Table of Contents
ISRN Family Medicine
Volume 2013, Article ID 638469, 15 pages
Review Article

Tramadol/Paracetamol Fixed-Dose Combination for Chronic Pain Management in Family Practice: A Clinical Review

1Centro de Salud Universitario Goya, c/O’Donnell 55, 28009 Madrid, Spain
2Johns Hopkins University, Baltimore, MD 21287, USA
3Association of Chronic Pain Patients, Houston, TX 77515, USA
4Arthritis Center Twente (MST & UT), P.O. Box 50.000, 7500KA Enschede, The Netherlands
5Department of Endocrinology, Diabetology and Osteology, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland
6Kansas University Medical Center, Kansas City, KS 66160, USA
7International Clinic Research, Overland Park, KS 66210, USA
8Department of Pain Medicine, Beaumont Hospital, Beaumont, Dublin 9, Ireland
9Service de Médecine Interne et Consultation de la Douleur, Hôpital Dieu, 75004 Paris, France
10Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia, PA 19140, USA

Received 30 January 2013; Accepted 19 February 2013

Academic Editors: D. Fung and C. Pearce

Copyright © 2013 Ignacio Morón Merchante et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The family practitioner plays an important role in the prevention, diagnosis, and early management of chronic pain. He/she is generally the first to be consulted, the one most familiar with the patients and their medical history, and is likely the first to be alerted in case of inadequate pain control or safety and tolerability issues. The family practitioner should therefore be at the center of the multidisciplinary team involved in a patient’s pain management. The most frequent indications associated with chronic pain in family practice are of musculoskeletal origin, and the pain is often multimechanistic. Fixed-dose combination analgesics combine compounds with different mechanisms of action; their broader analgesic spectrum and potentially synergistic analgesic efficacy and improved benefit/risk ratio might thus be useful. A pain specialist meeting held in November 2010 agreed that the fixed-dose combination tramadol/paracetamol might be a useful pharmacological option for chronic pain management in family practice. The combination is effective in a variety of pain conditions with generally good tolerability. Particularly in elderly patients, it might be considered as an alternative to conventional analgesics such as NSAIDs, which should be used rarely with caution in this population.