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There are no contraindications listed in the BNF. It has been suggested that carisoprodol may potentiate the effect of certain CNS drugs such as benzodiazepines and opioid analgesics, of which tramadol is the weakest bar codeine, dihydrocodeine, and dihydrocodeineone, also known as 'hydrocodone' in one or two countries, but whose main use is NOT as an analgesic but an antitussive. Definitive answers have never been published, largely due to the fact that pharmacologists are not certain how the skeleto- muscular relaxation properties of carisoprodol actually work. That drug has now been withdrawn in most countries; only India and the USA continue to use it in many prescriptions. Hydrocodone, unlike tramadol which is universal, is only available in the USA and Germany. In the USA it is used in combination with paracetamol to make a mild opioid analgesic, but its main use remains as a cough suppressant, in 10mg tablets. Most Tramadol (Zyban, Ultram) is prescribed in i/r doses of 50mg or m/r doses lasting 12 hours, of 100 or 150mg.

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