PAINOGESIC CO tablets are prescription-only medications used for managing moderate to moderately severe pain. They combine tramadol hydrochloride and paracetamol in a single tablet, offering a dual-action approach to pain relief.It is a film-coated tablet, classified as a Schedule 5 (S5) medicine in South Africa .
These tablets are sugar-free and film-coated for easier swallowing. They are particularly useful when simple painkillers like paracetamol or ibuprofen are no longer effective.
What the Active Ingredients Do
Here’s a quick breakdown of how the active ingredients work:
| Ingredient | Strength per Tablet | Function in the Body |
|---|---|---|
| Tramadol HCl | 37.5 mg | Opioid-like pain reliever; alters pain signals in the brain |
| Paracetamol | 325 mg | Common analgesic and antipyretic; blocks chemical messengers responsible for pain |
These two substances work together to enhance pain relief more effectively than either one alone.
Who Should Not Take PAINOGESIC CO
Avoid PAINOGESIC CO if you fall into any of the following categories:
| Do Not Use If You… |
|---|
| Are allergic to tramadol, paracetamol, or opioid-like medicines |
| Have alcohol poisoning or are a heavy drinker |
| Are on monoamine oxidase inhibitors (MAOIs) or took them within the past 14 days |
| Have severe liver disease or failure |
| Are withdrawing from narcotics |
| Have a condition that depresses your breathing or central nervous system |
| Suffer from epilepsy not controlled by treatment |
Important Precautions Before Use
Discuss with your doctor if you:
| Precautionary Condition |
|---|
| Take other products containing tramadol or paracetamol |
| Have liver or kidney problems |
| Recently experienced a head injury, or suffer from headaches or seizures |
| Are prone to medication dependence |
| Are an ultra-rapid metaboliser of tramadol |
| Have a history of alcohol or drug abuse |
Sudden withdrawal from PAINOGESIC CO may lead to withdrawal symptoms, including:
- Anxiety
- Restlessness
- Sweating
- Tremors
- Nausea
- Insomnia
Drug Interactions
Taking PAINOGESIC CO with certain medicines can cause serious reactions. Here’s a helpful summary:
| Interacting Medicine Type | Examples | Risks/Potential Effects |
|---|---|---|
| MAOIs (used for depression) | Tranylcypromine, moclobemide | Confusion, high blood pressure, coma |
| Antidepressants (SSRIs, TCAs, SNRIs) | Fluoxetine, paroxetine, amitriptyline, venlafaxine | Seizures, serotonin syndrome |
| Epilepsy medicine | Carbamazepine | Reduces tramadol effect |
| Sedatives/Tranquillisers | Diazepam, alprazolam, lorazepam | Increased drowsiness, breathing suppression |
| Painkillers with mixed agonist-antagonist action | Buprenorphine, nalbuphine | Decreased tramadol effect |
| Heart medication | Digoxin | Risk of heart toxicity |
| Anti-nausea medication | Ondansetron | Increased tramadol side effects |
| Blood thinner | Warfarin | Increased bleeding risk |
Always inform your doctor about all medications, including herbal remedies.
Use with Alcohol
Do not drink alcohol while taking PAINOGESIC CO. The combination can dangerously:
- Increase drowsiness
- Slow breathing
- Lead to loss of consciousness
- Increase liver damage risk (due to paracetamol)
Use in Pregnancy and Breastfeeding
PAINOGESIC CO is not safe during pregnancy or breastfeeding unless specifically prescribed by a doctor.
| Situation | Risk to Baby |
|---|---|
| During pregnancy | Risk of withdrawal symptoms in newborns |
| While breastfeeding | Tramadol may pass into breast milk and cause drowsiness |
Driving and Operating Machinery
Be cautious. PAINOGESIC CO may affect your ability to:
- Drive
- Use machinery
- Concentrate
If you feel sleepy, dizzy, or lightheaded, avoid such activities until the effects wear off.
Dosage Instructions
Only use PAINOGESIC CO under the guidance of your healthcare provider.
| Dosage Guidelines | Details |
|---|---|
| How to take | Swallow tablets whole with water; do not crush or chew |
| Frequency for adults | 1–2 tablets every 4–6 hours as needed |
| Maximum dose per day | Do not exceed 8 tablets in 24 hours |
| If you forget a dose | Take when remembered unless close to next dose; do not double up |
| If you take too much | Seek immediate medical help—even if you feel okay (paracetamol overdose can be delayed) |
Stopping the Medication Safely
If you’ve been taking PAINOGESIC CO for a long time, your body might become dependent. Do not stop abruptly—your doctor will reduce your dose gradually to avoid withdrawal symptoms.
Side Effects
Like all medicines, PAINOGESIC CO can cause side effects. They are not the same for everyone.
Common Side Effects:
| Side Effect | Description |
|---|---|
| Drowsiness | Feeling unusually sleepy |
| Dizziness or lightheadedness | Especially when standing up |
| Nausea or vomiting | Usually mild, but can be bothersome |
| Constipation | May occur with prolonged use |
| Headache | Occasionally reported |
Serious Side Effects (Seek Help Immediately):
| Symptom | Possible Cause |
|---|---|
| Skin rash, swelling, breathing difficulty | Allergic reaction (medical emergency) |
| Confusion, agitation, muscle twitching | Serotonin syndrome (especially with antidepressants) |
| Seizures or convulsions | Especially in people with epilepsy |
| Yellowing of skin/eyes | Liver damage due to paracetamol |
Storage Guidelines
| Storage Tip | Recommendation |
|---|---|
| Keep out of children’s reach | Store in a safe, locked cupboard |
| Store in original container | Protect from moisture and direct sunlight |
| Do not use after expiry date | Check the packaging and dispose safely if expired |
What’s in the Box?
Each film-coated PAINOGESIC CO tablet contains:
| Component | Amount |
|---|---|
| Tramadol HCl | 37.5 mg |
| Paracetamol | 325 mg |
| Sugar | None |
| Sodium content | Very low (0.035 mmol per tablet) |
This makes it suitable for patients who need sugar-free and low-sodium formulations.
Final Thoughts
PAINOGESIC CO tablets are a strong pain relief option designed for people who have not found relief with ordinary painkillers. However, because they contain tramadol—an opioid-related substance—they should be taken only under medical supervision.
Always follow your doctor’s instructions closely, avoid alcohol, and do not share your medicine with others.
For any side effects or questions, contact your healthcare provider or pharmacist.
Manufactured by:
Innovata Pharmaceuticals (Pty) Ltd
