
- in a state of shock (characterised by cold sweat)
- lupus or systemic lupus erythematosus (an autoimmune disease that causes inflammation)
- consciousness problems such as having a hard time staying alert
- lung problems e.g. asthma
- history of drug or alcohol abuse, or tendency for drug abuse or dependence
- history of fits or seizures
- mild to moderate liver disease
- mild kidney disease
- dehydration
Be sure to check with your doctor or pharmacist before giving Tramadol + Dexketoprofen to the elderly or debilitated patient (physically or mentally weak, usually due to illness or old age). Elderly people and debilitated patients may be more sensitive to the side effects.
Individuals who are intermediate metaboliser of CYP2D6 may require further monitoring of response to this medicine. If you know you have this gene type, inform your doctor.
Avoid long-term use of any painkillers.
Do not take this medicine for any other purpose other than what your doctor has advised.
Inform your doctor if you recently have undergone major surgery.
Tramadol + Dexketoprofen may cause dizziness or may cause you to suddenly fall asleep during your daily activities such as eating and watching television. Do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: headache, diarrhoea, dry mouth, indigestion, nausea, vomiting, constipation, stomach pain, excessive sweating, itching, chills, and dizziness with sensation of spinning.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swelling of the face, eyes or mouth
- rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
- pass out bloody or black as tar stools, vomiting blood or ground coffee-like material
- difficulty breathing
- unusual changes in mood or behaviour
- muscle weakness, cramping or numbness; fast or irregular heartbeat
- unusual bleeding or bruising
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Tramadol + Dexketoprofen if you are currently taking or have taken a medicine to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days. Do not take this medicine if you are also taking other medicines for pain and inflammation such as ketoprofen and celecoxib.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines that can cause drowsiness or affect your concentration e.g. diazepam
- blood-thinning medicines e.g. warfarin, aspirin
- medicines for depression e.g. fluoxetine, venlafaxine, amitriptyline
- medicines for mood disorders e.g. lithium, haloperidol
- medicines for migraine e.g. sumatriptan
- anti-inflammatory medicines e.g. betamethasone
- medicines for fits or seizures e.g. carbamazepine, phenytoin
- medicines for high blood pressure e.g. atenolol, captopril
- water pills e.g. spironolactone
- medicines used in organ transplant or certain immune disorders e.g. ciclosporin, tacrolimus
- medicines used to break up blood clots e.g. streptokinase
- medicines for HIV infection e.g. zidovudine, tenofovir
- digoxin (medicine for heart disease)
- probenecid (medicine for gout or high uric acid level in the blood)
- certain medicines for cancer e.g. methotrexate, pemetrexed
- certain medicines for diabetes e.g. glimepiride, glipizide
- St. John's wort (herbal medicine)
This list does not include all medicines that may interact with this medicine.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol. Alcohol intake may worsen the side effects caused by Tramadol + Dexketoprofen.
Store in a cool, dry place away from the reach of children.
Protect from light.
Medicines must not be used past the expiry date.
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