DOLET-T is a combination of Tramadol and Paracetamol. The effectiveness of Tramadol for pain relief has been shown to increase when combined with paracetamol.
Tramadol is classified as an opiate analgesic and used for management of moderate to severe pain. The analgesic actions of Tramadol are only partially reversed by naloxone, suggesting that the analgesic effects are not solely due to an opiate like action. Pharmacologically, Tramadol has been shown to be similar in its actions to tapentadol and levorphanol, indicating that is not only binds to the mu-opiate receptor but also inhibits re-uptake of norepinephrine and serotonin. It is now believed that Tramadol modules the effects of serotonin and norepinephrine to produce analgesia.
Paracetamol, also known as acetaminophen, is a medication for treatment of fever and pain. Its mechanism of action is believed to be due to inhibition of cycloxygenase (COX). The COX family of enzymes have been shown to be responsible for metabolism of arachidonic acid to prostaglandins. The drug is highly selective for COX2 and does not significantly decrease production of thromboxanes. Its analgesic and antipyretic effects are comparable to other non-steroidal anti-inflammatory agents
DDOLET-T is indicated for the treatment of moderate to severe pain. It can be used to treat both acute and chronic pain from a variety of causes. For moderate pain, its effectiveness is equivalent to morphine. The analgesic effects peak at about 3 hours after ingestion and last approximately 6-7 hours.
The adult oral dose of DOLET-T is one tablet taken every 6-8 hours. The formula is available as a tablet and is taken orally, as directed. DOLET-T can be prescribed for 2-3 weeks and re-evaluation is necessary before extending use. The formula is best taken first thing in the morning with a glass of water or with food. Patients should be advised not to chew or crush the tablet in the mouth but swallow it whole.
DOLET-T should not be administered in the following cases:
Caution should be exercised when DOLET-T is prescribed at the same time as selective serotonin receptor re-uptake inhibitors and tricyclic antidepressants because the risk of seizures is increased.
Risk of seizures may be increased when DOLET-T is prescribed to patients taking MAO inhibitors or antipsychotics.
Caution should be exercised when prescribing DOLET-T to patients with head trauma, metabolic disorders or alcohol withdrawal as the risk of seizures may be increased.
DOLET-T has the potential to cause physical and psychological dependence. In patients with a history of drug abuse or drug dependence, treatment with DOLET-T is not recommended.
DOLET-T should be used at low doses in elderly individuals as there is an increased risk of adverse effects like falls, depression and cognitive impairment.
DOLET-T should be used with great caution in individuals with liver or kidney failure.
DOLET-T should be stored at room temperature and away from the reach of children.
DOLET-T may interact with other medications. Hence, it is important to obtain a complete drug and herbal usage history from patients before prescribing the formula.
Because DOLET-T contains paracetamol, patients should be warned about acute liver failure when taken at high doses. This risk is heightened when there is frequent consumption of alcohol.
Most frequent side effects of DOLET-T include nausea, dizziness, itching, constipation, sedation and a headache. Except for constipation, these side effects are temporary. When prescribing a narcotic for pain, it is recommended that physicians also prescribe a laxative at the same time to prevent constipation, which can be severe.
DOLET-T is not recommended for women who are pregnant and those who are breast feeding. The effects of these agents on the newborn have not yet been determined and to be on the safe side, it should be avoided in this population.
DOLET- T tablets are available in a 10X10ís blister packing
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