J Investig Allergol Clin Immunol. 2003;13(1):56-9. Chronic urticaria with multiple NSAID intolerance: is tramadol always a safe alternative analgesic? Asero R(1). Author information: (1)Ospedale Caduti Bollatesi, Bollate, Italy. . BACKGROUND: Mechanisms underlying multiple intolerance to nonsteroidal.
This study aimed at assessing the tolerability of a central analgesic (tramadol) in a group of patients with CU and a history of intolerance to several NSAIDs, asking for a safe, alternative compound.
A similar proportion of CU patients did not tolerate rofecoxib, and higher proportions of patients did not tolerate acetaminophen and nimesulide. Twenty-three patients tolerated tramadol, whereas, surprisingly, in 5 (18%) patients tramadol induced urticaria, in one case with laryngeal edema.
Twenty-eight patients with CU exacerbated by several, distinct NSAIDs underwent single-blind, placebo-controlled, oral challenges with increasing doses of tramadol (50 mg total dose). Most of them underwent oral challenges with rofecoxib, paracetamol, and/or nimesulide as well.
In CU patients intolerant to NSAID, the tolerability of tramadol, as well as of other "alternative" drugs, should be assessed by oral challenge tests. Mechanisms other than COX inhibition may also play a role in drug intolerance in patients with CU.
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If so, drugs that are not active on COX-1 would be expected to be well tolerated by CU patients. Mechanisms underlying multiple intolerance to nonsteroidal anti-inflammatory drugs (NSAID) in patients with chronic urticaria (CU) are unclear. One hypothesis is that COX-1 inhibition may play a relevant pathogenic role.
Although every previous answer has some aspects that is right I'd differ by saying that "I'd trust the judgement of the physician that's following you" The reason is: Yes, Tramadol for IBS pain is un-orthodox. The drug is not the first choice, Tr.