|
DRUG CLASS AND MECHANISM:
Tramadol is a man-made (synthetic) analgesic (pain reliever). Its
exact mechanism of action is unknown but similar morphine. Like
morphine, tramadol binds to receptors in the brain (opioid
receptors) that are important for transmitting the sensation of
pain from throughout the body to. Tramadol, like other narcotics
used for the treatment of pain, may be abused. Tramadol is not a
nonsteroidal antiinflammatory drug (NSAID) and does not have the
increased risk of stomach ulceration and internal bleeding that
can occur with NSAIDs.
PREPARATIONS:
Tablets (immediate release): 50 mg. Tablets (extended release):
100, 200, and 300 mg.
STORAGE:
Store at room temperature, 15-30 C (59-86 F). Store in a sealed
container.
PRESCRIBED FOR:
Tramadol is used in the management of moderate to moderately
severe pain. Extended release tablets are used for moderate to
moderately severe chronic pain in adults who require continuous
treatment for an extended period.
DOSING:
The recommended dose of tramadol is 50-100 mg (immediate release
tablets) every 4-6 hours as needed for pain. The maximum dose is
400 mg/day. To improve tolerance patients should be started at 25
mg/day, and doses may be increased by 25 mg every 3 days to reach
100 mg/day (25 mg 4 times daily). Thereafter, doses can be
increased by 50 mg every 3 days to reach 200 mg day (50 mg 4 times
daily). Tramadol may be taken with or without food.
Recommended dose for extended release tablets is 100 mg daily
which may be increased by 100 mg every 5 days but not to exceed
300 mg /day. Extended release tablets should be swallowed whole
and not crushed or chewed.
DRUG INTERACTIONS:
Carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol) reduces
the effect of tramadol by increasing its inactivation in the body.
Quinidine (Quinaglute, Quinidex) reduces the inactivation of
tramadol, thereby increasing the concentration of tramadol by
50%-60%. Combining tramadol with monoamine oxidase inhibitors (for
example, Parnate) or selective serotonin inhibitors ((SSRIs, for
example, fluoxetine Prozac]) may result in severe side effects
such as seizures or a condition called serotonin syndrome.
Tramadol may increase central nervous system and respiratory
depression when combined with alcohol, anesthetics, narcotics,
tranquilizers or sedative hypnotics.
PREGNANCY:
The safety of tramadol during pregnancy has not been established.
NURSING MOTHERS:
The safety of tramadol in nursing mothers has not been
established.
SIDE EFFECTS:
Tramadol is generally well tolerated, and side effects are usually
transient. Commonly reported side effects include nausea,
constipation, dizziness, headache, drowsiness, and vomiting. Less
commonly reported side effects include itching, sweating, dry
mouth, diarrhea, rash, visual disturbances, and vertigo. Some
patients who received tramadol have reported seizures. Abrupt
withdrawal of tramadol may result in anxiety, sweating, insomnia,
rigors, pain, nausea, diarrhea, tremors, and hallucinations.
|
Quality
