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Search Results : Pain (Tramadol with paracetamol - Pain )
Records returned : 55 (on 21 Nov 2024 at 17:01:51). Return to search results for ' Pain '.
Drug
Indication
Status
Trust Alignment
Links
Restrictions/Comments
04.07.02
Non Formulary
Formulations :
- Not Specified
ASPH
RSFT
SASH
SABP
Primary Care
01.04.02
04.07.02
Green
Formulations :
- Tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
Tablets can be dissolved in water (off-label)
04.07.01
Green
Formulations :
- Tablets
ASPH
RSFT
SASH
SABP
Primary Care
Preferred
07.01.01
10.01.01
10.03.02
Green
Formulations :
- Oral suspension
- Tablets
ASPH
RSFT
SASH
SABP
Primary Care
04.07.02
Green
Formulations :
- Oral solution
- Tablets
ASPH
RSFT
SASH
SABP
Primary Care
Green (see narrative)
Formulations :
- Modified release tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
Consider use if standard release tablets are not tolerated or compliance is an issue.
04.07.02
Green (see narrative)
Formulations :
- Modified release capsules
- Modified release tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
Branded prescribing is recommended for modified release tramadol. Do not confuse 12 hourly and 24 hourly preparations.
Consider tramadol where maximum tolerated doses of codeine / dihydrocodeine are ineffective.
Green (see narrative)
Formulations :
- Soluble tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
Reserved for patients unable to swallow solid dose forms or for administration via an enteral tube.
Consider use where maximum tolerated doses of codeine / dihydrocodeine are ineffective.
Green (see narrative)
Formulations :
- Oro-dispersible
ASPH
RSFT
SASH
SABP
Primary Care
Important
Reserved for patients unable to swallow solid dose forms or for administration via an enteral tube.
Consider use where maximum tolerated doses of codeine / dihydrocodeine are ineffective.
04.07.01
Green (see narrative)
Formulations :
- Effervescent tablets
- Soluble tablets
- Suppositories
ASPH
RSFT
SASH
SABP
Primary Care
Important
Reserve for patients who cannot swallow solid dose forms.
Soluble / effervescent preparations have a high sodium content and more expensive than ordinary tablets.
Suppositories for use when oral route is not suitable
Green (see narrative)
Formulations :
- Oral suspension
ASPH
RSFT
SASH
SABP
Primary Care
Important
120mg/5ml and 250mg/5ml reserved for patients who cannot swallow solid dose forms or where sodium content of dispersible preparations is a problem.
Non-formulary: Paracetamol oral suspension 500mg/5ml. Much more expensive. Use a soluble formulation.
04.07.01
Green (see narrative)
Formulations :
- Effervescent tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
Fixed combinations are less preferable.
Low dose (8/500 co-codamol) not recommended.
Avoid effervescent formulations (high sodium content and more costly). Reserve for swallowing difficulties or patients with feeding tubes.
Secondary Care - for A&E / discharge only.
04.07.02
Green (see narrative)
Formulations :
- Patches
ASPH
RSFT
SASH
SABP
Primary Care
Important
Prescribe by brand. Care: available as 3-day, 4-day and 7-day patches.
Refer to Trust / Primary Care Pharmacy advice for locally preferred brands
04.07.02
Green (see narrative)
Formulations :
- Immediate release tablets
- Oral solution
- Oro-dispersible
ASPH
RSFT
SASH
SABP
Primary Care
Important
Orodispersible tablets are a cost-effective alternative to oral solution. Reserve oral solution and orodispersible tablets for patients in whom a solid dose form is not suitable.
04.07.01
Green (see narrative)
Formulations :
- Tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
Fixed combinations are less preferable.
Low dose (8/500 co-codamol) not recommended.
Secondary Care - for A&E / discharge only.
Green (see narrative)
Formulations :
- Capsules
ASPH
RSFT
SASH
SABP
Primary Care
Important
Capsules are more costly than tablets in primary care.
Fixed combinations are less preferable.
Low dose (8/500 co-codamol) not recommended.
04.07.01
Green (see narrative)
Formulations :
- Tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
Fixed combinations are less preferred. RSCH - prescribe as separate components - combination is non-formulary at RSCH.
The MHRA advises when prescribing dihydrocodeine with paracetamol, the tablet strength and dose must be clearly indicated
04.07.02
Green (see narrative)
Formulations :
- Capsules
- Oral solution
ASPH
RSFT
SASH
SABP
Primary Care
Important
For patients unable to tolerate / poor response to morphine. Modified-release preparations to be prescribed by brand
04.07.02
Green (see narrative)
Formulations :
- Capsules
ASPH
RSFT
SASH
SABP
Primary Care
Important
Consider use where maximum tolerated doses of codeine / dihydrocodeine are ineffective.
01.04.02
04.07.02
Green (see narrative)
Formulations :
- Oral solution
ASPH
RSFT
SASH
SABP
Primary Care
Important
Codeine phosphate oral solution 25mg/5ml.
Codeine linctus 15mg/5ml is ONLY licensed for cough.
04.07.02
Green (see narrative)
Formulations :
- Modified release tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
For use in patients where morphine sulfate is not suitable / not tolerated.
Modified-release preparations to be prescribed by brand
04.07.01
Green (see narrative)
Formulations :
- Tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
Reserve for when alternatives are contraindicated or ineffective.
At RSFT - initiation by pain team only.
04.07.02
Green (see narrative)
Formulations :
- Capsules (slow release)
- Granules (slow release)
- Tablets (slow release)
ASPH
RSFT
SASH
SABP
Primary Care
Important
Prescribe modified-release preparations by brand - refer to local guidelines for preferred brands.
Zomorph capsules (12-hourly) can be opened for administration in patients unable to swallow the capsules.
04.07.02
Blue
Formulations :
- Patches
ASPH
RSFT
SASH
SABP
Primary Care
Important
Prescribe by brand.
Not for use in opioid naïve patients.
Limited place in therapy - on specialist advice only
04.07.02
Blue
Formulations :
- Sublingual tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
Use in patients unable to tolerate oral medications or where morphine is contra-indicated
04.07.02
Red
Formulations :
- Injection
- Solution for infusion
ASPH
RSFT
SASH
SABP
Primary Care
Important
See separate listing for palliative care
01.04.02
04.07.02
Red
Formulations :
- Injection
ASPH
RSFT
SASH
SABP
Primary Care
04.07.02
Red
Formulations :
- Injection
ASPH
RSFT
SASH
SABP
Primary Care
Important
Alternative for patients unable to tolerate / poor response to morphine.
Care with dose conversion.
07.01.01
10.01.01
10.03.02
Red
Formulations :
- Intravenous infusion
ASPH
RSFT
SASH
SABP
Primary Care
Important
Restricted for patients where an oral NSAID is not suitable.
04.07.02
Red
Formulations :
- Intramuscular injection (IM)
ASPH
RSFT
SASH
SABP
Primary Care
Important
Obstetric analgesia
04.07.02
Red
Formulations :
- Injection
ASPH
RSFT
SASH
SABP
Primary Care
Important
Acute pain, including obstetric analgesia
04.07.02
Red
Formulations :
- Injection
ASPH
RSFT
SASH
SABP
Primary Care
Important
Limited stock - restrictions apply. Contact Pharmacy.
Safety alert for High Dose
Red
Formulations :
- Inhalation
ASPH
RSFT
SASH
SABP
Primary Care
Important
Acute, trauma pain.
RSCH - for use during removal of brachytherapy and transperineal prostate biopsies
04.07.02
Red
Formulations :
- Injection
ASPH
RSFT
SASH
SABP
Primary Care
Important
See separate listing for use in assisted ventilation and anaesthesia
Red
Formulations :
- Injection
- Nasal spray
ASPH
RSFT
SASH
SABP
Primary Care
Important
100mcg in 2ml injection used intranasally in paediatrics for painful procedures.
04.07.02
Red
Formulations :
- Injection
ASPH
RSFT
SASH
SABP
Primary Care
Important
See separate listings for palliative care and use in anaesthesia.
04.07.01
Red
Formulations :
- Intravenous infusion
ASPH
RSFT
SASH
SABP
Primary Care
Important
Prescribe in milligrams for doses <1g.
Review infusion prescriptions after 48-72 hours.
Note risk of overdose with IV paracetamol.
04.07.02
Red
Formulations :
- Injection
ASPH
RSFT
SASH
SABP
Primary Care
04.07.01
Non Formulary
Formulations :
- Tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
Fixed combinations are less preferred.
The MHRA advises when prescribing dihydrocodeine with paracetamol, the tablet strength and dose must be clearly indicated
04.07.01
Non Formulary
Formulations :
- Tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
Fixed combinations are less preferred.
The MHRA advises when prescribing dihydrocodeine with paracetamol, the tablet strength and dose must be clearly indicated
04.07.02
Non Formulary
Formulations :
- Tablets
ASPH
RSFT
SASH
SABP
Primary Care
04.07.02
Non Formulary
Formulations :
- Tablets
ASPH
RSFT
SASH
SABP
Primary Care
Important
Tablets - Not for chronic or acute, non-malignant pain.
Intramuscular injection used in obstetric pain.
04.07.02
Non Formulary
Formulations :
- Not Specified
ASPH
RSFT
SASH
SABP
Primary Care
02.09.00
04.07.01
Non Formulary
ASPH
RSFT
SASH
SABP
Primary Care
Important
This status applies to the use of aspirin for pain.
Refer to separate formulary entries for caridology indications.
04.07.02
Non Formulary
Formulations :
- Suppositories
ASPH
RSFT
SASH
SABP
Primary Care
04.07.02
Non Formulary
Formulations :
- Not Specified
ASPH
RSFT
SASH
SABP
Primary Care
04.07.02
Non Formulary
Formulations :
- Oral solution
ASPH
RSFT
SASH
SABP
Primary Care
Non Formulary
Formulations :
- Oral drops
ASPH
RSFT
SASH
SABP
Primary Care
04.07.02
Non Formulary
Formulations :
- Buccal tablets
- Buccal/sublingual
- Nasal spray
- Sublingual tablets
- Lozenges
ASPH
RSFT
SASH
SABP
Primary Care
Important
Immediate release fentanyl preparations are non-formulary for all pain indications EXCEPT for breakthrough pain in patients receiving opioid therapy for cancer pain.
Non Formulary
Formulations :
- Sublingual tablets
ASPH
RSFT
SASH
SABP
Primary Care
04.07.03
04.07.04
04.08.01
Non Formulary
Formulations :
- Not Specified
ASPH
RSFT
SASH
SABP
Primary Care
Important
Not for chronic or acute, non-malignant pain. See separate formulary entry for use in neuropathic pain
04.08.01
10.02.02
Non Formulary
Formulations :
- Not Specified
ASPH
RSFT
SASH
SABP
Primary Care
Non Formulary
Formulations :
- Not Specified
ASPH
RSFT
SASH
SABP
Primary Care
Important
No longer licensed because of safety concerns, particularly toxicity in overdose.
04.07.03
04.07.04
04.08.01
Non Formulary
Formulations :
- Not Specified
ASPH
RSFT
SASH
SABP
Primary Care
Important
Not for chronic or acute, non-malignant pain. See separate formulary entry for use in neuropathic pain.
For information about the icons and status values within this site, please refer to the keys below.
Icon/Links Key
NFD1
Non formulary
NFD2
Not assessed for formulary status. Apply to APC / DTC before use.
CD
Controlled drug. Prescribing and/or storage requirements may apply
R
Restrictions apply
SA
Safety Alert
U
Unlicensed - no UK marketing license in place
Un
Off-label use. Not licensed for this indication.
NHSE
Treatment commissioned by NHS England
CDF
CDF
ICB
Treatment commissioned by the ICB
BlueTeq form to be completed
NICE
Traffic Light Status Key
Red
Amber
Green
Black
Amber Star
Green (see narrative)
Non Formulary
See Below
N/A
Blue
Green - Black
See narrative
Do not initiate in new patients