Tramadol
is an opioid pain medication. It is available in the market with the brand name
Ultram among others. It is also available in combination with acetaminophen
(paracetamol) or as longer-acting formulations. On a dosage to dosage basis, it
has about one-tenth of the potency of morphine and is equally potent to
pethidine and codeine.
Tramadol
is useful in relieving moderate to moderately severe pain. It helps manage
severe pain enough to require an opioid analgesic and for which alternative
treatments are inadequate. It is also available in injection along with oral
tablets/ capsules and liquid. There is moderate evidence of its use as a
second-line treatment for fibromyalgia as a secondary painkiller.
Tramadol
is a medicine that works in the brain to change how your body responds to pain
and how your body feels. It starts its work of relieving the pain within an
hour when you take the immediate-release formulation within an hour. Its
painkilling effects last about 6 hours.
You
should avoid using it if you are allergic to Tramadol or if you have:
●
Bowel or
stomach obstruction (including paralytic ileus);
●
Asthma
(severe) or breathing problems;
●
Used MAO
inhibitors (include linezolid, methylene, isocarboxazid, blue injection,
phenelzine, rasagiline, selegiline, and tranylcypromine); or
●
Recently
used sedatives, alcohol, narcotic medications, or tranquilizers
Donot give Tramadol to a child younger than 12 years old. In Ultram ER’s case,
one should not give it to anyone younger than 18 years old. If someone younger
than 18 years old and recently had surgery to remove tonsils or adenoids, then
they must not take this medicine. Avoid giving Tramadol to children between
12-18 who have conditions that may cause breathing problems.
There
are chances of seizures if you take this medicine without asking the doctor
about your stroke risk, which may be higher if you ever had a head injury,
epilepsy, or other seizure disorder.
The
seizure risk due to this medicine is also higher if you use certain
antidepressants, muscle relaxants, opioids, or other medications.
Your
baby could become drug dependent if you use this drug during pregnancy. It can
cause life withdrawal symptoms in the baby after its birth. Babies dependent on
habit-forming medicine may need medical treatment for several months. Tell your
doctor if you are expecting or plan to conceive. If you are breastfeeding, ask
your doctor before taking Tramadol.
To
ensure Tramadol is safe for you, tell the doctor if you ever had:
●
Sleep apnea
●
Breathing
problem
●
Liver or
kidney disease
●
Problem with
gallbladder, pancreas, or thyroid
●
Urination
problems
●
A stomach
disorder
●
Mental
illness (or suicide attempt)
Tramadol dosage
This
medicine is available in strengths of 50 mg, 100 mg/24 hours, 200 mg/24 hours,
300 mg/24 hours, 100 mg, 150 mg/24 hours.
Usual
adult dosage for pain (17 years or older)
●
50 to 100 mg
orally every 4-6 hours
●
For the
patients who do not require rapid onset of analgesic effect: initial dosage- 25
mg/day orally; titrate in 25 mg increments every three days to reach a dose of
25 mg four times a day; increase the quantity by 50 mg as tolerated every three
days.
●
Maximum
amount- 400 mg per day
Usual
adult dose for chronic pain
ER:
18 Years or older (tramadol-naive)- 100 mg orally once a week
●
Individually
titrate in 100 mg increments every five days to an effective dose.
●
Maximum
dose- 300 mg/day
For
patients currently receiving Tramadol IR: Calculate 24 hour IR requirement and
begin with a total daily ER dosage rounded down to the next lowest 100 mg/day
increment orally.
Conversion
from other opioids:
●
100 mg/day
ER orally
●
Individually
titrate in 100 mg increments every five days to an effective dose
●
Maximum
dose- 300 mg/day
Seek
medical help if you have signs of an allergic reaction to Tramadol. Allergic
reaction include hives, difficult breathing, swelling in face or throat, or a
severe skin reaction involving fever, sore throat, a red or purple skin rash
that spreads and cause blistering and peeling, burning in your eyes and skin
pain. Tramadol can slow your breathing, just like other narcotic medicines. Too
much weakness in breathing may lead to death.
An
attendant should give you naloxone or ask for medical help if you have slow
breathing with long pauses, you are hard to wake up or have blue-colored lips.
Call for medical help if you have:
●
Noisy
breathing, shallow breathing
●
Sighing,
sleep apnea
●
A slow heart
rate
●
Weak pulse
●
A
light-headed feeling
●
Seizures
●
Missed
menstrual periods
●
Sexual
problems, loss of interest in sex, impotence
●
Nausea,
vomiting, loss of appetite
●
Dizziness,
worsening tiredness, or weakness
It
may cause serotonin syndrome also. Agitation, hallucinations, fever, sweating,
shivering, rapid heart rate, muscle stiffness, loss of coordination, nausea,
vomiting, or diarrhea are symptoms of serotonin syndrome. Serious aftereffects
are more likely to occur in older adults and those who are malnourished or
overweight.
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