The Scottish Medicines Consortium has rejected tramadol 37.5mg/ paracetamol 325mg (Tramacet)® and nicotinic acid modified release (Niaspan)® for use on the NHS in Scotland.
Tramacet is a compound analgesic containing both paracetamol and tramadol. The review concluded that tramacet has similar efficacy to other compound analgesics but the individual components are available separately at significantly lower cost.
Suitable alternatives include different analgesics or, if necessary, paracetamol and tramadol separately.
Niaspan is a high dose preparation of a vitamin for dyslipidaemia that increases HDL and reduces triglyderides and to some extent LDL. The review found no evidence of benefit in terms of patient outcomes such as reductions in cardiovascular events.
Suitable alternatives include statins, such as simvastatin and other lipid lowering drugs.
Action: Clinicians should avoid using either of these drugs. Alternatives are suggested above.