Fexmid

Fexmid is a brand name used for a fixed-dose analgesic that combines acetaminophen (paracetamol) and tramadol hydrochloride. Formulations and tablet strengths vary by country, but the combination is marketed as an option for the relief of moderate to moderately severe pain when a single analgesic is not sufficient. It is intended for short-term use and should be taken exactly as prescribed or labeled.

Mechanism: acetaminophen provides analgesia and antipyretic effects through central mechanisms, while tramadol is a weak mu-opioid receptor agonist with additional activity as a serotonin and norepinephrine reuptake inhibitor. The two components work together to produce pain relief.

Safety and side effects: common adverse effects include nausea, dizziness, constipation, and drowsiness. Serious risks include liver injury from acetaminophen if doses exceed the recommended maximum, respiratory depression with high tramadol exposure, and potential dependence or withdrawal with longer use. Serotonergic drug interactions can increase the risk of serotonin syndrome. Caution is advised with alcohol and other central nervous system depressants.

Contraindications and cautions: hypersensitivity to acetaminophen, tramadol, or any component; significant hepatic impairment or chronic alcohol use; acute intoxication or severe respiratory impairment; children under 12 or certain age restrictions in some regions; pregnant or breastfeeding individuals should consult a clinician.

Regulatory status: tramadol-containing products are controlled substances in many countries with restrictions on dispensing and prescription requirements. Availability and labeling may vary by jurisdiction.

See also: Ultracet, analgesics.