Tramadol and acetaminophen and Varenicline tartrate

• Generic Name: acetaminophen / tramadol
• Dosage Forms: n.a.
• Other Brand Names: Ultracet

Tramadol and acetaminophen combination is used to relieve acute pain severe enough to require an opioid treatment and when other pain medicines did not work well enough or cannot be tolerated. When used together, the combination provides better pain relief than either medicine used alone. In some cases, you may get relief with lower doses of each medicine.

Tramadol belongs to the group of medicines called opioid analgesics (narcotics). It acts in the central nervous system (CNS) to relieve pain. When tramadol is used for a long time, it may become habit-forming (causing mental or physical dependence). Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Physical dependence may lead to side effects when you suddenly stop taking the medicine. Since tramadol and acetaminophen is only used for short-term relief of pain, mental and physical dependence will probably not occur.

Acetaminophen is used to relieve pain and reduce fever in patients. It does not become habit-forming when taken for a long time. But acetaminophen may cause other unwanted effects when taken in large doses, including liver damage. Although rare, use of acetaminophen has been reported to lead to liver transplantation and death, usually at high doses and when multiple acetaminophen-containing products have been used.

Tramadol and acetaminophen is available only under a restricted distribution program called the Opioid Analgesic REMS (Risk Evaluation and Mitigation Strategy) program.

• Generic Name: varenicline
• Dosage Forms: n.a.
• Other Brand Names: Chantix, Chantix Starter Pack, Chantix Continuing Month

Adjunct in the cessation of cigarette smoking.

USPHS guideline for the treatment of tobacco use and dependence recommends varenicline as one of several first-line drugs that may reliably increase long-term smoking abstinence rates.

In clinical studies, varenicline therapy increased continuous abstinence rates compared with placebo or active comparator (e.g., bupropion). Also reduced urge to smoke.

In studies in patients with stable, documented cardiovascular disease and patients with mild to moderate COPD, efficacy of varenicline was comparable to that in the general smoking population without these conditions.

Also evaluated in patients with stable major depressive disorder in a postmarketing study; benefits also observed in this population without evidence of increased neuropsychiatric effects. (See Neuropsychiatric Symptoms and Suicidality under Cautions.)

Efficacy and safety of varenicline given in conjunction with other smoking cessation therapies (e.g., bupropion, nicotine replacement therapy) not established.