Opioid + NSAID combination
Tramadol with dexketoprofen
Brand names: Skudexa
Adult dose
Dose: 75/25mg PO every 8h (max 3 tabs/day, ≤5 days)
Route: PO
Frequency: q8h
Clinical pearls
- Acute moderate-severe pain — short-term (≤5 days)
- Avoid in epilepsy and serotonergic combinations
Contraindications
- Active peptic ulcer
- Severe HF
- Severe renal/hepatic impairment
- Concurrent MAOI
- NSAID asthma
- Pregnancy (3rd trimester)
Side effects
- GI bleeding
- Renal impairment
- Nausea
- Dizziness
- Constipation
- Sedation
- Seizures (rare)
Interactions
- MAOIs
- SSRIs
- Anticoagulants
- ACEi/ARB
- Lithium
- Methotrexate
Monitoring
- Pain
- U&E
- BP
Reference: BNF; NICE; SmPC; https://bnf.nice.org.uk/drugs/tramadol-with-dexketoprofen/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Morphine Milligram Equivalents (MME) Calculator · Pain / Opioids
- Opioid Conversion / Equianalgesic Guide · Pain Management
- Numeric Rating Scale (NRS) Pain Assessment and Management · Pain Management
- Finnegan Neonatal Abstinence Scoring Tool (FNAST) · Neonatal Abstinence Syndrome
- Modified Finnegan Neonatal Abstinence Score (NAS) · Neonatal
- FAST Exam Protocol — Focused Assessment with Sonography in Trauma · Trauma
Pathways
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
- Syncope Assessment · ESC 2018 Syncope Guidelines; NICE NG109
- Acute Chest Pain · NICE CG95; ESC 2023 ACS Guidelines