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Desmetramadol a safer, more effective analgesic than tramadol

19 Oct 2019
Healthcare providers to educate the public and promote awareness of the consequences of paracetamol overdose

Desmetramadol is able to provide the analgesic benefits of tramadol without the associated metabolic liabilities, according to a recent series of trials.

The study involved two consecutive randomized, double-blind, three-period cross-over, placebo- and active comparator-controlled trials. Researchers randomly assigned 103 healthy participants to receive 50 mg tramadol and 20 mg desmetramadol either with (trial A; n=43; mean age, 28.4±8.0 years; 100 percent male) or without (trial B; n=60; mean age, 28.0±6.8 years; 70 percent male) cotreatment with paroxetine.

In trial A, participants treated with tramadol (mean change, –0.46±0.19; p=0.022) and desmetramadol (mean change, –0.60±0.15; p=0.0005) exhibited significant decreases in average cold-induced pain perception at 30 seconds relative to placebo controls. No significant differences were reported when the two active treatments were compared against each other (p=0.47).

In the male subgroup of trial B, tramadol failed to produce significantly better analgesia relative to placebo (p=0.90), while desmetramadol significantly outperformed both tramadol (p=0.003) and placebo (p=0.036).

Moreover, in the presence of paroxetine, desmetramadol provided 44-percent longer pain tolerance duration relative to placebo than did tramadol.

In trial A, tramadol and desmetramadol showed comparable safety profiles. Cotreatment with paroxetine seemed to result in fewer adverse events.

“Desmetramadol thus obviates the metabolic liabilities of tramadol while preserving its safety profile, because it does not rely on the activity of CYP enzymes for its activity,” said researchers.

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Most Read Articles
5 days ago
In patients with atrial fibrillation (AF) and stable coronary artery disease (CAD), rivaroxaban monotherapy is noninferior to combination treatment with an antiplatelet therapy in terms of cutting the risk of cardiovascular events and mortality, according to data from the AFIRE trial.
Elvira Manzano, 6 days ago
Supplementation with omega-3 fatty acids or vitamin D3 for up to 5 years has no effect on kidney function in adults with type 2 diabetes (T2D), the VITAL-DKD* ancillary study has shown.
Jairia Dela Cruz, 3 days ago
Many patients with nonvalvular atrial fibrillation (NVAF) in Thailand use anticoagulants, but the uptake of nonvitamin-K oral anticoagulants remains suboptimal despite showing an upward trend, according to data from the COOL-AF registry presented at the European Society of Cardioloy (ESC) Asia Congress 2019 with APSC and AFC.
Yesterday
Monotherapy with tocilizumab (TCZ) shows good tolerability profile and results in remission in most patients with polymyalgia rheumatica (PMR) despite the absence of glucocorticoids, according to the 2-year results of a single-centre, open‐label pilot study.