Relief of Pain and Inflammation : Narcotic Analgesics
ITRAM1 “Tramtor injection” 50 mg/ml; 2 ml/amp
OCAMA2 “Camadol capsule” 50 mg/cap
適應症：中度至嚴重性的急慢性疼痛。
Usual dose:
Adult (> 16 yrs): 25 mg/day, titrated in 25 mg increments as separate doses every 3 day to reach 25 mg qid; then, may increase total daily dose by 50 mg as tolerated to reach 50 mg qid, after titration, 50-100 mg q4-6h; max. 400 mg/day.
Dose adjustment:
Renal impairment: CrCl < 30 mL/min, increase dosing interval to 12 h; max. 200 mg/day.
Liver disease: for p’ts with cirrhosis, 50 mg PO q12h.
Geriatric (> 75 yrs): max. 300 mg/day.
Contraindication:
Intoxication with alcohol, hypnotics, narcotics, centrally acting analgesics, opioids, or psychotropic drugs.
Precaution:
Abrupt discontinuation; concomitant use of CNS depressants, serotonergic drugs (SSRIs, TCAs, MAOIs, and triptans), other opioids, antipsychotics, or other drugs that reduce seizure threshold.
Adverse effect:
Common: pruritus, constipation, diarrhea, nausea, vomiting, dizziness, headache, somnolence.
Serious: orthostatic hypotension, syncope, tachyarrhythmia, anaphylactoid reaction, impaired cognition, seizure, hallucinations, dyspnea.
健保使用規範：
1.癌症病例使用。
2.用於非癌症慢性頑固性疼痛（疼痛期超過六個月）之病人，須同時符合下述條件：(1)須為服用NSAIDS仍無法控制疼痛或有嚴重副作用者；(2)須檢附疼痛評估報告，內容須包括疼痛強度及疼痛緩解的VAS與VRS (Visual Analogue Scale和Verbal Rating Scale)。(87/4/1)
3.注射劑須符合(1)限不能口服，且不能使用肛門栓劑之病人使用；(2)本類藥品不可作為急性上呼吸道感染之例行或長期性使用；(3)使用本類藥品，每次不可連續超過五天。