Tomogex 10 Tablets

Paracetamol (acetaminophen) provides analgesia by inhibiting cyclooxygenase (COX) enzymes, primarily in the central nervous system, reducing prostaglandin production. Tramadol is an opioid analgesic that works on opioid receptors and also inhibits norepinephrine and serotonin reuptake, providing additional pain relief.

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Antipyretic/Analgesic, Opioid Analgesic

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Tablet

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Paracetamol and Tramadol are used for:

• Pain Relief
• Fever
• Moderate to Severe Pain Management

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Tomogex dosage for the indication of moderate to severe pain, duration as needed:

• Adults - 1 tablet every 6 hours as needed, not exceeding 8 tablets/day.
• Children - Not recommended.

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Paracetamol overdose can cause liver damage, while tramadol overdose may lead to respiratory depression. Seek emergency medical care.

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If you miss a dose, consume as soon as you remember. If it is close to the next feeding, skip the missed dose. Do not double up on doses.

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Paracetamol is taken every 4-6 hours as needed, while tramadol is usually taken every 6-8 hours. Follow the dosage instructions for each medication.

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Paracetamol + Tramadol should not be used if:

• Hypersensitivity
• Severe liver disease
• Concurrent use of MAO inhibitors (Tramadol)

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Possible side effects of Paracetamol and Tramadol include:

• Nausea
• Drowsiness
• Constipation
• Dizziness
• Allergic reactions

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The warnings and precautions for Paracetamol and Tramadol are:

• Patient with hypovolaemia, CV disease (including acute MI)
• History of seizures or risk factors for seizures (e.g., CNS infection, metabolic disorders, malignancy, alcohol/drug withdrawal), delirium tremens, head injury, intracranial lesions, elevated intracranial pressure, toxic psychosis, emotional disturbance including depression
• History of drug abuse or acute alcoholism
• Acute abdominal conditions, adrenal insufficiency (e.g., Addison disease)
• Biliary tract dysfunction, acute pancreatitis
• Prostatic hyperplasia, urinary stricture, significant COPD or cor pulmonale, substantially decreased respiratory reserve, hypoxia, hypercapnia, pre-existing respiratory depression
• G6PD deficiency, thyroid dysfunction
• Not recommended in patients with severe respiratory insufficiency
• Avoid use in patients with circulatory shock, impaired consciousness or coma, moderate to severe sleep-disordered breathing and suicidal patients
• Cachectic, debilitated or morbidly obese patients
• Avoid abrupt withdrawal
• Renal and mild to moderate hepatic impairment
• Elderly
• Pregnancy and lactation

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The drug interactions with paracetamol and tramadol include:

• Anticoagulants (e.g., warfarin) – Can enhance bleeding risk with paracetamol.
• CNS Depressants (e.g., alcohol) – Can enhance CNS depressant effects of tramadol.

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For Paracetamol and Tramadol, food interactions that should be considered are:

• Taking with food may help enhance absorption.
• Avoid alcohol as it may increase the risk of side effects.

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Store Paracetamol and Tramadol at room temperature, protected from light and moisture. Keep them in their original containers and out of reach of children. Dispose of any expired or unused medications according to local disposal guidelines or through a drug take-back program.

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