Comparative Pharmacology
Head-to-head clinical analysis: ULTRACET versus WYGESIC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ULTRACET versus WYGESIC.
ULTRACET vs WYGESIC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
ULTRACET is a combination of tramadol (a centrally acting opioid agonist) and acetaminophen (a centrally acting analgesic with antipyretic effects). Tramadol binds to mu-opioid receptors and inhibits norepinephrine and serotonin reuptake. Acetaminophen's mechanism is not fully understood but involves inhibition of cyclooxygenase (COX) enzymes in the central nervous system.
WYGESIC (ibuprofen and hydrocodone) combines a nonsteroidal anti-inflammatory drug (ibuprofen) that inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis, and a narcotic analgesic (hydrocodone) that acts as a mu-opioid receptor agonist.
1-2 tablets (37.5 mg tramadol/325 mg acetaminophen per tablet) orally every 4-6 hours as needed for pain, not to exceed 8 tablets per day.
1-2 tablets (paracetamol 325 mg / tramadol 37.5 mg) orally every 4-6 hours as needed for pain, not to exceed 8 tablets per day.
None Documented
None Documented
Tramadol: 5.1 ± 0.9 hours (range 4-6 hours) for the parent drug; the active M1 metabolite has a half-life of 6.7 ± 1.7 hours. In hepatic impairment, tramadol half-life increases ~2-3 fold. Acetaminophen: 2-3 hours (range 1.25-3 hours); prolonged in overdose.
3–4 hours in healthy adults; prolonged to 5–6 hours in moderate renal impairment (CrCl 30–50 mL/min) and >11 hours in severe renal impairment (CrCl <30 mL/min).
Tramadol and its metabolites are primarily excreted via the kidneys (approximately 90% of the dose), with about 30% excreted as unchanged drug and 60% as metabolites. Approximately 10% is excreted in feces. Acetaminophen is primarily conjugated in the liver and excreted renally as glucuronide (60-80%) and sulfate (20-30%) conjugates, with about 5% excreted unchanged.
Primarily renal: 90% as unchanged drug and glucuronide conjugate; <5% fecal.
Category C
Category C
Opioid Analgesic Combination
Opioid Analgesic Combination