Tramadol 37.5/325 mg is a combination analgesic containing tramadol hydrochloride (37.5 mg) and paracetamol (325 mg) per tablet. This fixed-dose combination is used for the short-term management of moderate to moderately severe acute pain when single-agent therapy is insufficient. This overview is for educational purposes only and is not an offer to sell or supply medication. Tramadol-containing products are prescription-only in the UK and many other countries and must be used under the supervision of a licensed clinician.
Tramadol 37.5 mg: an opioid-acting analgesic with both μ-opioid receptor activity and inhibitory effects on serotonin and norepinephrine reuptake.
Paracetamol 325 mg (acetaminophen): a non-opioid analgesic and antipyretic that complements tramadol’s effect and allows effective pain relief at lower tramadol doses.
Combining tramadol with paracetamol produces additive analgesia and can reduce the need for higher opioid dosing.
Short-term relief of postoperative pain.
Management of acute musculoskeletal pain, dental pain, or other situations where moderate pain is present and needs effective control.
Used when non-opioid measures alone are inadequate.
Healthcare professionals select this combination when the expected benefits outweigh risks, and for the shortest effective duration.
Tablets are intended for oral administration.
Dosing regimens vary by country and individual patient factors (age, weight, renal/hepatic function). Clinicians typically recommend the lowest effective dose for the shortest possible time.
Patients with impaired kidney or liver function, older adults, or those taking interacting medications often require dose adjustments or alternative therapy.
Always follow a prescriber’s instructions and local national guidance for exact dosing.
Tramadol provides analgesia through a mixed mechanism: weak activation of opioid receptors and inhibition of neurotransmitter reuptake (serotonin and norepinephrine), which modulates pain pathways. Paracetamol acts centrally to reduce pain and fever; together they enhance pain relief compared to either component alone.
Nausea and vomiting
Dizziness, drowsiness or sedation
Constipation
Headache
Sweating
Side effects are generally dose-related and should be discussed with the prescribing clinician.
Respiratory depression: Risk increases with higher doses and when combined with other central nervous system depressants (e.g., alcohol, benzodiazepines, opioids).
Dependence and misuse: Tramadol is an opioid-related drug with potential for tolerance, dependence, and misuse. Use should be appropriate, limited, and supervised.
Seizure risk: Tramadol lowers the seizure threshold—use caution in patients with epilepsy or those on medications that predispose to seizures.
Serotonin syndrome: Risk when combined with other serotonergic drugs (e.g., certain antidepressants). Symptoms include agitation, high temperature, autonomic instability, and neuromuscular abnormalities.
Paracetamol toxicity: Avoid exceeding the maximum recommended total daily dose of paracetamol from all sources to prevent liver injury.
Tramadol interacts with numerous medicines (CNS depressants, certain antidepressants, MAO inhibitors, anticonvulsants, and potent CYP enzyme inhibitors/inducers). Contraindications and precautions must be reviewed by a prescriber.
Take exactly as prescribed; do not increase dose or frequency without medical advice.
Avoid alcohol and inform your clinician about all other medicines you take.
Report severe side effects (difficulty breathing, extreme drowsiness, confusion, allergic reactions) immediately.
Do not combine with other paracetamol-containing products to avoid overdose.
Store securely and keep out of reach of children; properly dispose of unused medication per local guidance.
