抄録
Objective: The tramadol hydrochloride/acetaminophen combination tablet (Tramcet) is a nonnarcotic analgesic and is expected to have efficacy for relief of chronic pain in patients who have failed to respond well to nonsteroidal anti-inflammatory drugs (NSAIDs). This report describes the use of Tramcet in clinical practice by eight patients suffering from knee osteoarthritis (OA) that was poorly controlled with NSAIDs.
Methods: Seven patients were treated initially with a single daily dose of tablets (one tablet contained tramadol and acetaminophen); the dose was titrated up to three tablets t.i.d as necessary. An initial dose of three tablets per day was administered to the eighth patient, and this dosage was maintained for 4 weeks. All patients were simultaneously administered metoclopramide to prevent nausea and emesis, side effects that were anticipated to occur most frequently. The effectiveness was evaluated by changes in the pain visual analog scale (VAS) from baseline to each visit to the clinic. Adverse events (AEs) were monitored for all patients. Additionally, patients were examined for hepatic function after more than 4 months' treatment with Tramcet.
Results: Seven of the eight patients continued Tramcet treatment over 4 weeks. There were large improvements in VAS in six patients in the first 2 weeks of treatment. Although there was no marked change of VAS in one patient for 2 weeks of treatment at a dose of 1 tablet q.d., the VAS improved after the dose was increased to 2 tabs b.i.d. for weeks of treatment. Only one patient discontinued the administration early due to AEs (nausea, sleepiness, and stomach ache). Constipation occurred in another patient, but it resolved without treatment. There were other noteworthy AEs, including those relating to liver function.
Conclusion: Tramcet was useful for the relief of chronic pain caused by knee OA that was poorly controlled with NSAIDs.
