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Combined analgesics and chronic pain
Last reviewed: 23.04.2024
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For the treatment of chronic pain syndrome (HBS) of different myologies, combined therapies based on acetaminophen in combination with small narcologically safe doses of weak opioid analgesics such as codeine or tramadol are of particular interest. These combined drugs are superior in efficiency to paracetamol in its pure form and do not refer to narcotic drugs.
The combination of paracetamol (500 mg), codeine (8 mg) and caffeine (30 mg), increases the quality of analgesia achieved with the isolated use of the same dose of paracetamol. The drug is presented in the form of tablets and soluble tablets. A single dose is 1-2 tablets (0.5-1.0 g based on paracetamol), daily up to 6-8 tablets (maximum 4 g of paracetamol, 64 mg of codeine and 240 mg of caffeine).
Effective is a combination of non-opioid analgesic paracetamol (325 mg) and opioid-tramadol (37.5 mg). The first provides a rapid onset of analgesic effect, the second strengthens and prolongs it. Single dose is 1-2 tablets, maximum (650 mg of paracetamol and 75 mg of tramadol), daily - maximum 8 tablets (2.6 g of paracetamol and 300 mg of tramadol). In patients older than 75 years, the interval between taking single doses of analgesic should be at least 6 hours. The drug is effective in acute and chronic pain syndromes of medium intensity of different genesis. Contraindications to the appointment of the drug are hepatic and respiratory failure, epilepsy, pregnancy, breast-feeding, simultaneous intake of alcohol (enhances toxic effects on the liver), sedatives, drugs containing paracetamol and tramadol. All drugs considered in this section are classified as "non-narcotic". It should be emphasized that various drugs of this series, used for analgesia, have a different spectrum of side effects, which allows the doctor in the specific clinical situation to select and prescribe the most safe of the patient, taking into account the individual characteristics of the organism and associated diseases.
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