Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog


Tramacet has been launched recently and is being heavily promoted in the form of adverts and journal inserts. It contains 325mg of Paracetamol and 37.5mg of Tramadol per tablet.

Given the recent announcement of the withdrawal of Co-proxamol, we feel it would be inappropriate to transfer patients to this drug. We are also concerned that this new product contains subtherapeutic doses of both ingredients.

It currently costs £10.07 for 60 tablets which is over £9 more than the cost of 100 Paracetamol and £3 more than 100 Co-codamol 30/500mg tablets.

Action: There can be no good reason to use Tramacet in any circumstance.

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104 Comments to “Tramacet”

  1. I was initially prescribed Tramahexel but due to no available stock, I am now taking Tramacet for severe osteoarthritis. Both these tablets relieve the pain miraculously and I don't have any side effects. But I have been told recently by a nursing sister that all these Trama.... medicines are very bad for me. Why is that?

    Comment by Claudia — September 25, 2012 #

    1. @Claudia,

      These medicines, if used appropriately, are fine. Tramadol does have some side effects that make some clinicians wary about using this medication if the safer alternatives have not been tried first.

      Comment by Matthew Robinson — September 26, 2012 #

  2. Hi

    I have a staff member who is on Tramacet after a vehicle accident. He claims he cannot work because he is hallucinating and is drowsy. Does this sound likely?

    Comment by Frank Hayward — July 30, 2012 #

    1. @Frank,

      Tramadol, one of the ingredients in Tramacet, can cause both of these side effects.

      Comment by Matthew Robinson — July 30, 2012 #

  3. I have been taking Tramacet for several years for fibromyalgia but recently they have not worked so well. My doctor gave me Naproxen, so for several days I was not taking the Tramacet. I had two bad nights of severe 'restless legs', red hot skin, and the shivers, flu like symptoms, like a bad cold, and unable to sleep. Once I started taking the Tramacet again all these symptoms disappeared. I do not know whether these symptoms were caused by stopping the Tramacet or starting the Naproxen.

    Comment by Audrey — June 16, 2012 #

    1. @Audrey,

      Those symptoms all sound very much like withdrawal from the tramadol ingredient in the Tramacet. If you are supposed to be stopping them I'd suggested you wean down gradually rather than abruptly stopping them.

      Comment by Matthew Robinson — June 16, 2012 #

      1. Thank you Matthew for your advice. You are right of course, I did try to stop them suddenly. I will do what you advise. I do not wish to experience those symptoms again.

        Comment by Audrey — June 17, 2012 #

  4. My Husband was in a vehicle accident in August 2011. His leg was badly damaged, the doctor put steel to hold his leg together, I tried several pain medicine, nothing really helped until I then got some Hydrocone which help but was unable to get more when the supplied finished then I tried the Tramacet which he's presently using 2 at night time only. This was a blessing for this is really helping with the pain. How long will he be able to use this for? I don't want him to addicted to pain killers.

    Comment by Roses — December 8, 2011 #

    1. Roses,

      I think your husband is unlikely to become physically addicted to Tramacet if he's only taking two at night.

      Comment by Matthew Robinson — December 8, 2011 #

  5. Hi
    I am thinking about asking me doctor to put me on tramacet as I have used Tramadol in the past which helped for many years but after 10 years of taking them they stopped working. I also take celebrex as I have many allergies to medication especially pain killers. I have fibromyalgia and a few other conditions. I cant take morphine, viox, disafenic as I am allergic to them.

    when I start started taking tramadol I felt very ill for about 10 days but once that was over it was fine. The best combination that I had was tramadol and celebrex as that give the most pain relief.

    Comment by Deetramacet — July 12, 2011 #

  6. Hi iv been taking Tramacet for about a week now for severe back pain and, but I have noticed all down my right arm and my hand goes numb and my leg twitches, is this normal?

    Comment by Niki — April 4, 2011 #

  7. @ judy parry,, hi r u the same judy parry who worked as a councillor over 20yrs ago?

    Comment by Michelle — February 22, 2011 #

  8. Thanks for the information. Should I get her off of Tramadol as she keeps saying she is getting hot flushes. She has been on it since Tuesday 2 pills every four hours. I know the pain is not causing the hot flushes. Does she go off it cold turkey or slowly and how slowly


    Comment by Dennis — January 23, 2011 #

    1. @Dennis,

      It's going to be a case of taking the lesser of 2 evils. Is your wife better off with the hot flushes and being relatively pain free or is she better off with no hot flushes and in some more pain? That is something only she can decide as only she will know how bad these symptoms are relative to each other.

      If the pain is easing she could reduce her pain killer use and with that the side effects should also start to fade. Suddenly stopping the pain killers would not normally be advisable though as her pain may become quite severe, although she would unlikely get withdrawal effects after such a short period of treatment.

      Comment by Matthew Robinson — January 23, 2011 #

  9. My wife just had a historectomy and she did not want codiene as it would cause constipation. The doctor put her on Tramacet instead. Today is the fifth day since sugery and she says for a few days now she twitches at night trying to sleep, feels hot and has no appetite. yesterday she tried to take only one pill but after a few hours her pain was a 6/10 so she took two the next time she took meds. What is causing this strangeness? What elese can she take for her pain that is not addicting if this is what is happening

    Comment by Dennis — January 22, 2011 #

    1. @Dennis,

      I would suspect the tramadol in the Tramacet as the cause of the twitching legs and maybe the other symptoms too. She still obviously needs some pain killers so it's worth discussing with the doctors. Yes, codeine can cause constipation, but so can lying in bed after a hysterectomy and so can tramadol. Any constipation can always be remedied with laxative treatment while the pain killers are necessary.

      Comment by Matthew Robinson — January 22, 2011 #

  10. I,m sitting here feeling rotten I have been taking tramaset for over 3 years now and I have decided to slowly get myself off them. I was prescibed them for server back ache and only took them when I needed them but slowly over time I have ended up taking them 4 times a day even when I didnt really need them for pain. Yep I would say I was addicted to them because I have cut down to 2 twice a day and I slowly doing it that way. I have all I can describe is a whooshie head hot and cold and what is like bumblebees in my head, and I feel completey washed out and could sleep at the drop if a hat.It feels like I have flu on the way all the time, but I dont care I,m not giving up I,m going to beat this. The reason I have decided to come off them is that I have developed IBS since having my Gall Bladder removed due to Gall Stones and the constipation is unbeliveable and I,m sure is the drugs that are causing it. Good luck to all those trying to give this awful drug up

    Comment by Helen — September 26, 2010 #

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