Dytracet combines tramadol 37.5 mg with paracetamol 325 mg. It is prescribed for moderate to severe short-term pain that paracetamol or an anti-inflammatory alone has not controlled. It is Schedule 5 because of the tramadol, and it is intended for short courses.
What is Dytracet?
Dytracet is a Schedule 5 film-coated tablet listed in the South African Medicine Price Registry containing tramadol hydrochloride 37.5 mg and paracetamol 325 mg.
This is the same fixed combination sold under other names in South Africa — Ultracet and Tramacet among them. Being given one brand instead of another is ordinary substitution, and if you have been prescribed two of them by different doctors, that is a duplication rather than two treatments.
Why the ratio is what it is. The two ingredients relieve pain through different routes and on different timescales:
Paracetamol 325 mg acts centrally within about half an hour, giving early relief.
Tramadol 37.5 mg is a weak opioid that also increases serotonin and noradrenaline in the spinal cord. It builds more slowly and lasts longer.
Pairing a fast, short agent with a slower, longer one produces smoother relief than either alone — and the deliberately low tramadol dose means the opioid exposure is a fraction of a standalone tramadol capsule.
That low dose is the point of the product. It is a step below plain tramadol on the pain ladder, not above it — a way of getting useful opioid effect with less opioid.
What is Dytracet commonly used for?
- Moderate to severe acute pain, short-term.
- Pain after surgery, including dental procedures.
- Acute back, neck and musculoskeletal pain, after injury or strain.
- Osteoarthritis pain, where anti-inflammatories are unsuitable — which is common in people with stomach, kidney or heart problems.
- Pain not controlled by paracetamol or an anti-inflammatory alone, as a step up rather than a first choice.
- Short-term flares of longer-standing pain, under medical direction.
Where it is genuinely useful is the middle ground: pain too severe for paracetamol, in someone who cannot take an anti-inflammatory. That is a real and common situation, and this combination fills it better than most alternatives.
Where it should not go is into long-term daily use. Evidence for lasting benefit in chronic non-cancer pain is weak, while dependence, tolerance and side effects accumulate steadily.
Two absolute practical rules:
No other paracetamol. Each tablet contains 325 mg. Cold and flu remedies, sinus products and compound painkillers frequently contain paracetamol, and stacking them is the commonest route to accidental overdose.
No other opioid. Do not combine it with tramadol, codeine-containing painkillers or anything stronger without medical direction.
How Dytracet fits into this medicine category
| Step | Examples | Where it fits |
|---|---|---|
| Simple analgesics | Paracetamol (Donapan) | Mild pain and fever |
| Anti-inflammatories | Ibuprofen, diclofenac | Pain with inflammation; stomach and kidney cautions |
| Weak opioid combinations | Dytracet, Ultracet, Tramacet | Moderate pain; less opioid than tramadol alone |
| Weak opioids | Tramadol, codeine | Moderate to severe pain |
| Strong opioids | Morphine, oxycodone | Severe pain, supervised |
| Corticosteroids | Prednisone | Inflammatory conditions, in courses |
See the pain, inflammation and musculoskeletal medicines hub.
What to check before using Dytracet
Do not drink alcohol with it. Both suppress breathing and consciousness, and the combination is more than additive.
Tell your doctor or pharmacist if you:
- Take an antidepressant — SSRIs, SNRIs, tricyclics — triptans for migraine, or St John’s wort. Tramadol’s serotonin effect means these combinations can cause serotonin syndrome.
- Take benzodiazepines, sleeping tablets, gabapentin or pregabalin, or other sedating medicines — the risk of dangerously slowed breathing rises substantially.
- Have epilepsy or a history of seizures. Tramadol lowers the seizure threshold, and this is a genuine consideration rather than a formality.
- Have liver disease — both ingredients matter — or kidney disease.
- Have breathing problems, particularly sleep apnoea or severe COPD.
- Have a history of dependence on opioids, alcohol or other substances.
- Weigh under 50 kg, or are malnourished — both lower the safe paracetamol threshold.
- Take warfarin, where regular paracetamol use affects anticoagulation control.
- Are pregnant or breastfeeding.
- Are elderly, where dose reductions and a greater risk of falls and confusion apply.
Do not drive until you know how it affects you. Follow the prescribed dose and daily maximum exactly — with paracetamol in the tablet, exceeding it matters more than with most painkillers.
Possible cautions and when to ask a pharmacist or doctor
Common effects are nausea, vomiting, dizziness, drowsiness, dry mouth, constipation and sweating. Nausea is common early and usually settles; constipation does not, and is worth managing from the start.
Get emergency help for:
- Suspected paracetamol overdose. Someone who has taken too much may feel entirely well for a day or more while serious liver damage develops. Go to an emergency department immediately with the packaging, even if they seem fine and even if it was accidental. The antidote works best given early.
- Very slow, shallow or difficult breathing, extreme drowsiness or unresponsiveness.
- Seizures.
- Serotonin syndrome — agitation, confusion, fever, sweating, shivering, muscle twitching or a racing heart.
- Swelling of the face, lips or tongue, difficulty breathing, or a blistering rash.
Dependence and withdrawal are real. Regular use beyond a short period leads the body to adapt, and stopping abruptly causes anxiety, sweating, insomnia, tremor, nausea and flu-like symptoms. Ask your doctor to plan a gradual reduction rather than stopping on your own.
Contact your doctor if pain is not controlled, if you need more than prescribed, if drowsiness is interfering with daily life, or if the course is ending with no plan for what follows. And if you have been prescribed two brands of the same combination, tell a pharmacist — that is a duplication worth catching.
Related medicine guides
- Browse Pain, Inflammation & Musculoskeletal Medicines guides
- Read: Prednisone used for
- Read: Donapan used for
Frequently asked questions
What are Dytracet tablets used for? Moderate to severe short-term pain — after surgery or dental work, acute back and musculoskeletal pain, and pain not controlled by paracetamol or an anti-inflammatory alone.
What is in it? Tramadol 37.5 mg and paracetamol 325 mg.
Is it the same as Ultracet or Tramacet? Yes, the same fixed combination under different brand names. If you have been given two of them, that is a duplication.
Is it stronger than plain tramadol? No. The tramadol dose is a fraction of a standalone capsule — it is a step below plain tramadol, not above it.
Can I take paracetamol with it? No. It already contains paracetamol. Check every other product you take, including cold and flu remedies.
Is it addictive? It contains an opioid, and regular use causes dependence. Do not stop abruptly after regular use.
Can I drink alcohol on it? No. The combination dangerously suppresses breathing.
Can I take it if I have epilepsy? Tell your doctor. Tramadol lowers the seizure threshold.