The contraindications reported for dexketoprofen and tramadol as single agents should be taken into account.
Dexketoprofen must not be administered in the following cases: hypersensitivity to dexketoprofen, to any other NSAID, or to any of the excipients listed in Description; patients in whom substances with a similar action (e.g. acetylsalicylic acid, or other NSAIDs) precipitate attacks of asthma, bronchospasm, acute rhinitis, or cause nasal polyps, urticaria or angioneurotic oedema; known photoallergic or phototoxic reactions during treatment with ketoprofen or fibrates; patients with active peptic ulcer/gastrointestinal haemorrhage or any history of gastrointestinal bleeding ulceration or perforation; patients with history of gastrointestinal bleeding or perforation, related to previous NSAIDs therapy; patiens with chronic dyspepsia; patients who have other active bleedings or bleeding disorders; patients with Crohn's disease or ulcerative colitis; patients with severe heart failure; patients with moderate to severe renal dysfunction (creatinine clearance ≤59 ml/min); patients with severely impaired hepatic function (Child-Pugh C); patients with haemorrhagic diathesis and other coagulation disorders; patients with severe dehydration (caused by vomiting, diarrhoea or insufficient fluid intake).
Tramadol must not be administered in the following cases: hypersensitivity to tramadol or to any of the excipients listed in Description; in acute intoxication with alcohol, hypnotics, analgesics, opioids or psychotropic medicinal products; in patients receiving MAO inhibitors, or who have taken them within the last 14 days (see Interactions); in patients with epilepsy not adequately controlled by treatment (see Precautions); severe respiratory depression; Children younger than 18 years to treat pain after surgery to remove the tonsils and or adenoids; Adolescence between 12 and 18 years who are obese or have conditions such as obstructive sleep apnea or severe lung disease, which may increase the risk of serious breathing problems.
Skudexa is contraindicated during pregnancy and lactation (see Use in Pregnancy & Lactation).