Frontiers in Clinical Drug Research: Hematology

Author(s): Soumendra Darbar, Srimoyee Saha, Kausikisankar Pramanik and Atiskumar Chattopadhyay * .

DOI: 10.2174/9789815039535122050007

Haematological Modulations by Fixed Dose Combination (FDC) of Tramadol Hydrochloride/Paracetamol (THP)

Pp: 154-167 (14)

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Abstract

SHS investigation development is considered from the geographical and historical viewpoint. 3 stages are described. Within Stage 1 the work was carried out in the Department of the Institute of Chemical Physics in Chernogolovka where the scientific discovery had been made. At Stage 2 the interest to SHS arose in different cities and towns of the former USSR. Within Stage 3 SHS entered the international scene. Now SHS processes and products are being studied in more than 50 countries.

Abstract

Analgesics as fixed-dose combination are very useful for fast pain relief.
Overdose or chronic use of analgesics, especially fixed doses form, develop mild to
severe adverse effects and sometimes damage various organs like the liver, kidney and
brain. Tramadol hydrochloride/paracetamol (THP) is a fixed-dose combination (37.5
mg of Tramadol hydrochloride and 325 mg of paracetamol) extensively used for the
treatment of moderate to severe pain. Administration of THP upon animal model
severely disturbed hepatic and renal biochemical parameters, which leads to altering
normal cellular homeostasis. In this context, our recent study established that the
application of Tramadol hydrochloride/paracetamol produced deleterious effects on
haematological parameters in the experimental murine model. 1.12 g/300 ml and 1.68
g/300 ml chronic administration of Tramadol hydrochloride/paracetamol (THP)
decrease the packed cell volume (PCV), haemoglobin (Hb), mean cell volume (MCV),
means cell haemoglobin (MCH) and increase the mean corpuscular haemoglobin
concentration (MCHC) and white blood cell (WBC) in an experimental animal model.
Other haematological parameters likes red blood corpuscle (RBC), reticulocyte (RT),
haematocrit (HCT) did not show any significant changes upon animals. Increased
MCHC inhibits the oxidation process and energy balance, whereas elevated WBC
levels indicate immune system damage. Decreased haemoglobin and PCV indicate that
Tramadol hydrochloride/paracetamol (THP) is an indirect cause of anaemia. It may be
concluded that prolonged or chronic administration of THP may cause severe
thrombocytopenia, leading to the failure of the immune system, anemia, and a very low
erythrocyte count. These side effects increase according to the dosage and duration of
the treatment. So clinicians, patients and pharmacists should be aware of the
deleterious effects of Tramadol hydrochloride/paracetamol (THP) on haematological
parameters when using this combination.

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