Panol-T - Tablet Paracetamol + Tramadol Hydrochloride - 325mg+37.5mg 1 Tablet(s) / Tablet Virgo Pharmaceuticals Ltd. Introduction: Panol-T is a pain relieving medicine. It is used in various conditions such as muscle ache, back pain, joint pain, menstrual cramps, and toothache. Panol-T can be taken with or without food. The dose and duration will depend on what you are taking it for and how well it helps your symptoms. You should keep taking the medicine even if you feel better until the doctor says it is alright to stop using it. Using this medicine may cause few common side effects such as nausea, vomiting, constipation, weakness, and dryness in mouth. If you experience any such side effects... Uses of Panol-T: Pain relief Side effects of Panol-T: NauseaVomitingConstipationWeaknessDizzinessDryness in mouthSleepiness How to use Panol-T: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Panol-T may be taken with or without food, but it is better to take it at a fixed time. How Panol-T works: Panol-T is a combination of two medicines: Paracetamol/Acetaminophen and Tramadol. Paracetamol/Acetaminophen is an analgesic (pain reliever) which works by blocking the release of certain chemical messengers that cause pain. Tramadol is an opioid analgesic (pain reliever) which works by blocking the transmission of pain signals to the brain to lower pain perception. Indication: Moderate to severe pain Administration: May with or without food. Adult Dose: Oral Moderate to severe pain Adult: 1-2 tab 6 hrly. Max: 8 tab/day. Max duration: 5 days. Hepatic impairment: Moderate: Increase dosing interval. Severe: Contraindicated. Child Dose: Not recommended in child under 18 years of age. Renal Dose: Renal impairment: CrCl (ml/min) Dosage Recommendation 10-30 Increase dosing interva to 12 hr.ly <10 Not recommended. Contraindication: Hypersensitivity to tramadol, paracetamol or opioids. Situations where opioid use may be contra-indicated (e.g. acute intoxication with alcohol, hypnotic drugs, centrally-acting analgesics, opioids or psychotropic drugs). Severe hepatic impairment, uncontrolled epilepsy. Concurrent use or within 2 wk of discontinuation from MAOIs. Mode of Action: Tramadol is a centrally acting opioid analgesic which binds to mu-opioid receptors and weakly inhibits the reuptake of norepinephrine and serotonin. Paracetamol, a para-aminophenol derivative, has analgesic, antipyretic and weak anti-inflammatory activity. Together, tramadol and paracetamol has faster onset of action compared to tramadol alone and longer duration of action compared to paracetamol alone. Precaution: Patient w/ epilepsy controlled by treatment, risk of seizure, cranial trauma, biliary tract disorder, altered state of consciousness for unknown reasons, problems affecting the resp centre or resp function, increased intracranial pressure, suicidal tendency or patients in a state of shock. Not a suitable substitute in opioid-dependent patients. May cause withdrawal symptoms, dependence and abuse. Severe renal impairment. Elderly. Pregnancy and lactation. Patient Counselling May impair ability to drive or operate machinery. Monitoring Parameters Monitor pain relief, resp rate, BP, and pulse rate; signs of tolerance, abuse, or suicidal ideation. Side Effect: Postural hypotension, resp depression, hepatotoxicity, Stevens-Johnson syndrome, toxic epidermal necrolysis, bradycardia, collapse, allergic reactions w/ resp symptoms (e.g. dyspnoea, bronchospasm, wheezing, angioneurotic oedema), changes in appetite, motor weakness, changes in mood, activity, cognitive and sensorial capacity; exacerbation of asthma, withdrawal symptoms (e.g. agitation, anxiety), skin rash, blood dyscrasias, hypoprothrombinemia. Potentially Fatal: Severe anaphylactic reactions. Interaction: Increased risk of seizures and serotonin syndrome w/ SSRIs, SNRIs, TCAs, and 5-HT agonists (e.g. sumatriptan). Increased CNS depression w/ barbiturates, benzodiazepines, other anxiolytics, hypnotics, sedative antidepressants, sedative antihistamines, neuroleptics, centrally-acting antihypertensive drugs, thalidomide and baclofen. Decreased analgesic efficacy w/ ondansetron. Increased INR w/ warfarin. Potentially Fatal: Increased risk of seizure and serotonin sydrome w/ MAOIs.