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An International Peer Reviewed Journal for Pharmaceutical, Medical & Biological Sciences

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European Journal of Pharmaceutical and Medical Research (EJPMR) has indexed with various reputed international bodies like : Google Scholar , Indian Science Publications , InfoBase Index (In Process) , SOCOLAR, China , Research Bible, Fuchu, Tokyo. JAPAN , International Society for Research activity (ISRA) , Scientific Indexing Services (SIS) , Polish Scholarly Bibliography , Global Impact Factor (GIF) (Under Process) , Universal Impact Factor , International Scientific Indexing (ISI), UAE  , Index Copernicus , CAS (A Division of American Chemical Society) USA (Under Process) , Directory of Open Access Journal (DOAJ, Sweden, in process) , UDLedge Science Citation Index , CiteFactor , Directory Of Research Journal Indexing (DRJI) , Indian citation Index (ICI) , Journal Index (JI, Under Process) , Directory of abstract indexing for Journals (DAIJ) , Open Access Journals (Under Process) , Impact Factor Services For International Journals (IFSIJ) , Cosmos Impact Factor , Jour Informatics (Under Process) , Eurasian Scientific Journal Index (ESJI) , International Innovative Journal Impact Factor (IIJIF) , Science Library Index, Dubai, United Arab Emirates , Pubmed Database [NLM ID: 101669306] (Under Process) , IP Indexing (IP Value 2.40) , Web of Science Group (Under Process) , Directory of Research Journals Indexing , Scholar Article Journal Index (SAJI) , International Scientific Indexing ( ISI ) , Scope Database , Academia , 

 ISSN 2394-3211

Impact Factor: 7.065

 ICV - 79.57



Dr. Syed Shahid Noor, Dr. Irshad Bhutto, Dr. Kazim Najjad, Dr. Ghazanfar and Dr. Ali Yasir Khan*


Objective: The objectives of the study were to evaluate adverse effects mainly Central Nervous System (CNS) and Gastrointestinal (GI) in Pakistani subjects by using Tramal Plus® (Tramadol 37.5mg/Paracetamol 325mg) during the pain management in routine practice. Material and methods: This was an Observational, Prospective, multi-centre study conducted as per GCP guidelines at the leading hospitals of Karachi. The study compliances were monitored by Contract Research Organization (CRO). Total number of 310 subjects were enrolled, Tramal Plus® tablets for the duration of 2 weeks (14 days). During the course of treatment, the GI adverse effects were evaluated by valid GI AE’s questionnaire (Dutch questionnaire) whereas CNS adverse effects mainly drowsiness and respiratory depression were also monitored. SPSS version 19 was used for the statistical analysis of the results. Results: As per results of 300 subjects’, none reported respiratory depression whereas 7 subjects (2.3%) reported mild drowsiness and only 5 (1.7%) subjects reported moderate drowsiness. The subjects also reported drowsiness at baseline visit, 39 (13%) subjects had mild drowsiness and 2 (0.7%) subjects had moderate drowsiness, they were already on concomitant medications and were known case of hypertension and Diabetes Mellitus. For GI adverse effects, the most common reported adverse events were mild nausea (5, 1.7%), mild constipation (4, 1.33%), vomiting (2, 0.7%) and epigastric pain (2, 0.7%). Conclusions: The study data of Tramal plus results depicted the reduced incidence of AEs, improved tolerability with no serious adverse events as were reflected in global studies on tramadol and paracetamol combination when compared to Tramadol alone in pain management. It was also observed in local Pakistani population that drowsiness as an adverse effect can be associated with concomitant medications and co-morbid diseases patients while managing the pain.

Keywords: Pain Management, Tramal Plus®, adverse effects, Pakistani population.

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Google Scholar Indian Science Publications InfoBase Index (In Process) SOCOLAR, China Research Bible, Fuchu, Tokyo. JAPAN International Society for Research activity (ISRA) Scientific Indexing Services (SIS) Polish Scholarly Bibliography Global Impact Factor (GIF) (Under Process) Universal Impact Factor International Scientific Indexing (ISI), UAE Index Copernicus CAS (A Division of American Chemical Society) USA (Under Process) Directory of Open Access Journal (DOAJ, Sweden, in process) UDLedge Science Citation Index CiteFactor Directory Of Research Journal Indexing (DRJI) Indian citation Index (ICI) Journal Index (JI, Under Process) Directory of abstract indexing for Journals (DAIJ) Open Access Journals (Under Process) Impact Factor Services For International Journals (IFSIJ) Cosmos Impact Factor Jour Informatics (Under Process) Eurasian Scientific Journal Index (ESJI) International Innovative Journal Impact Factor (IIJIF) Science Library Index, Dubai, United Arab Emirates Pubmed Database [NLM ID: 101669306] (Under Process) IP Indexing (IP Value 2.40) Web of Science Group (Under Process) Directory of Research Journals Indexing Scholar Article Journal Index (SAJI) International Scientific Indexing ( ISI ) Scope Database Academia