Tramadol is a synthetic painkiller belonging to a group of medicines known as Opioid Analgesics. It works by blocking pain signals to the brain to lower pain perception. It is also used in relieving acute pain after surgery.

• Tramadol is a narcotic-like pain relieving oral medicine that is used as a treatment for moderate to severe pain in adults.
• The extended-release-tablet formulation of this drug is used to treat moderate to severe chronic pain when treatment is needed around the clock.

• Headache
• Dizziness
• Sleepiness
• Vomiting
• Nausea
• Constipation
• Sense of imbalance
• Irregular heartbeat
• Agitation
• Anxiety.

Those who misuse or abuse tramadol are at risk for developing an addiction.

• After frequent, prolonged tramadol use, many people develop a tolerance to the drug. This means they have to take larger doses to feel the drug’s effects.
• Along with tolerance, tramadol users may experience withdrawal symptoms when they stop using the drug.
• Tramadol withdrawal can cause irritability, depression and flu-like symptoms.
• Do not drive or work with tools or machinery if your alertness is affected.
• It is not advisable to drink alcohol during treatment with this medicine as it might increase sleepiness.

Diclofenac is a Nonsteroidal Anti-Inflammatory Drug (NSAID). This medicine works by reducing substances in the body that cause pain and inflamation.

• Diclofenac is used to relieve pain, swelling (inflammation), and joint stiffness. Reducing these symptoms helps you do more of your normal daily activities.
• Diclofenac is used to treat mild to moderate pain, or signs and symptoms of osteoarthritis or rheumatoid rthritis.
• Diclofenac powder (Cambia) is used to treat a migraine headache attack. Cambia will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

• Upset stomach, nausea, heartburn, diarrhea, constipation, gas, headache, drowsiness, and dizziness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
• This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.
• Tell your doctor right away if any of these unlikely but serious side effects occur: hearing changes (such as ringing in the ears), mental/mood changes, difficult/painful swallowing, symptoms of heart failure (such as swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).

• You should not use diclofenac if you have a history of allergic reaction to aspirin or NSAIDs (non-steroidal anti-inflammatory drugs).
• Diclofenac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
• Diclofenac may also cause stomach or intestinal bleeding, which can be fatal.
• Taking diclofenac during the last 3 months of pregnancy may harm the unborn baby.
• It passes into breast milk. While there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.
• To make sure this medicine is safe for you, tell your doctor if you have:
• Heart Disease, High Blood Pressure
• Ulcers or Bleeding In Your Stomach
• Asthma
• Liver or Kidney Disease
• If You Smoke.