【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，用於老年人時須謹慎使用(監測血鈉值)。 #高警訊藥品

鴉片類止痛 Indicated for the management of moderate to severe pain

Analgesic Combination
Acetaminophen is a synthetic nonopiate derivative of p-aminophenol that produces analgesia and antipyresis.
Tramadol binds to μ-opiate receptors in the CNS causing inhibition of ascending pain pathways, altering the perception of and response to pain.

1. Hypersensitivity to acetaminophen, tramadol, or any component of the formulation
2. Children younger than 12 years of age
3. Significant respiratory depression, acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
4. Patients with known or suspected gastrointestinal obstruction (including paralytic ileus)
5. Concurrent use of monoamine oxidase inhibitors (MAOIs) or use within the last 14 days

C

Not recommended.

1. Central nervous system: Drowsiness, dizziness, insomnia, anxiety, confusion, euphoria, fatigue, headache, nervousness
2. Dermatologic: Diaphoresis, pruritus, skin rash
3. Endocrine & metabolic: Hot flash
4. Gastrointestinal: Constipation, anorexia, diarrhea, nausea, xerostomia, abdominal pain, dyspepsia, flatulence, vomiting
5. Genitourinary: Prostatic disease
6. Neuromuscular & skeletal: Tremor, weakness

1. Two tablets every 4 to 6 hours as needed for pain relief
2. Maximum: 8 tablets/day (acetaminophen 2,600 mg/tramadol 300 mg per day); Do not exceed 5 days of therapy

1. CrCl ≥30 mL/minute: No dosage adjustment necessary.
2. CrCl <30 mL/minute: Maximum: Two tablets every 12 hours

Use is not recommended (acetaminophen and tramadol undergo extensive hepatic metabolism).