Tramadol dosage. Interaction with other drugs

Drug addicts use many pharmaceutical drugs to get a high. These medications include Tramadol. The danger of this medicine is that in high doses it causes addiction after the first dose and leads to irreversible damage to internal organs and the psyche.

Tramadol as a drug

Tramadol belongs to the group of narcotic opioid analgesics. Previously, it could be bought at a pharmacy, albeit with difficulty, but now the drug is being withdrawn from circulation everywhere.

Tramadol is available in oral capsules, injection ampoules and rectal suppositories. In Russia, it is prescribed only to terminally ill patients who experience unbearable pain in the later stages of illness.

In the past, the drug was used as part of drug addiction treatment. Due to the fact that it has an effect on the central nervous system, it relieves pain during withdrawal symptoms, but only aggravates other manifestations. Therefore, restrictions are now placed on the use of the drug.

Currently, half of the patients at drug dispensaries are people dependent on Tramadol. According to statistics, thousands of schoolchildren use the drug.

As part of anti-drug treatment, they restore body functions damaged as a result of taking Tramadol, correct the patient’s behavior and suppress cravings for the drug. At this stage, antidepressants and antipsychotics are used, and treatment with nootropic drugs continues in parallel.

The patient is also influenced by psychotherapeutic methods. Individual and group classes are offered at different centers. Hypnosis with the development of aversion to the drug at the subconscious level, acupuncture, and electrical stimulation can be used.

The longest stage is maintenance therapy aimed at maintaining the achieved result and preventing breakdowns. After discharge from the medical facility, the patient must continue to attend psychotherapy sessions and take restorative medications. The duration of anti-relapse treatment can be up to five years.

The drug Tramadol is a synthetic analgesic,
belongs to the group of opioid drugs, has an effect on the central nervous system and spinal cord, causing hyperpolarization of membranes and inhibiting the conduction of pain impulses.

Gives a powerful analgesic effect that lasts for a long time. Activates opiate receptors in the brain and gastrointestinal tract. Slows down the destruction and stabilizes the concentration of catecholamines in the central nervous system.

The drug Tramadol is a selective agonist of mu-opioid receptors, selectively inhibiting the neuronal reuptake of serotonin and norepinephrine. The analgesic effect of Tramadol, at the same doses, is 5-10 times weaker than that of morphine.

If the dosage specified in the instructions is followed, Tramadol does not have a significant effect on respiration and hemodynamics, does not change pressure in the pulmonary artery, and does not have a significant slowing effect on intestinal motility.

Has a sedative and mild antitussive effect. With prolonged therapy, tolerance is likely to develop. The analgesic effect occurs 15-30 minutes after internal use of the drug and continues to act for up to 6 hours.

Pharmacokinetics of Tramadol

After oral administration, the drug is approximately 90% absorbed by the gastrointestinal tract. The maximum concentration of Tramadol in the blood plasma is reached two hours after administration. With a single dose of the drug, bioavailability is 68%, and increases with use.

The drug binds to plasma proteins by 20%. Tramadol can cross the placental barrier at concentrations similar to plasma concentrations. Metabolized to 11 metabolites, of which 1 is active. It is excreted 10% through the intestines and 90% by the kidneys.

Indications for use of Tramadol

Tramadol is used for severe and moderate pain of inflammatory, traumatic and vascular etiology. When performing diagnostic or therapeutic procedures associated with painful sensations. And also in the postoperative period, and for patients with cancer. For mild pain, the use of the drug is not recommended.

Contraindications for the use of Tramadol

• hypersensitivity to Tramadol;
• conditions with depressed breathing or a depressed central nervous system due to alcohol or drug poisoning;
• pregnancy;
• breastfeeding (except for one-time doses);
• taking monoamine oxidase inhibitors;
• severe renal or liver failure.

Tramadol should be used with caution in patients with: drug addiction, confusion, intracranial hypertension, traumatic brain injury, epileptic syndromes (cerebral origin), abdominal pain of unknown origin.

Side effects of Tramadol

According to reviews received, Tramadol may cause side effects such as: increased sweating, dizziness, headache,
weakness, lethargy, paradoxical stimulation of the central nervous system (hallucinations, nervousness, anxiety, agitation, muscle spasms, tremors, euphoria, emotional lability), drowsiness, sleep disturbances, confusion, impaired motor coordination, seizures, depression, amnesia, cognitive impairment , unsteady gait.

Side effects of Tramadol on the digestive system may include: dry mouth, nausea, flatulence, abdominal pain, constipation or diarrhea.

From the cardiovascular system in the form of: tachycardia, orthostatic hypotension, fainting, collapse.

From the urinary system: difficulty urinating, dysuria, urinary retention.

Side effects are also possible in the form of: allergic reactions, visual disturbances, taste disturbances, menstrual irregularities.

Long-term use of the drug causes dependence. With abrupt withdrawal, withdrawal syndrome appears.

Overdose

Reviews received about Tramadol overdose show possible manifestations of the following symptoms: collapse, coma, miosis, apnea, vomiting, depression of the respiratory center, convulsions.

Treatment of overdose is carried out by maintaining the airway and maintaining the activity of the cardiovascular system. Naloxone is used to relieve opiate-like effects, and benzodiazepine is used for seizures.

Dosage and methods of application

According to the instructions, Tramadol is used intravenously, intramuscularly, subcutaneously, orally and rectally.

Orally: adults and children over 14 years of age, single use - one tablet or capsule of 0.05 g with liquid, or 20 drops of an internal solution with liquid or sugar. Repeated administration is possible after 30-60 minutes, in the same dosage, no more than 8 times a day.

Rectally: 0.1 gram up to 4 times a day.

Intravenously (slowly), subcutaneously and intramuscularly: 0.05-0.1 g. If the effect is insufficient, further infusion at a rate of 12 mg/hour or additional oral administration. The total dose per day should not exceed 0.4 g.

For children over one year old, only in the form of drops or parenterally, with a dosage of 1-2 mg/kg. Daily dosage up to 8 mg/kg.

For elderly people and patients with kidney failure, a prescription for Tramadol should be filled taking into account individual dosage.

special instructions

Tramadol should not be used to treat drug withdrawal symptoms. Do not use simultaneously with ethanol. For one-time use, it is permissible not to interrupt breastfeeding. During therapy, persons employed in potentially hazardous work, including driving, should be careful.

Interaction with other drugs

Tramadol is incompatible with solutions of diclofenac, indomethacin, diazepam, nitroglycerin, phenylbutazone, flunitrazepam. Enhances the effect of drugs that depress the central nervous system and ethanol.

With long-term use of barbiturates or opioid analgesics, cross-tolerance develops. When barbiturates are taken in combination with Tramadol, reviews show an increased anesthetic effect.

In combination with monoamine oxidase inhibitors, furazolidone, procarbazine and antipsychotropic drugs, the seizure threshold is reduced and there is a risk of seizures.

Storage of the drug

Tramadol is stored according to rules similar to those for storing morphine and other narcotic drugs. V. Dispensing from pharmacies is only possible upon presentation of a prescription for Tramadol.

Sincerely,

HEXAL HEXAL/ Salutas Pharma GmbH HEXAL+KANOPHARMA PRODUCTION KRKA LANNACHER POLFA SLOVAKOFARMA STADA Akrikhin HFC JSC BRYNTSALOV-A, JSC Heksal AG Heksal AG/Kanonpharma Production LANNACHER HEILMITTEL/MEZ Lannacher/Moscow endocrine plant Merkle G MBH Moscow Endocrine Plant, Federal State Unitary Enterprise OZON, LLC Organika OJSC Pranafarm, LLC Salutas Pharma GmbH FGBU RKNPK Ministry of Health and Social Development - EPMBP FGU "RKNPK Rosmedtekhnologii" - EP MBP Hemofarm A.D. Hemofarm D.O.O Hemofarm concern A.D. Stada Artsnaimittel AG EP IBP "RK NPK" FA for high-tech medical science

Country of origin

Austria Austria/Russia Germany Russia Serbia Serbia and Montenegro Yugoslavia

Product group

Painkillers

Opioid analgesic, cyclohexanol derivative

Release forms

• 10 - contour cell packaging (1) - cardboard packs. 10 - contour cell packaging (3) - cardboard packs. 10 - contour cell packaging (5) - cardboard packs. 10 - cellular contour packaging (2) - cardboard packs 10 - cellular contour packaging (2) - cardboard packs. 2 ml - ampoules (5) - cardboard packs. 2 ml - ampoules (10) - cardboard packs. 2 ml - ampoules (5) - contour cell packaging (1) - cardboard packs. 2 ml - ampoules (5) - contour cell packaging (2 ml - ampoules (5) - plastic contour packaging (1) - cardboard packs. 2 ml - ampoules (5) - plastic contour packaging (1) - cardboard packs. 20 - polymer jars (1) - cardboard packs Solution for injection in ampoules of 1 and 2 ml, 5 ampoules in a blister pack, 1-2 blister packs with instructions for use per pack.

Description of the dosage form

• Capsules Solution for injections Solution for injections clear colorless liquid Tablets Tablets

pharmachologic effect

Opioid analgesic, cyclohexanol derivative. Non-selective agonist of mu-, delta- and kappa receptors in the central nervous system. It is a racemate of (+) and (-) isomers (50% each), which are involved in various ways in the analgesic effect. The (+) isomer is a pure opioid receptor agonist, has low tropism and does not have pronounced selectivity for various receptor subtypes. Isomer (-), inhibiting the neuronal uptake of norepinephrine, activates descending noradrenergic influences. Due to this, the transmission of pain impulses to the gelatinous substance of the spinal cord is disrupted. Causes a sedative effect. In therapeutic doses it practically does not depress breathing. Has an antitussive effect.

Pharmacokinetics

Absorption - 90%; bioavailability when administered intramuscularly is 100%. The maximum concentration in blood plasma after intramuscular administration is 45 minutes, M1 metabolite is 3 hours. Penetrates the blood-brain barrier and the placenta, 0.1% is excreted in breast milk. The volume of distribution is 203 l when administered intramuscularly. Connection with blood plasma protein - 20%. Metabolized in the liver by N- and O-demethylation followed by conjugation with glucuronic acid. 11 metabolites have been identified, of which mono-O-demethyltramadol (M1) has pharmacological activity. The half-life in the second phase is 6 hours (tramadol), 7.9 hours (M1); in patients over 75 years old - 7.4 hours (tramadol); with liver cirrhosis - 13.3 ± 4.9 hours (tramadol), 18.5 ± 9.4 hours (M1); for chronic renal failure (creatinine clearance less than 5 ml/min) - 11 ± 3.2 hours (tramadol), 16.9 ± 3 hours (M1). Excreted by the kidneys (25-35% unchanged), the average cumulative renal excretion rate is 94%. About 7% is eliminated by hemodialysis.

Special conditions

In the case of long-term treatment, the possibility of developing drug dependence cannot be excluded. Tramadol is used at increased intervals in elderly patients. Under close medical supervision and in reduced doses, tramadol should be used against the background of the effects of anesthesia, hypnotics and psychotropic drugs. The drug should not be combined with narcotic analgesics due to poor predictability of interaction effects. It is not recommended for use in the treatment of drug withdrawal syndrome. Combination with MAO inhibitors should be avoided. Patients with epilepsy or patients susceptible to developing seizures should take Tramadol only for health reasons. During the period of treatment with the drug, alcohol consumption is not allowed and it is not recommended to engage in activities that require increased attention and high speed of psychomotor reactions (driving vehicles and operating machinery). In the case of a single dose, there is no need to interrupt breastfeeding.

Compound

• Tramadol /tramal semi-finished product for preparation of caps 0.105g tramadol 50 mg; Auxiliary ingredients: sodium acetate, water and tramadol 50 mg; Auxiliary ingredients: sodium acetate, water for tramadol g/x 50 mg/ml; Auxiliary ingredients: sodium acetate, water d/in tramadol g/x 50 mg/ml; Auxiliary ingredients: sodium acetate, water d/in tramadol g/x 50 mg; Auxiliary ingredients: calcium hydrogen phosphate, magnesium stearate, colloidal silicon dioxide

Tramadol indications for use

• Pain syndrome of moderate and severe intensity of various etiologies: postoperative period, trauma, myocardial infarction, neuralgia, pain in cancer patients, pain relief during painful diagnostic or therapeutic procedures.

Tramadol contraindications

• Hypersensitivity to the drug and other opiates. Conditions accompanied by respiratory depression or severe depression of the central nervous system (poisoning with alcohol, sleeping pills, narcotic analgesics, psychotropic drugs). Simultaneous use of MAO inhibitors (and two weeks after their discontinuation). Severe liver and/or renal failure (creatinine clearance less than 10 ml/min). Pregnancy and lactation (use is possible only for health reasons) and should be limited to one-time administrations only. Children's age (up to 1 year). With caution: Convulsions of central origin, drug addiction, confusion, epileptic syndrome (cerebral origin), in patients with abdominal pain of unknown origin, traumatic brain injury, increased intracranial pressure, impaired renal and/or liver function, as well as hypersensitivity to other opioid agonists

Tramadol dosage

• 100 mg 5% 50 mg 50 mg/ml 50 mg 50 mg/ml

Tramadol side effects

• From the nervous system: sweating, dizziness, headache, weakness, fatigue, lethargy, paradoxical stimulation of the central nervous system (nervousness, agitation, anxiety, tremors, muscle spasms, euphoria, emotional lability, hallucinations), drowsiness, sleep disturbance, confusion, disturbance coordination of movement, convulsions of central origin (with intravenous administration in high doses or with simultaneous administration of antipsychotic drugs), depression, amnesia, impaired cognitive function, paresthesia, gait instability. From the digestive system: dry mouth, nausea, vomiting, flatulence, abdominal pain, constipation, diarrhea, difficulty swallowing. From the cardiovascular system: manifestations of vasodilation, tachycardia, orthostatic hypotension, syncope, collapse. Allergic reactions: urticaria, itching, exanthema, bullous rash. From the urinary system: difficulty urinating, dysuria, urinary retention. From the senses: impaired vision, taste. From the respiratory system: dyspnea. Other: menstrual irregularities. With long-term use - drug dependence, with sudden withdrawal - withdrawal syndrome.

Drug interactions

When used simultaneously with drugs that have a depressant effect on the central nervous system, ethanol may increase the depressant effect on the central nervous system. When used simultaneously with MAO inhibitors, there is a risk of developing serotonin syndrome. When used simultaneously with serotonin reuptake inhibitors, tricyclic antidepressants, antipsychotics, and other drugs that lower the seizure threshold, the risk of developing seizures increases. When used simultaneously, the anticoagulant effect of warfarin and phenprocoumon is enhanced. When used simultaneously with carbamazepine, the concentration of tramadol in the blood plasma and its analgesic effect decreases. When used simultaneously with paroxetine, cases of the development of serotonin syndrome and seizures have been described. When used simultaneously with sertraline and fluoxetine, cases of the development of serotonin syndrome have been described.

Overdose

respiratory depression and seizures

Storage conditions

• store at room temperature 15-25 degrees
• keep away from children
• store in a place protected from light

Information provided by the State Register of Medicines.

Synonyms

• Mabron, Protradon, Sintradon, Tradol, Tramagit, Tramadol-Acri, Tramadol Lannacher, Tramadol-Ratiopharm, Tramadol retard, Tramadol-Slovakopharma, Tramadol Stada, Tramal, Tramal retard, Tramalgin, Tramundin retard.

Active substance

Tramadol hydrochloride (tramadol)

Release form, composition and packaging

Pills white with faintly noticeable inclusions, round, flat, slightly rough, chamfered, with a characteristic strawberry smell.

Excipients: lactose, microcrystalline cellulose, magnesium stearate, crospovidone, macrogol 4000, sodium saccharin, colloidal silicon oxide, flavoring.

10 pieces. - blisters (1) - cardboard packs.
10 pieces. - blisters (2) - cardboard packs.
10 pieces. - blisters (3) - cardboard packs.
10 pieces. - blisters (5) - cardboard packs.

Capsules hard gelatin, with a yellow body and a green cap; the contents of the capsules are white or almost white powder.

Excipients: calcium hydrogen phosphate, sodium starch glycolate, magnesium stearate.

Composition of the capsule shell: gelatin, titanium dioxide, yellow iron oxide, indigotine (E132).

10 pieces. - contour cellular packaging (1) - cardboard packs.
10 pieces. - contour cell packaging (2) - cardboard packs.
10 pieces. - contour cell packaging (3) - cardboard packs.
10 pieces. - contour cell packaging (5) - cardboard packs.
10 pieces. - contour cell packaging (10) - cardboard packs.

10 ml - dark glass dropper bottle (1) - cardboard packs.
20 ml - dark glass dropper bottle (1) - cardboard packs.
50 ml - dark glass dropper bottle (1) - cardboard packs.
100 ml - dark glass dropper bottle (1) - cardboard packs.

pharmachologic effect

Opioid analgesic with a mixed mechanism of action. Refers to centrally acting analgesics. Has a pronounced analgesic effect. Non-selective antagonist of opioid mu-, delta- and kappa receptors in the central nervous system with the highest affinity for mu receptors. Inhibits neuronal reuptake and enhances the release of serotonin. It also has an antitussive effect and does not interfere with gastrointestinal motility.

Duration of action is about 4-8 hours.

Pharmacokinetics

Suction

After administration, tramadol is quickly and almost completely absorbed from the gastrointestinal tract (about 90%). Cmax in the blood is determined after approximately 2 hours. Bioavailability is about 70%, does not depend on food intake and increases with repeated use of the drug.

Distribution

Plasma protein binding is about 20%. Tramadol penetrates the BBB and the placental barrier. Approximately 0.1% is excreted in breast milk.

Metabolism

Metabolized by demethylation and conjugation to 11 metabolites, only one of which (O-demethyltramadol) has pronounced pharmacological activity (2-4 times higher than the activity of Tramadol).

Removal

Tramadol and its metabolites are excreted mainly by the kidneys (up to 90%) and through the intestines (about 10%). T1/2, regardless of the route of administration, is about 6 hours. In elderly patients, with and with renal failure, the T1/2 value increases.

Indications

— pain syndrome of moderate and severe intensity of various etiologies (postoperative period, trauma, pain in cancer patients);

— for the purpose of pain relief during painful diagnostic or therapeutic procedures.

Contraindications

- conditions accompanied by respiratory depression or severe depression of the central nervous system (poisoning with alcohol, sleeping pills, narcotic analgesics, psychotropic drugs);

- simultaneous use of MAO inhibitors (and 2 meals after their withdrawal);

- pregnancy;

- lactation period (use is possible only for health reasons);

- age up to 14 years;

- hypersensitivity to the drug.

Dosage

Pills

initial dose - 1 tablet. (50 mg) orally with a small amount of liquid, regardless of meals; if there is no effect within 30-60 minutes, you can take 1 more tablet; at strong pain a single dose can immediately be 100 mg (2 tablets). The effect, depending on the severity of pain, lasts for 4-8 hours. The daily dose of Tramadol should not exceed 400 mg (8 tablets).

The duration and regimen of use are determined by the attending physician

The tablets can be swallowed without chewing, washed down with the required amount of liquid, regardless of meals, or pre-dissolved in 1/2 glass of water.

Capsules

The dose of the drug is selected by the doctor individually depending on the intensity and nature of the pain.

Adults and teenagers over 14 years of age: initial dose - 1 capsule (50 mg) orally with a small amount of liquid, regardless of meals; if there is no effect within 30-60 minutes, you can take 1 more capsule; at severe pain a single dose can immediately be 100 mg (2 capsules). The effect, depending on the severity of pain, lasts for 4-8 hours. The daily dose of tramadol should not exceed 400 mg (8 capsules).

This dosage form should not be prescribed children weighing less than 25 kg and aged less than 14 years.

Elderly patients, patients with impaired liver and kidney function if necessary, the interval between doses of the drug should be increased.

The duration and regimen of use are determined by the attending physician.

Capsules should be swallowed without chewing, with the required amount of liquid, regardless of meals.

Oral solution

The dose of the drug is selected by the doctor individually depending on the intensity and nature of the pain.

Adults and teenagers over 14 years of age: the dose is 50 mg (20 drops). If there is no desired effect, you can take another 20 drops after 30-60 minutes. If necessary, the drug can be taken again after 4-6 hours. The daily dose should not exceed 400 mg (160 drops).

For children aged 1 to 14 years a single dose is 1-2 mg/kg body weight. Approximate dosages for children are given in the table (1 drop of solution corresponds to approximately 2.5 mg of tramadol g/x).

Elderly

patients, patients with impaired liver and kidney function if necessary, increase the interval between doses of the drug. The prescribed number of drops should be taken with a small amount of liquid or with sugar, regardless of meals. The duration and regimen of use are determined by the attending physician.

The bottle with the dispensing device is equipped with a child-resistant cap. To open the bottle, press on the cap and rotate from left to right.

Side effects

The most common symptoms are dizziness, nausea, constipation, headache, drowsiness (in 15-30% of patients), vomiting, itching, symptoms of psychostimulant action, asthenia, sweating, dyspepsia, dry mouth, diarrhea (5-15% of patients).

With a frequency of less than 5%, weight loss, hypotension and tachycardia, paresthesia, hallucinations, tremor, abdominal pain, visual disturbances, and urinary retention are possible.

The incidence of side effects increases with increasing duration of drug use. With long-term use in large doses, the possibility of developing drug dependence cannot be ruled out.

About all side effects, incl. not listed above should be reported to your doctor.

Overdose

Symptoms: constriction of the pupils, vomiting, respiratory depression and convulsions.

Treatment: first aid for poisoning is maintaining adequate pulmonary ventilation and symptomatic therapy in a specialized department. In mild cases, gastric lavage is sufficient. The application is not decisive, because does not eliminate all symptoms of poisoning and may cause convulsions. Hemodialysis is not very effective. For convulsions, intravenous administration of diazepam is advisable.

Drug interactions

With the simultaneous use of Tramadol with drugs that have a depressant effect on the central nervous system, as well as with ethanol, their effect may be enhanced.

With simultaneous use of Tramadol with other inducers of metabolic enzymes, the analgesic effect of Tramadol may be weakened.

With systematic use of barbiturates, especially phenobarbital, there is a possibility of reducing the analgesic effect of opioid analgesics.

Long-term use of opioid analgesics or barbiturates stimulates the development of cross-tolerance.

Naloxone activates respiration, eliminating analgesia after the use of opioid analgesics.

special instructions

In elderly patients, Tramadol is used at increased intervals.

The drug should be used with caution and under the supervision of a physician in patients with impaired renal and liver function, with traumatic brain injuries, increased intracranial pressure, patients with epilepsy, as well as persons with drug dependence on opioids.

Under close medical supervision and in reduced doses, Tramadol should be used against the background of the effects of anesthesia, hypnotics and psychotropic drugs.

The drug should not be combined with narcotic analgesics due to poor predictability of the interaction effect.

With long-term use of carbamazepine, the effect of Tramadol may be weaker.

Impact on the ability to drive vehicles and operate machinery

While using tramadol, you should not drive a car or do other work that requires increased alertness.

Pregnancy and lactation

During pregnancy, long-term use of Tramadol should be avoided due to the risk of developing addiction in the fetus and withdrawal syndrome in the neonatal period.

If it is necessary to take it during lactation, it should be taken into account that Tramadol is excreted in breast milk in small quantities.

Tramadol is used to relieve severe to moderate pain. Its action is similar to that of narcotic analgesics. It affects the brain, changing its response to pain. Tramadol can be taken in tablet form or in ampoule (liquid) form.

How to use tramadol

Tramadol is used as prescribed by a doctor to relieve pain. Typically, the drug is taken every 4 or 6 hours. You can take tramadol with or without food. Ask your doctor how to relieve nausea while taking the drug (for example, your doctor may tell you to lie down for 1 to 2 hours after taking the drug and try not to move your head).

The dosage of the drug depends on your health condition and response to treatment. The risk of side effects can be reduced if you start using tramadol with a minimum dose and then increase it further. Follow your doctor's directions carefully.

The maximum recommended dose of tramadol is 400 mg per day. If you are over 75 years of age, the maximum recommended dose is 300 mg per day. Do not increase your dose on your own, or take the medicine more often or for longer than prescribed.

As a general rule, painkillers work more effectively if they are taken at the first sign of pain; if you expect it to worsen, the effect of taking the drug may decrease. If you have persistent pain (such as that associated with arthritis), your doctor may also prescribe long-acting narcotic medications. This type of therapy may also include non-narcotic drugs, for example, acetaminophen, ibuprofen. Ask your doctor if it is safe to use tramadol in combination with other medications.

If tramadol is used for a long time, then after you stop taking it you may experience a “withdrawal reaction”: increased anxiety, profuse sweating, nausea, runny nose, muscle pain. To prevent withdrawal reactions, your doctor may reduce your dose gradually. With long-term use of tramadol, its effectiveness may also decrease. If you feel this is what is happening, be sure to tell your doctor.

Along with the benefits of tramadol, the medicine can also cause drug addiction. The formation of such dependence may be increased if you have a history of drug addiction or alcohol addiction. Tramadol should be taken strictly in accordance with medical prescriptions to reduce the occurrence of such risks. You should also tell your doctor if the pain does not go away or becomes worse when using tramadol.

Side effects

Taking tramadol may cause side effects such as constipation, vomiting, dizziness, drowsiness or headache. Some of these effects may disappear after using tramadol for some time. If these symptoms persist, tell your doctor. To prevent constipation, ask your doctor to prescribe an appropriate diet and drink more water. Let your doctor also help you choose the most effective laxative.

Remember that your doctor has prescribed Tramadol because you believe the drug will provide more benefits than the risks of side effects.

If you experience unlikely but serious side effects such as changes in mental status or mood (confusion, hallucinations), severe stomach or intestinal pain, difficulty urinating, be sure to tell your doctor.

Seek immediate medical attention if you experience fainting, shallow breathing, unusual sleepiness, or trouble waking up from sleep. The medicine can also increase the level of serotonin in the body. Rare, but can cause a serious condition called serotonin syndrome. The risk of increased overall toxicity in the body occurs if you are simultaneously taking other drugs that also increase serotonin levels. If you experience symptoms such as fast heartbeat, hallucinations, loss of coordination, severe dizziness, nausea, vomiting, diarrhea, muscle twitching, severe anxiety, seek emergency medical attention.

Serious allergic reactions to tramadol are quite rare. You should also seek medical help if you have a rash or itching, swelling (of the face, tongue, throat), severe dizziness, and trouble breathing.

Precautionary measures

Before taking tramadol, tell your doctor if you are allergic to this medication or have other allergies. This medicine may contain inactive ingredients that can cause allergic reactions or other problems. Ask your doctor for more information about tramadol.

Before prescribing tramadol, your doctor should know your medical history. Especially the presence of brain disorders (head injuries, tumors, seizures), breathing problems (asthma, apnea, chronic obstructive pulmonary disease (COPD), kidney and liver diseases, a tendency to mental disorders).

If possible, the doctor should tell you your family history: has any of your relatives suffered or is suffering from drug addiction or alcoholism, is there any stomach or intestinal diseases, diseases of the gallbladder or pancreas in the family.

This medicine may cause dizziness and drowsiness. Avoid driving, using machinery, or doing any activity that requires alertness until you are sure it is safe to do so. Avoid drinking alcohol. Give your doctor a complete list of the medications you use. Including those purchased without a prescription.

Older people may be most susceptible to side effects from tramadol use. They are characterized by confusion, dizziness, drowsiness, and slow or shallow breathing. Before using tramadol, women of childbearing age should talk with their doctor about the risks and benefits. You should tell your doctor if you are pregnant or planning to become pregnant. During pregnancy, the use of tramadol is important if it is impossible to do without taking the drug. At the same time, using tramadol during the first two months of pregnancy increases the risk of birth defects in the unborn child.

Taking tramadol in high doses or for a long time before the expected due date can also harm the unborn baby. Reducing the dose and number of doses of the drug can reduce the risk. You should also tell your doctor if you notice symptoms in your newborn such as slow or shallow breathing, irritability, persistent vomiting, diarrhea, or crying. If the drug passes into breast milk, tramadol can also cause unwanted effects on the newborn. Tell the doctor right away if your baby experiences unusual sleepiness, difficulty feeding, or trouble breathing. Consult your doctor before you start breastfeeding.

Interactions

Tramadol interactions with other medications may increase the risk of serious side effects. Other pain medications (mixed narcotic agonists-antagonists, narcotic antagonists) may interact with tramadol. Taking MAO inhibitors with tramadol can cause serious (sometimes fatal) problems. Avoid taking isocarboxazid, linezolid, moclobemide, phenelzine, Phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine while taking tramadol. Most MAO inhibitors should also not be taken within two weeks of starting tramadol. Follow your doctor's orders exactly.

The risk of increased serotonin levels increases if you are also taking other drugs that increase serotonin. This group includes certain antidepressants, such as fluoxetine/paroxetine, duloxetine/venlafaxine and others. Some medications may help remove tramadol from the body, which will negatively affect the effect of taking the drug. These include quinidine, azole imidazole (eg, itraconazole), drugs used to treat HIV (eg, ritonavir), macrolide antibiotics (eg, erythromycin), drugs used to treat seizures (eg, carbamazepine).

The risk of side effects such as slow or shallow breathing and excessive drowsiness may increase if you take tramadol with other medications that have similar side effects. Be sure to tell your doctor if you are taking medications to improve sleep or relieve anxiety (alprazolam, diazepam, zolpidem), muscle relaxants, other narcotic pain medications (morphine), and psychiatric medications (risperidone, amitriptyline, trazodone). The combination of medications may need to be changed.

Overdose

In case of overdose of the drug, you must contact emergency medical services.

Notes

The drug is not used with other medications. Tramadol is used to treat a specific condition and no other. Taken only on the recommendation of the attending physician. A missed dose does not affect the final result.

Storage

Tramadol should be stored at room temperature, protected from light and moisture, out of the reach of children and pets.

Note 1:

This review article on how and when tramadol is used is not a substitute for the complete instructions from the manufacturer of the drug, serves for brief information purposes only and cannot be a definitive guide to action. Carry out any actions related to treatment and use of medications solely on the basis of the prescription of your attending physician.